There is one kind of wound where pain at night is a known feature: ischemic ulcers, which are wounds caused by poor blood flow. A common symptom is aching pain in the foot or leg, often at night. Pain may go away when the leg is dangled down.
Other signs tend to go with it. When you raise the leg, it turns pale and cool to touch. Dangling the leg down off the side of a bed or chair causes the leg to turn red. The skin on the leg appears shiny, tight, dry, and hairless. If you recognize several of these alongside the night pain, describe them to your provider as a group rather than one symptom at a time.
It matters because of what causes these wounds. Narrowed arteries, or atherosclerosis, are the most common cause. To treat an ischemic ulcer, blood flow to your legs needs to be restored. You may need to take medicine. In some cases, you may need surgery. Night pain that fits this pattern is pointing at circulation, which is a different problem from an infection or a dressing that is not working.
For wounds that are not on the leg or foot, and for wounds with no circulation problem behind them, there’s no clear explanation here for why pain would be worse at night. People sometimes offer everyday explanations — fewer distractions, a different position — but this article won’t present them as fact.
Two warnings are worth knowing if night pain has you trying things for relief. Do not wear compression stockings or wraps unless told to by your provider. These may restrict blood flow. And do not soak your feet in hot water.