Restless legs syndrome is diagnosed clinically from five features: an urge to move the legs, usually with an uncomfortable sensation; worse at rest; relieved by movement; worse in the evening or at night; and not explained by another condition.
Restless legs syndrome is diagnosed clinically from five features: an urge to move the legs, usually with an uncomfortable sensation; worse at rest; relieved by movement; worse in the evening or at night; and not explained by another condition.
All five are required. The urge to move is the core feature, and people struggle to describe the accompanying sensation, reaching for words like crawling, fizzing, aching, or simply an unbearable need to move. It builds at rest, particularly sitting in the evening or lying in bed, and is relieved, at least temporarily, by walking or stretching. The circadian pattern, worse in the evening and night, is characteristic and is what separates it from most other leg complaints.
Ferritin should be measured in everyone with restless legs syndrome, and this is the single most important test. Iron deficiency is a common and treatable contributor, and the threshold used in restless legs is higher than the usual laboratory cutoff for anaemia, so a ferritin reported as normal may still warrant treatment. Kidney function is checked, since renal impairment is associated. Pregnancy is a recognised trigger. Certain medications, including many antidepressants, antihistamines and anti-nausea drugs, commonly worsen it.
Nocturnal leg cramps are painful, localised and brief, without the urge to move. Peripheral neuropathy causes numbness and burning that does not improve on walking and lacks the evening pattern. Akathisia from medication produces generalised inner restlessness rather than a specifically leg-centred urge. Periodic limb movements during sleep frequently coexist but are a separate finding, reported by a bed partner. Restless legs syndrome is diagnosed clinically; sleep studies are not required for it.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: National Institute of Neurological Disorders and Stroke; MedlinePlus, National Library of Medicine; MedlinePlus: peripheral nerve disorders.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.