Why does my leg wound hurt more when I raise my leg?

Aching pain that’s often worse at night, pain that may go away when the leg is dangled down, and a leg that turns pale and cool when raised are symptoms of an ischemic ulcer, a wound caused by poor arterial blood flow. Elevation is advised for a different wound: venous ulcers.

This pattern — worse when the leg is up, better when it hangs down — is a recognized one, and it points to one kind of wound in particular.

Ischemic ulcers are wounds caused by poor arterial blood flow. Their symptoms include aching pain in the foot or leg, often at night. The pain may go away when the leg is dangled down. Dangling the leg down off the side of a bed or chair causes the leg to turn red, and when you raise the leg, it turns pale and cool to touch.

These are features of that wound, not advice about what to do. What they show is that the pattern is recognized, and which kind of wound it goes with.

That matters because the opposite instruction is given for a different leg wound. For venous ulcers, putting your feet above your heart as often as possible — for example, lying down with your feet propped up on pillows — is one of the four things that help treat the wound.

So elevation is treatment for one leg ulcer and is linked with worse pain in the other. If you have been told to elevate and raising the leg makes the pain worse, that is a finding to report rather than something to push through or quietly stop doing.

It also helps to describe it precisely when you report it, because the detail is what makes it useful: whether the pain comes on when the leg is raised, whether it eases when the leg is lowered, and whether it is worse at night.

Nothing here can tell you which wound you have. Checking the blood flow in the area around the wound is part of what a wound care team does, and that is the finding this pattern points toward.

What to watch for

Pain that may go away when the leg is dangled down, and a leg that turns pale and cool to touch when raised, are symptoms of an ischemic ulcer.

If elevation has been advised and raising the leg makes the pain worse, report it rather than quietly stopping.

Do not wear compression stockings or wraps unless told to by your provider. These may restrict blood flow.

Contact your provider right away if pain at a wound will not go away even after taking pain medicine.

Wound Wizard is general education and can’t assess your leg or tell you which wound you have. Your own clinician is the right person to ask.

What we look at

  • Checking the blood flow in the leg
  • Identifying the type of wound and what caused it
  • Reviewing any elevation or compression advice already given
  • Building a treatment plan based on what they find

Sources

  1. Ischemic ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000742.htm
  2. Venous ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000744.htm
  3. How wounds heal — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000741.htm