Waking up with unexpected pain and soreness, like a muscle ache or cramp, can be jarring. One MyLupusTeam member asked, “Has anyone just woken up with a sore calf muscle? I haven’t hurt myself. Any thoughts on what this could be?”

Systemic lupus erythematosus (SLE), the most common type of lupus, can affect nearly every part of the body. So, if you wake up in the morning with sore calves or other muscle pain, you may wonder if it’s related to your lupus diagnosis.

This article explores possible causes of morning calf pain in people living with lupus and offers tips for managing the discomfort.

Is Calf Pain a Common Symptom of Lupus?

Lupus is known to cause myalgia (general aches and pains in the muscles). This type of muscle pain usually affects the neck, thighs, shoulders, and upper arms, but it can happen anywhere in the body, including the calves. Muscle pain and stiffness may or may not involve swelling.

One MyLupusTeam member noticed their muscle pain gets worse during a lupus flare: “I’m in the middle of a flare-up — very fatigued and aching all over.”

Myositis (inflammation of the muscles) can also occur with lupus, though it’s less common than myalgia. Myositis usually affects the hips and shoulders more than the calves. Lupus is also known to cause joint pain and bone issues, which can contribute to discomfort in nearby muscles.

Although muscle pain from lupus most often affects larger muscle groups, some people living with lupus notice soreness or cramping in their calves during a flare. Pain may also come from tendon inflammation, joint problems, or nerve irritation.

If calf pain is new, one-sided, or doesn’t go away, it’s important to consider other possible causes — some of which may be serious.

What Are Common Causes of Calf Pain?

Calf pain can strike for a variety of reasons, including blood clots, cramps, certain medications, injury, and narrowed arteries. Many of these causes are not directly related to lupus, but they may still affect people living with lupus.

Blood Clots

One MyLupusTeam member asked, “Do you have any risk for blood clots in your legs?”

Compared to the general population, people with SLE have a higher risk of deep vein thrombosis (DVT) — a blood clot that forms in a deep vein, often in the leg.

One review found that people with lupus are more than 6.5 times as likely to develop DVT compared to people without lupus. This higher risk may be due to antiphospholipid antibodies, which are common in lupus and can make blood more likely to clot.

DVT is a serious condition that can cause swelling, pain, warmth, or discoloration in the affected leg. If untreated, a clot can break off and travel to the lungs — a complication known as a pulmonary embolism.

Seek immediate medical attention if you experience sudden, one-sided calf pain, especially with swelling or skin changes.

Other risk factors for DVT include:

• Using oral contraceptives (birth control)
• Undergoing surgery
• Sitting or lying down for long periods (such as during travel or bed rest)

Cramping

Often called a charley horse, a calf cramp can be intense and painful but usually goes away after a few minutes. These cramps often strike at night, so waking up with calf pain is not uncommon. “I have them so bad that they wake me up out of a deep sleep! Sometimes they take hours to calm down!” one MyLupusTeam member said.

Cramping may be triggered by:

• Dehydration
• Stress or physical exertion
• Kidney problems (which can occur with lupus and affect electrolyte balance)

When the body’s levels of minerals like potassium, calcium, or magnesium are off, muscles may spasm or cramp — especially in the calves.

Medication Side Effects

Some medications can contribute to muscle pain. For example:

• Cholesterol-lowering drugs (statins) can sometimes cause muscle injury or soreness.
• Long-term corticosteroid use, which is common in lupus treatment, may lead to muscle weakness or pain.

If you suspect that your calf pain may be related to a medication, talk to your doctor about possible alternatives or solutions.

Injury

The calf muscles are vulnerable to overuse, strain, and direct impact from everyday movement or exercise. Common causes of calf injury include:

• Muscle strain from overstretching
• Tendinitis (inflammation of the tendons that connect muscles to bones)
• Contusions (bruises from impact)

Even walking or standing for long periods can aggravate the calf if the muscle has been strained.

Peripheral Artery Disease

Peripheral artery disease (PAD) occurs when arteries in the legs become narrowed or blocked due to atherosclerosis (fatty buildup). This reduces blood flow and can cause cramping or pain in the calves, especially while walking.

One MyLupusTeam member wrote, “I have what the doctor says is poor blood circulation.”

Lupus increases the risk of heart and blood vessel problems, including PAD. Other risk factors include smoking, diabetes, and high cholesterol. PAD-related calf pain typically improves with rest but returns with activity.

Fibromyalgia

Fibromyalgia is a chronic (long-term) condition that causes widespread pain, fatigue, sleep issues, and sensitivity to touch. It often includes muscle pain or weakness, which may be felt in the calves or other parts of the body.

This condition is more common in people with lupus than in the general population. Although fibromyalgia is not caused by lupus, the two conditions can occur together — and their symptoms may overlap.

Preventing and Managing Aching Muscles With Lupus

To help prevent the muscle, bone, and joint problems associated with lupus, the Lupus Foundation of America recommends:

• Eating foods rich in calcium and vitamin D
• Staying physically active, as your health allows
• Quitting smoking
• Limiting or avoiding alcohol

How To Relieve Calf Muscle Pain

When calf muscle pain occurs, here are a few strategies you can try to ease the pain:

• Rest the sore muscle — Try to stay off the leg as much as possible to avoid further strain.
• Apply a cold compress — Wrap an ice pack, frozen veggies, or ice cubes in a towel and place it on the sore area for up to 20 minutes. Repeat every two hours as needed.
• Use compression — A compression sock, wrap, or bandage can help reduce swelling. Avoid compression if you have poor circulation, nerve problems, or suspect a blood clot. When in doubt, ask your doctor if compression is safe for you.
• Elevate your leg — Raise your calf above the level of your heart by using pillows or folded blankets while lying down.
• Take a nonsteroidal anti-inflammatory drug (NSAID) — Medications like ibuprofen or naproxen may reduce pain and inflammation.
• Try gentle stretching — Light stretching can help improve circulation and ease muscle tightness.
• Consider physical therapy — If your pain persists or you think it may be due to an injury, a physical therapist can help guide your recovery.

If your cramp may be due to dehydration or low electrolytes, try:

• Drinking fluids with added electrolytes, such as sports drinks or coconut water
• Eating potassium-rich foods, like bananas or leafy greens
• Maintaining a balanced diet to support your muscles and overall health

One member shared, “My calf cramps have always been due to low potassium, dehydration, or a glitch with my kidneys.”

When To Be Concerned About Calf Pain

In most cases, waking up with calf pain isn’t a sign of anything serious. However, if the pain is intense and comes with swelling, skin discoloration, or trouble walking, contact your healthcare provider right away. These symptoms could be a sign of DVT or another condition that needs medical treatment.

If you’re having ongoing calf pain or frequent muscle soreness and you think it might be related to lupus, talk with your rheumatologist. They can help identify possible causes and recommend treatments that are right for your condition.

When you’re living with an autoimmune disease like lupus, your healthcare team is there to help you feel your best and support your overall quality of life.

Join the Conversation

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

What helps you manage morning calf pain? Let others know in the comments below.