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Patients with restless legs syndrome (RLS) feel the need to move their legs (and sometimes arms) when they sit or lay down. This is done in an effort to relieve discomfort in the limbs, which has been described as a deep creeping, crawling, pulling, itching, tingling, burning, aching or painful sensations.

Some patients find it difficult to describe these sensations, but others have compared it to feeling like insects are crawling around inside their legs. Symptoms of RLS do not usually resemble common discomfort of the limbs, such as muscle cramps or numbness.

The unpleasant sensations that provoke RLS typically affect the calf but can occur at any point between the thigh and ankle. They also can affect any part of the arm. Patients often find relief by moving their legs or arms, but this reprieve is only brief.

Symptoms are most likely to occur at night, particularly as patients are trying to get to sleep or during the early stages of sleep. Because of this delay in sleep onset, patient can have different sleep disorders, including trouble falling asleep or have problems remaining asleep. These problems can result in daytime fatigue and difficulty with concentration. Patients may be less productive at work and may struggle to carry out day-to-day tasks. This lack of sleep also can lead to mood swings and depression.

RLS symptoms can range from mild to severe. Patients with mild RLS may not notice any symptoms until they are required to sit or lay still for long periods of time (e.g., during airplane travel, long car trips, while sitting in a movie theater). Patients with moderate RLS may experience symptoms once or twice a week. Severe cases can produce symptoms that occur more than twice a week. RLS symptoms often can worsen during periods of stress.

Patients diagnosed with secondary RLS generally experience symptoms at the same time as the illness, medication or medical condition causing their RLS. Symptoms usually disappear after the precipitating cause goes away. Pregnant women many not experience symptoms of RLS until their third trimester. These symptoms often disappear within a few weeks of delivering the infant, although they can reappear later in life.

Many people with RLS also experience wild, involuntary jerking or twitching of their legs (or arms) for up to a minute. This usually occurs at night, when patients are resting or laying down. This type of involuntary movement is a sign of a condition known as periodic limb movement disorder.