Painful restless legs: what to know

People describe aching, throbbing, pulling, crawling, or tingling deep in the legs. Symptoms often appear while sitting or lying down, are worse in the evening, and can delay sleep. Restless legs syndrome is one possible explanation. Iron deficiency anaemia, chronic kidney disease, peripheral neuropathy, pregnancy, some medicines, and excess caffeine may also be relevant. Pain limited to one area after an injury, or pain that does not change with movement, may point to another problem.

Keep a regular sleep routine, take gentle daytime exercise, and stretch or massage the legs before bed. A warm bath or heat pack may be soothing; protect the skin from burns. Reduce caffeine late in the day and avoid nicotine or alcohol near bedtime. Do not take iron supplementation unless a clinician has confirmed that it is suitable, because the cause and dose need checking.

Seek urgent help for one-sided leg swelling, warmth, redness, or tenderness with sudden breathlessness or chest pain. Arrange a medical review if symptoms regularly disturb sleep, are worsening, begin after a new medicine, or come with weakness, loss of sensation, or balance problems. Assessment may include a medicine review and tests for iron status, kidney function, or other contributors.

Ask whether your symptoms fit restless legs syndrome, whether iron testing is appropriate, and whether any medicine could be aggravating them. Explain when symptoms start, what movement does, and how sleep is affected.