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My legs are painful and restless at night. Why?

Do you ever feel a crawling sensation in your lower limbs at night and the irresistible urge to move your legs? If so, you’re not alone. Many people routinely suffer from Restless Leg Syndrome (RLS), a neurological disorder that sometimes lasts for several hours and can disrupt your sleep.

Why does it happen?

RLS seems to occur during periods of inactivity, usually in the evening when people are resting or falling asleep. For some people, nerve damage can trigger sleep apnea or sleep deprivation, but there is no universal consensus on causality. Interestingly, although it was once thought RLS may occur due to muscle abnormalities or a disturbance in the part of the brain that controls movement, new research seems to suggest low iron levels may cause it in the brain, for which, unfortunately, there are no tests. This is very different from iron levels in the blood; subsequently, many people with RLS symptoms can have a blood test for iron- deficiency only for it to come back normal.

Who gets it?

RLS has a 60% chance of being inherited, and it can appear at any age, although women are twice as likely to get it than men. In children, is it sometimes mistaken for “growing pains”. There’s no apparent trigger for onset in most cases, and some may get it occasionally, whereas others suffer from it daily.

There’s also a recognised link between RLS and pregnancy, possibly brought on by low iron and folate levels. Around 20% of women experience RLS during pregnancy, although it often stops once the baby arrives.

How to manage it

Despite the high number of people suffering from RLS and the significant impact upon their lives, research into effective treatments is still ongoing, and the exact cause remains unknown. The pathophysiology is known partially, and it is believed that there is an association between the different variants of genetic mutations combined with dopaminergic and brain iron dysregulation, which plays an important role.

Fortunately, however, there are things you can try to help reduce your symptoms, but discovering what works for you may be a matter of trial and error as everyone will respond differently.


Only around 20% of sufferers will require medication (such as anti-seizure drugs), but it is essential to seek the advice of your GP if your symptoms are impacting your day to day life.

Compression socks

These may help by applying pressure to the leg and increasing blood flow into the extremities at night.

Evening stroll

When symptoms tend to be at their worst in the evening, a gentle walk around the block can help, and some people say that using an exercise bike is useful.

Pillow support

Try sleeping with a pillow between your legs; this may prevent compression of the nerves in your legs.


Supplements including iron, magnesium, vitamin D and folic acid can also help but check with your GP first before taking these.

Reduce caffeine intake

For many people with RLS, caffeine is a trigger, but recent research has shown that caffeine can also help, so you need to identify whether or not you are sensitive to caffeine. If you are, you probably already know, but if you drink a lot of caffeine, you may have become immune to it, so reduce your consumption (don't just stop as you might experience withdrawal) to see how it impacts your symptoms.

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