If you've ever felt an overwhelming, almost electrical urge to move your legs at night, your body is telling you something real. Restless legs syndrome (RLS), also known as Willis-Ekbom disease, affects approximately 10 percent of adults in some form in the United States, and yet many patients spend years being dismissed, misdiagnosed, or told it's just stress. It isn't. It's a recognized neurological condition with identifiable causes, and in many cases, a very treatable one.

And in a significant number of RLS cases, one of those causes is a vein problem lying just beneath the skin’s surface.

We consulted Center for Vein Restoration (CVR) vein specialist, Alfredo F. Gurmendi, MD, FACS, lead physician at CVR’s vein clinic in Rio Rancho, New Mexico, for more information about the link between restless leg syndrome, vein disease, and treatment options.

Do you struggle with restless legs?  Stop guessing and start getting answers. Take CVR's free Vein Quiz to find out if vein disease may be behind your symptoms.

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What Does Restless Legs Syndrome Feel Like?

RLS is more than just fidgety legs. It's a neurological condition with specific diagnostic hallmarks recognized by the National Institutes of Health (NIH). Most people describe the sensations as creepy-crawly, tingling, burning, aching, or like an electric current running through their lower limbs.

What distinguishes RLS from ordinary leg discomfort is its pattern. The urge to move is nearly irresistible, and it's almost always tied to a period of rest or inactivity, whether you're sitting at your desk, riding in a car, or lying in bed. Movement brings temporary relief, but once you stop, the sensations return. Symptoms tend to be at their worst in the evening and overnight, which is why RLS is one of the most common causes of chronic sleep disruption in adults.

Did you know? RLS may begin at any age, including childhood, and affects approximately twice as many women as men.

The Vein Disease Connection: More Than a Coincidence

Understanding why vein disease can trigger RLS helps you understand what's happening inside your legs. Healthy leg veins have small one-way valves that push blood upward toward the heart against gravity. When those valves weaken or fail, blood flows backward and pools in the lower legs instead of circulating properly. That buildup creates pressure that spreads outward into the smallest surrounding vessels, causing tissue to swell and nearby nerves to become irritated and overactive.

Researchers believe the irresistible urge to move the legs may actually be the body's involuntary attempt to fix the problem. When you move or stretch, your leg muscles contract and physically squeeze blood back up toward the heart, temporarily relieving that pressure and the uncomfortable sensations that come with it. The moment you stop moving, blood pools again, and the symptoms return, which is exactly the cycle most RLS sufferers know all too well.

And the research supporting this connection has grown steadily and more compelling.

A 2023 study published in the Journal of Vascular and Interventional Radiology examined 506 patients and found that 85 percent of those reporting RLS symptoms also demonstrated abnormal venous findings. Among patients presenting with both RLS and leg cramps, 91 percent had venous abnormalities. Following treatment, 93 percent reported continued relief at both 90 days and one year.

A comprehensive 2024 systematic review indexed in PubMed that analyzed all available research confirmed what earlier studies had been pointing to: RLS and vein disease are closely linked, and conditions such as varicose veins and poor venous circulation often co-occur with RLS symptoms.

Ready for a good night’s sleep? The board-certified vein experts at Center for Vein Restoration can help.

👉 Book your consultation with a CVR vein specialist today and discover how simple relief can be.

Chronic Venous Insufficiency Symptoms to Watch For

Because RLS and CVI share many overlapping symptoms, patients are frequently treated for one condition without ever being evaluated for the other. Common signs of CVI include:

Varicose veins visible on the legs or thighs, leg and ankle swelling that worsens throughout the day, a persistent sense of heaviness or fatigue in the legs, aching or throbbing, and skin changes or discoloration around the ankles and lower legs. 

None of these symptoms are a normal sign of aging. They are signs of vein disease, and they are treatable.

CVI is diagnosed through a duplex ultrasound examination, a painless, non-invasive scan that maps blood flow through the veins and identifies any abnormal reflux.

Treating RLS: What's Changed? What are the Current Guidelines?

The right treatment for RLS depends on what's causing it in the first place. When another health condition is driving the symptoms, treating that condition often resolves the RLS on its own. A straightforward example is iron deficiency: if low iron is the culprit, restoring healthy iron levels frequently brings relief.

For patients whose RLS is rooted in vein disease, treating the underlying venous insufficiency is often the most effective path to lasting relief. One study published in PubMed found that patients who underwent minimally invasive vein procedures had their RLS symptom scores drop by 63 percent following treatment.

The way doctors treat RLS with medication has changed significantly in recent years. Guidelines from the American Academy of Sleep Medicine now recommend nerve-calming medications like gabapentin and pregabalin as the first choice for treating RLS. 

The same guideline warns against routinely using older medications like pramipexole and ropinirole, which were commonly prescribed for years. Research has shown that taking these older drugs long-term can actually make RLS symptoms worse over time, not better, causing them to become stronger and start earlier in the day. If you are currently taking a dopamine-based medication for RLS, this is worth bringing up with your doctor at your next visit.

For those looking to manage symptoms at home, options include gentle stretching and massage, warm baths before bed, moderate daily exercise, compression devices, and iron supplementation when a blood test confirms a deficiency.

Could Vein Disease Be Behind Your Restless Legs Syndrome?

The first step toward knowing whether vein disease is behind your RLS is a duplex ultrasound, a quick, painless, non-invasive scan that maps blood flow through your leg veins and pinpoints any problem areas. There are no needles, no radiation, and no recovery time. It's simply the most reliable way to see what's actually going on beneath the surface. 

Schedule a consultation with a CVR vein specialist today and find out if your veins are the missing piece of your RLS diagnosis. Book online HERE.

How Vein Treatment Makes a Difference for RLS

If you have been living with RLS and haven't found lasting relief through medications or lifestyle adjustments, the missing piece of your treatment may be an undiagnosed vein problem. Researchers have noted that venous insufficiency should be ruled out before beginning drug therapy for RLS.

Several minimally invasive, in-office vein procedures are available to treat CVI, including endovenous laser ablation, radiofrequency ablation, and sclerotherapy. These treatments close off the malfunctioning veins, restore healthier circulation, and, in many patients, significantly reduce or eliminate restless leg symptoms. Most procedures are covered by insurance when medically indicated.

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Frequently Asked Questions

Q: Can treating my varicose veins actually cure my restless legs syndrome? 
For patients whose RLS is rooted in chronic venous insufficiency, treating the underlying vein disease can significantly reduce or fully eliminate symptoms. Research shows that minimally invasive procedures like radiofrequency ablation and sclerotherapy have produced dramatic symptom relief in the majority of patients with both conditions.

Q: How do I know if my restless legs are caused by vein disease or something else? 
The best way to find out is to consult a vein specialist, who will use a duplex ultrasound to examine blood flow in your legs and identify any abnormal reflux. Because CVI and RLS share so many overlapping symptoms, including aching, heaviness, and nighttime discomfort, a proper vascular evaluation is often the first step toward an accurate diagnosis.

Q: Is restless legs syndrome a serious condition, or is it just an annoyance? 
RLS is a legitimate neurological disorder that can seriously disrupt sleep, reduce quality of life, and, over time, contribute to anxiety, depression, and chronic fatigue. If your symptoms are frequent and interfere with your daily functioning, they deserve proper medical attention rather than simply being dismissed as a quirk.

Q: Does insurance cover treatment for vein disease related to RLS? 
Most major insurance plans cover treatment for chronic venous insufficiency when it is medically documented and diagnosed through ultrasound. Center for Vein Restoration works with most insurers and can help determine your coverage before any procedure begins.