Is Restless Leg Syndrome (RLS) a Neurological Condition?

The short answer is yes, restless leg syndrome (RLS) is a neurological condition, not just an annoying nighttime quirk. It’s a recognized disorder that affects the brain, nerves, and your quality of life. [1] If you’ve ever been lying in bed, finally ready to doze off, and suddenly felt twitchy legs with an overwhelming urge to move them, you know firsthand how disruptive restless legs can be.

Why Do My Legs Feel Weird and Restless at Night?

Restless leg syndrome, also known as Willis-Ekbom Disease (WED), is a sensory-motor neurological disorder that causes uncomfortable sensations, such as tingling, crawling, or pulling, along with an irresistible urge to move your legs.[1] RLS can affect one ot both legs, anywhere from your thigh to your ankle.[2] Movement may temporarily relieve the discomfort.

While these feelings can happen during the day, they usually worsen at night when you’re trying to sleep [2]. Without treatment, this cycle can lead to chronic sleep disruption, fatigue, and a lower quality of life [3]. Because of this, restless leg syndrome is also classified as a sleep-wake disorder [4]. Recognizing RLS as both a neurological and a sleep disorder helps guide more effective treatment plans.

Is My Restless Legs Problem Coming from My Brain or My Nerves?

RLS appears to involve both the brain (central nervous system) and the network of nerves throughout the body (peripheral nervous system). Research indicates that faulty dopamine signaling in movement-control areas of the brain plays a significant role [1], and brain iron deficiency may impair the efficiency of these pathways.[5] Because nerve pathways carry movement and sensation signals between the brain and legs, disruptions in either system can trigger the hallmark symptoms. [6]

Am I Imagining My Restless Legs or Is RLS a Real Condition?

Though sometimes dismissed, RLS is a well-documented condition with measurable neurological changes, not just “in your head.” Brain imaging shows altered iron storage and dopamine function in RLS patients. [4; 7] These biological changes explain symptoms and confirm RLS as a real, diagnosable disorder, not anxiety or overreaction.[1]

How Do I Know If I Might Have RLS?

If your legs seem to have a mind of their own, especially at night, you might be wondering, “Is this restless leg syndrome?”

According to the NHS, you may have RLS if you notice any of these patterns:

• Strong urge to move your legs with burning or crawling feelings.
• Symptoms worsen during rest, especially in the evening or at night.
• Moving your legs brings brief relief.
• Symptoms occur several times a week.
  

Does this sound like your nightly routine? If it does, it’s time to talk to your healthcare provider.

H3 What Could Be Causing My Restless Legs?

RLS can be primary (developing on its own) or secondary (caused by another condition).
Primary RLS often runs in families, particularly when symptoms begin before the age of 40. [1]
Secondary causes and risk factors include:

• Iron deficiency (even without anemia) [8]
• Chronic kidney disease [1]
• Peripheral neuropathy [6]
• Pregnancy, especially in the third trimester [8]
• Certain medications, including some antihistamines, antidepressants, and antipsychotics [6]
• Conditions such as diabetes, Parkinson’s disease, and spinal cord lesions [1]

Risk increases with age and is more common in women. [1]

How Will My Doctor Figure Out If I Have RLS?

Diagnosing RLS relies on your doctor assessing your symptoms and medical history.[9] This condition is often under- or misdiagnosed. As a lesser-known condition, your primary care physician may miss the signs, but a neurologist will look deeper into your symptoms.[10]

Unfortunately, there is no single blood test or imaging technique that definitively indicates the presence of restless leg syndrome.[10] Instead, your doctor may:

1. Ask when symptoms started, what triggers them, and what brings relief [1]
2. Perform a neurological exam to check nerve and muscle function [11]
3. Order blood tests to look for iron deficiency or other underlying issues [9]
4. Rule out other causes, such as neuropathy, muscle cramps, or arthritis [11]

Is There Anything That Helps RLS?

Your treatment focuses on symptom relief and addressing underlying causes. Many people improve with:

• Lifestyle changes: Regular exercise, reduced caffeine and alcohol, and a consistent sleep routine [12]
• Iron therapy: Supplementation for low ferritin [1]
• Medications: Dopamine agonists, certain anti-seizure drugs, or opioids [5]
• Treating related conditions: Managing kidney disease, neuropathy, or pregnancy-related factors [2]

Can I Still Live a Full Life Even If I Have RLS?

