Is Restless Legs Syndrome Painful?

If you’ve ever tried to fall asleep after a long day of work only to be kept awake by an overwhelming urge to move your legs, you should know you’re not alone. Many of those with restless legs syndrome (RLS), also called Willis-Ekbom disease, describe the condition as feeling a tingling, creeping, crawling, itching, or pulling sensation in the legs, typically occurring at nighttime and preventing sound sleep.

But what does the condition truly feel like, and does it cause pain? Just as important, can vein treatment improve the quality of life for those working to manage symptoms of RLS? Let’s discuss how RLS often manifests in day-to-day life and how to move forward with a thoughtful care approach when seeking treatment.

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Restless Legs Syndrome: Understanding Common Symptoms

As we delve into whether RLS is painful for those afflicted by it, let’s also clarify a common misconception surrounding its symptoms—one that may have originated from its name. While the name of the condition may imply that its symptoms are nothing more than a nuisance or minor annoyance, symptoms such as tingling, restlessness, itching, and crawling sensations can be highly disruptive and painful to live with, especially when it impacts restful sleep.

This is especially true for those affected by late-onset cases of the condition, which are diagnosed after age 45 and thought to progress faster. Between three and 15 of the U.S. population may have restless legs, with women affected by the condition more often than men, according to Mount Sinai. The health network adds that lower leg pain is one of the most prevalent symptoms in late-onset RLS, and this form is more likely to result from a nervous system problem than a family history.

It’s also important to consider that while some people who report RLS symptoms experience them only sporadically, others experience them consistently—and these sensations aren’t limited to nighttime or the legs, either. According to Yale Medicine:

“Messages from the brain cause a feeling like an energy is building up in the legs…This can occur with just about any frequency or severity—it can happen a couple of times a year or several times a night. In extreme cases, restless legs can happen anytime, even during a conversation with a friend or at a work meeting. People have reported the same feeling of restlessness in their arms, face, torso, and genitals, although these are rare compared to symptoms in the legs.” -Yale Medicine

The takeaway? While RLS symptoms have a general pattern in how they manifest, it’s important to recognize that the condition impacts each person differently regarding specific symptom types, locations, timing, and severity. This is critical to remember because it can help you provide a highly detailed description of your symptoms to your CVR physician when discussing the best treatment plan.

Causes of RLS Pain: A Deeper Look

We’ve clarified that RLS does cause pain and discomfort for those affected by the condition—but why? There are several reasons, many involving the neurological factors believed to influence the general onset of RLS:

Sensory Processing Abnormalities

During RLS, the brain misinterprets signals from the legs, causing the uncomfortable, restless sensations that often accompany symptoms such as burning, itching, or tingling. According to the NHS, evidence shows a connection between RLS and the basal ganglia, a part of the brain that uses the neurotransmitter dopamine to help coordinate movement. Since dopamine levels naturally decrease at the end of the day, RLS is more likely to occur or worsen at night.

This irregular sensory perception manifests as RLS pain, which can range from mild to severe. This discomfort often leads to the urge to move or massage the legs to find relief. When left untreated, the condition can worsen, leading to chronic pain and interference with quality of life, largely due to the disrupted sleep it causes.

Increased Leg Sensitivity

Many people who live with RLS have a higher sensitivity to sensory input in their legs. This can make sensations that typically feel normal—for example, touching fabric—feel intense, exaggerated, and, yes, even painful. Even slight movements or pressure put on the legs may be perceived as more uncomfortable for those with RLS than they would be for someone without the condition.

This is particularly true when RLS comes with circulation problems associated with chronic venous insufficiency. Vascular and circulation problems such as varicose veins can contribute to poor blood flow and congestion in the lower extremities, leading to fluid buildup in the legs and resulting in swelling, heaviness, and discomfort. This can make the skin and nerves in the legs even more sensitive and worsen existing RLS symptoms.

With that in mind, exploring professional vein treatment options is highly beneficial for those living with RLS. Patients experiencing both RLS and vein problems often find that improving blood flow with professional vein treatment, such as sclerotherapy or laser therapy, can reduce the intensity of their symptoms while helping to alleviate the discomfort and heightened sensitivity contributing to RLS pain.

Impact of Sleep Deprivation on Pain Management

Here’s an aspect of RLS pain that many people don’t stop to think about: the true impact RLS has on the body’s ability to achieve long-term, rejuvenating sleep. We’ve discussed that most people with the condition experience their symptoms at night, making it difficult to relax and get to sleep in the first place. This discomfort often prevents patients from entering the deep, restful, and restorative stages of sleep, which ultimately leads to chronic sleep deprivation when left unaddressed.

It's a vicious cycle: an ongoing lack of sleep may increase pain sensitivity, making the discomfort from RLS feel more intense in the days that follow. Over time, the cumulative effect of poor sleep can worsen both pain and severity of RLS symptoms, and the cycle continues.

It’s also important to recognize that a long-term lack of restorative sleep can hinder the body’s ability to manage inflammation, worsening RLS leg pain in several ways. Sleep deprivation may contribute to fluid retention, increased swelling, and more intense leg pain in cases where poor circulation is also a factor. That said, treating both the sleep issues and the underlying vein problems that come with RLS offers a thorough approach to managing the condition and its symptoms.

RLS Pain: Final Remarks

While some aspects of RLS remain unclear, its causes, symptoms, and treatments are well understood--offering hope and relief.

Are you ready to start sleeping soundly again? Explore how vein treatment may be the solution by taking our SELF-ASSESSMENT or scheduling a consultation online via our SCHEDULING PORTAL.