Restless legs syndrome and your veins: is there a link?

2026-10-14

• RLS is a strong urge to move your legs at rest that usually gets worse in the evening and at night.
• Similar feelings occur with venous insufficiency, but RLS has wider causes: iron, kidneys, pregnancy and medicines.
• If your legs feel heavy and swollen by evening and better when raised, it is worth having your veins checked.
• Don't take iron or sleeping pills on a guess: tests and a doctor's advice come first.
• Sudden swelling and pain in one leg is not RLS but a reason to call 103 straight away.

The long day is over, you finally get into bed, and your legs seem to come alive. It feels as if ants are crawling inside them, something pulls and aches under the skin, and the only relief is to get up and walk around the room. As soon as you lie down again it all starts over, and sleep slips past midnight.

That is how many people describe restless legs syndrome. Lots of them immediately think of their veins, and not without reason: similar sensations do occur with venous insufficiency. But this condition has other causes too, and what helps you depends on which one is behind it. Let's take it step by step.

What is restless legs syndrome?

RLS, also called Willis–Ekbom disease, is a neurological condition that causes a strong, sometimes irresistible urge to move your legs. Doctors look for a few typical features:

• an urge to move the legs, usually with unpleasant sensations such as tingling, crawling, or a pulling or aching feeling deep in the calves;
• symptoms start or get worse at rest, when you are sitting or lying down;
• movement, such as walking or stretching, eases them for as long as you keep moving;
• the sensations are stronger in the evening and at night than during the day.

Sometimes the arms are affected too. Because of frequent waking, people with RLS often don't get enough sleep and feel tired and irritable during the day.

What causes RLS?

In some people it is a condition in its own right and often runs in families. In others it is linked to different health problems:

• low iron levels in the body, even without obvious anaemia;
• pregnancy, especially the second half;
• chronic kidney disease;
• nerve damage in the legs, for example from diabetes;
• some medicines, including certain remedies for allergy, nausea or depression; don't stop them on your own, but do discuss them with your doctor;
• lack of sleep, caffeine, alcohol and smoking, which can make symptoms worse.

That is why restless legs are a reason to see a GP or neurologist rather than to treat yourself. Simple blood tests often reveal a cause that can be put right.

How are veins linked to restless legs?

In chronic venous insufficiency, blood pools in the legs, the veins become overfilled, and by evening you may get heaviness, a bursting feeling, aching, night cramps and, in some people, that same unpleasant restlessness. It is no surprise that the complaints are similar and sometimes occur together: a person with varicose veins can have both RLS and venous symptoms at the same time.

Specialists still debate how close the link is, as research findings are limited and contradictory. In practice, something else matters more: working out which part of your symptoms comes from the veins. To do that, a phlebologist examines your legs and, if needed, arranges a duplex ultrasound. We have described how pooling of blood shows itself in our article on heavy legs in the evening.

Veins, RLS or something else: how can you tell?

Only a doctor can give the final answer, but a few clues will help you describe your symptoms more precisely at your appointment:

• Vein symptoms: heaviness and a bursting feeling build up after long standing or sitting and in hot weather, the ankles swell by evening, widened veins are visible, and resting with your legs raised brings relief.
• RLS: the key feature is an overwhelming urge to move while at rest, especially in bed; relief lasts only while you keep moving, and there may be no visible changes on the legs.
• Night cramps: a sudden, painful tightening of a muscle, usually in the calf, that eases once you stretch it; this is a different condition.
• Nerve damage: burning, numbness or feet that feel like cotton wool, which also bother you during the day.
• Poor arterial blood flow: calf pain that comes on when walking and goes away with rest. This needs a prompt medical check, and you should not start using compression on your own.

What can you do starting today?

While you wait for your appointment, a few simple steps can help. They are useful for both RLS and vein symptoms:

• Go to bed and get up at the same times, and allow enough hours for sleep.
• Avoid strong tea, coffee, energy drinks and alcohol in the evening; many people notice their legs are more restless after a late tea session.
• Stay active during the day: walking and moderate exercise usually ease symptoms, while a very intense late workout can sometimes make them worse.
• Before bed, gently stretch your calves, take a warm but not hot shower, or give your legs a light massage.
• On long journeys, for example by train to Samarkand or Bukhara, choose an aisle seat and get up for a walk now and then.
• If your doctor has confirmed venous insufficiency, rest with your legs raised and wear compression stockings if they recommend them.

Restless legs and vein symptoms are common in expectant mothers. During pregnancy, any medicines or supplements should be taken only on a doctor's advice, and general tips are gathered in our article on how pregnancy and vein disease are closely linked.

When should you see a doctor, and which tests are needed?

See a GP or neurologist if restless legs disturb your sleep several times a week, if you feel very sleepy during the day, or if the symptoms started during pregnancy. The doctor may order blood tests, including iron stores, kidney function and blood sugar. Don't take iron supplements without tests: both too little and too much iron are harmful.

If, besides the restlessness, you notice heaviness, swelling, visible veins or skin changes on your lower legs, book an appointment with a phlebologist as well. Often the right answer comes from two consultations together.

If your doctor links your symptoms to your veins, they may also discuss venotonic medicines. The instruction for Phlebodia 600 (diosmin 600 mg) lists restless legs syndrome among the symptoms of lymphovenous insufficiency of the legs, alongside heaviness, tiredness and pain; it is usually taken as 1 tablet a day with a meal, and if symptoms do not ease within 2 weeks, you should see a doctor. Other causes, such as low iron or kidney disease, need different help. You will find the details in the official instruction. Before use, read the instruction leaflet and consult a specialist.

The main points

Restless legs syndrome is neither a whim nor just nerves; it is a condition with real causes, and veins are only one of them. Describe your sensations to your doctor in detail, have the tests they recommend, and in the meantime settle into a regular sleep routine, move more during the day and skip the late-night tea. Calm legs and a good night's sleep are well within reach.

Sources: 1. De Maeseneer MG, Kakkos SK, Aherne T, et al. ESVS 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184–267. 2. Instructions for medical use of Phlebodia 600 (Republic of Uzbekistan).

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