Absolutely! Living with restless leg syndrome doesn’t mean giving up the life you love. While RLS can be persistent, it’s manageable with the right approach. Early diagnosis, combined with lifestyle changes and personalized treatment, can help you sleep better, stay active, and alleviate symptoms.[1]

If you suspect you have RLS, consulting a neurologist specializing in movement disorders is crucial. They’ll give you an accurate diagnosis, rule out other causes, and create a treatment plan just for you.

Don’t let symptoms take over. The sooner you get help, the sooner you can enjoy better sleep, more energy, and a fuller life despite RLS.

Find RLS Relief with a Neurology Evaluation

If you’ve been living with restless legs but feel like your symptoms aren’t entirely under control, you’re not alone, and there’s hope. A thorough neurology evaluation can uncover overlooked triggers, fine-tune your treatment plan, and offer new options to help you finally get the relief you deserve.

Disclaimer: This blog is for informational purposes only and is not a substitute for medical advice. Discuss any ongoing neurological symptoms, restless leg syndrome, or sleep-related issues with your healthcare provider. Seek emergency care or call 911 if you suddenly experience new or worsening symptoms like severe muscle weakness, numbness, difficulty walking, or loss of bladder or bowel control. If the medications you’re taking for RLS cause unexpected side effects like severe dizziness, chest pain, or confusion, seek care immediately.

Resources:

1. Restless Legs Syndrome. National Institute of Neurological Disorders and Stroke [Internet]. Published November 28, 2023. Accessed August 08, 2025. Available from: https://www.ninds.nih.gov/health-information/disorders/restless-legs-syndrome
2. Restless Legs Syndrome (RLS). Johns Hopkins Medicine [Internet]. Accessed August 08, 2025. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/restless-legs-syndrome-rls
3. Restless Leg Syndrome – Symptoms. NHS UK [Internet. Published August 2018. Accessed August 8, 2025. Accessed August 08, 2025. Available from: http://nhs.uk/conditions/restless-legs-syndrome/symptoms
4. Didriksen M, Nawaz MS, Dowsett J, Bell S, et al. Large genome-wide association study identifies three novel risk variants for restless legs syndrome. Commun Biol [Internet]. 2020 Nov 25;3(1):703. doi: 10.1038/s42003-020-01430-1. PMID: 33239738; PMCID: PMC7689502. Accessed August 08, 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/33239738/
5. Allen RP. Restless Leg Syndrome/Willis-Ekbom Disease Pathophysiology. Sleep Med Clin. 2015;10(3):207-xi. doi:10.1016/j.jsmc.2015.05.022. Accessed August 08, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4559751/
6. Silber MH, Becker PM, Earley C, et al. Willis-Ekbom Disease Foundation Revised Consensus Statement on the Management of Restless Legs Syndrome. Mayo Clinic Proceedings [Internet]. September 2013;88(9):977-986. Accessed August 08, 2025. Available from: https://www.mayoclinicproceedings.org/article/S0025-6196(13)00559-4/pdf
7. González-Parejo P, Martín-Núñez J, Cabrera-Martos I, Valenza MC. Effects of Dietary Supplementation in Patients with Restless Legs Syndrome: A Systematic Review. Nutrients [Internet]. 2024 Jul 18;16(14):2315. doi: 10.3390/nu16142315. PMID: 39064758; PMCID: PMC11280425. Accessed August 08, 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/39064758
8. Restless legs syndrome – Causes. NHS UK [Internet]. Published August 28, 2018. Accessed August 08, 2025. Available from: https://www.nhs.uk/conditions/restless-legs-syndrome/causes/
9. Restless legs syndrome – Diagnosis. NHS UK. Published August 28, 2018. Accessed August 08, 2025. Available from: https://www.nhs.uk/conditions/restless-legs-syndrome/diagnosis/
10. Berg S. What doctors wish patients knew about restless leg syndrome. American Medical Association AMA. Published August 07, 2024. Accessed August 08, 2025. Available from: https://www.ama-assn.org/delivering-care/prevention-wellness/what-doctors-wish-patients-knew-about-restless-leg-syndrome
11. Restless Legs Syndrome: Detection and Management in Primary Care. American Family Physician AFP [Internet]. 2000;62(1):108-114. Accessed August 08, 2025. Available from: https://www.aafp.org/pubs/afp/issues/2000/0701/p108.html
12. Restless legs syndrome – Treatment. NHS UK. Published October 20, 2017. Accessed August 08, 2025. Available from: https://www.nhs.uk/conditions/restless-legs-syndrome/treatment/