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Is It Restless Leg Syndrome or Peripheral Neuropathy—Or Both?

Does leg discomfort have you pacing your bedroom at night? Or do you experience burning and tingling in your legs and feet during long car trips or air travel?

You could have restless leg syndrome (RLS) or peripheral neuropathy (PN). These two conditions have symptoms that can mimic one another at times, but the two conditions are quite different.

“What is interesting is that RLS and PN are two separate entities but are often confused and misdiagnosed for one another,” said Joyce Lee-Iannotti, MD, a neurologist and sleep medicine specialist with Banner Brain & Spine. “Further complicating things is that neuropathy can be a secondary cause of RLS, such as kidney disease, iron deficiency or pregnancy, or someone can have both RLS and neuropathy at the same time."

How to tell the difference between RLS and neuropathy

RLS symptoms are often described as “creepy crawly” or “jumpy leg” sensations, but they can also be described as painful at times. To see if you have RLS, your health care provider will look for the following specific features:

  • You have an urge to move your legs to stop discomfort or unusual feelings.
  • Your symptoms worsen during rest or inactivity, such as lying or sitting.
  • Your symptoms tend to go away with movement, such as walking or stretching.
  • The urge to move or unpleasant sensations occur in the evening or nighttime.
  • The disorder is not explained by another current sleep disorder, medical or neurological disorder, medication use or substance abuse disorder.

Neuropathy symptoms are often described as “burning, shooting, electrical or pins-and-needles” in the arms, legs, feet and hands.

While both can cause leg discomfort, there are some hallmark differences between the two.

“Whereas RLS tends to occur at night, neuropathy doesn’t only occur at night, but typically occurs during the day and night,” Dr. Lee-Iannotti said. “Rest doesn’t make neuropathy worse, but movement doesn’t make it better either. In fact, patients often say that movement makes the pain worse.”

As well, RLS tends to run in families, but there may or may not be a familial link with neuropathy—depending on whether it is inherited or acquired.

If you think you have RLS or neuropathy

It can be very difficult to self-diagnose whether you have RLS or neuropathy. If you suspect something is wrong, discuss your symptoms with your health care provider and get evaluated to rule out other causes for your discomfort. If your symptoms are severe, your provider may refer you to a neurologist or sleep specialist for further evaluation.

“Often a comprehensive history, thorough neurological examination and even neurological testing may be required to help determine diagnosis and appropriate treatment options,” Dr. Lee-Iannotti said.

To find a Banner Health specialist near you, visit bannerhealth.com.

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