Do you ever find yourself tossing and turning at night because your legs won’t calm down? Or maybe you feel a strange tingling or burning sensation that won’t go away? If so, you might have searched online for answers and found terms like restless leg syndrome (RLS) and peripheral neuropathy.
“Restless leg syndrome and neuropathy can easily be confused,” said Izayadeth Jennings, MD, an internal medicine specialist and current sleep medicine fellow with Banner – University Medicine. “However, they are quite different, with different causes, symptoms and treatments.”
It can be hard to know if you have RLS or neuropathy. Understanding the key signs of each condition is important for getting the proper care. Read on to learn the main differences between RLS and neuropathy, helping you spot your symptoms and guiding you on what to do next.
What is restless leg syndrome?
Restless leg syndrome (RLS) is a nervous system and muscular problem that causes people to feel the urge to move their legs. It affects 10% of the U.S. population and is also known as Willis-Ekbom disease.
“These symptoms usually worsen at night during rest or inactivity and can make it hard to sleep,” Dr. Jennings said. “Sometimes they can be seen during the day if you are resting or inactive.”
What is neuropathy?
Peripheral neuropathy affects approximately 30 million Americans. It occurs when the nerves located outside the brain and spinal cord (peripheral nerves) are damaged. Neuropathy can cause sharp, stabbing or burning pain.
“People with neuropathy often describe it as an electrical, shooting pain or a pins and needles sensation in their legs, feet or hands, most commonly,” Dr. Jennings said. It can also affect balance and coordination, leading to falls.
Key differences between RSL and neuropathy
While RLS and neuropathy may share some overlapping symptoms, they have four distinct differences:
- Timing of symptoms: RLS symptoms often get worse when you are still, especially at night. Neuropathy can hurt at any time of the day.
- Movement response: “Symptoms of RLS can usually be relieved by movement, like walking or stretching,” Dr. Jennings said. For neuropathy, movement may not help and can sometimes worsen the pain.
- Location of the symptoms: RLS usually affects only the legs, while neuropathy can affect your legs, feet and hands.
- Different causes: The exact cause of RLS is unknown, but it is often linked to some medical conditions, like iron deficiency, pregnancy, vitamin deficiency, neurological conditions and medications. “Having a family history of RLS can also increase your risk of developing it,” Dr. Jennings said.
Peripheral neuropathy is commonly caused by diabetes (diabetic neuropathy), HIV and chemotherapy. It is also seen in chronic liver and kidney disease and in those who abuse alcohol.
Can RLS and neuropathy happen together?
While they are different conditions, some health issues can lead to both RLS and neuropathy. When they happen together, symptoms may become more intense and painful.
“Diabetes can cause nerve damage and contribute to RLS symptoms,” Dr. Jennings said. “Factors like iron deficiency or kidney disease can also increase the chances of experiencing both.”
Diagnosing RLS and neuropathy
The process for diagnosing RLS and neuropathy is different. Here’s how your health care provider may approach each condition:
Diagnosing restless leg syndrome
- Medical history: Your provider will ask about your symptoms, including when they happen and how they affect your sleep and daily life.
- Physical exam: This will help rule out other conditions that may be causing your symptoms.
- Questionnaire: Your provider may ask specific questions to assess your symptoms and their impact on your quality of life.
- Blood test: These lab tests can check for iron levels, vitamin deficiencies and kidney function.
- Sleep study: Sometimes, a sleep study may be recommended to see your sleep patterns and how RLS affects your rest.
Diagnosing peripheral neuropathy
- Medical history: Similar to RLS, your provider will ask about your symptoms and any healthy conditions you have.
- Physical exam: This will help identify areas of numbness or weakness in your body.
- Nerve conduction study: This test measures how well your nerves send signals. Nerve conduction studies focus on the electrical activity in your nerves. It can show if there is damage to the nerves.
- Electromyography (EMG): An EMG test checks how your muscles respond to nerve signals. It focuses on your muscles both at rest and during activity. This helps determine if nerve damage is present.
Treatment options
Treatment for RLS and neuropathy will depend on the underlying cause and the severity of the condition.
For restless leg syndrome:
- Lifestyle changes: “Regular exercise, good sleep hygiene and avoiding caffeine, alcohol and exercise too close to bedtime may help,” Dr. Jennings said. “Hot baths may also help, too.”
- Medications: Your provider may prescribe medicines like gabapentin, which helps control RLS symptoms. It may also help with neuropathy symptoms.
- Iron supplements: If your iron is low, supplements may relieve symptoms.
For neuropathy:
- Managing underlying conditions: Treating diabetes or other causes can slow neuropathy progression.
- Pain relief: Over-the-counter (OTC) pain relievers, topical creams or prescription medications can help manage pain.
- Physical therapy: Physical therapy can help improve strength, balance and coordination.
When to seek help
While RSL and neuropathy may not be life-threatening, they can be bothersome. It’s important to see your health care provider right away. Early treatment can lead to better management and improved quality of life.
Contact your provider if you:
- Have problems sleeping due to leg discomfort or pain.
- Experience chronic pain, numbness or tingling in your legs, feet or hands.
- Notice any changes in your ability to move or balance.
Bottom line
While restless leg syndrome and peripheral neuropathy may have some overlapping symptoms, they are different conditions requiring different treatment and care. If unsure what is causing your leg discomfort, contact your health care provider or a Banner Health specialist. Getting the right help can improve your quality of life and reduce pain.
