“Restless Legs Syndrome” is a poorly understood but common patient complaint .  In this disorder patients experience intense, unpleasant sensations in their legs and an urge to move their legs in an effort to relieve these sensations.  Moving the legs or exercising temporarily relieves the sensations which patients describe as “antsy”, “wormy” and in 30%, painful.  Women are affected more than men and lying down and trying to relax usually triggers the sensations.  Typically, the area between knee and ankle is involved.  Obviously, Restless Legs Syndrome is a real sleep disrupter. In the United States, over half of the RLS patients are treated with several classes of neurologically directed medications with variable results and of course, occasional side effects.  However, the evidence in support of a purely neurological cause of Restless Legs Syndrome is still not compelling. I wanted to share with you several  recent and well done studies that reinforce not only the strong presence of documented chronic venous disease in patients with criteria established Restless Legs Syndrome (RLS) but also a surprisingly effective treatment for RLS when venous insufficiency is found  in these patients. The new information is that many, (perhaps nearly 50%) of RLS patients have been found to have quantifiable and substantial chronic venous disease.   Treating this venous insufficiency with the newer and effective minimally invasive techniques ( Laser/EVLT), is now a reasonable and medically safe approach to the RLS patient. The first medical study, (McDonagh, B., et. al., Vol.22,No.4,PHLEBOLOGY,2007) documents the surprisingly close association between patients who meet the International  RLS Study Group criteria for RLS AND are found to have ultrasound documented chronic venous disease. The second study,  (Hayes,C.A., et. al.,Vol.23, pg. 112-117, PHLEBOLOGY,2008) takes this information and actually studies the effect of treating established RLS  patients with laser endovenous ablation.  The results are quite good in eliminating or greatly diminishing RLS symptoms.  Dr. McDonagh’s and Dr. Hayes’ research groups have been instrumental in developing both diagnostic and treatment recommendations for RLS.  We owe these physicians a great deal of admiration and respect for continuing their efforts on behalf of patients with RLS. The RLS patient is often difficult to diagnose let alone treat.  However, there are a number of medical history similarities between RLS  patients and those with symptomatic chronic venous disease.  RLS may be a syndrome still in search of an cause, but there is evidence that there exists a disproportionate number of RLS patients who also have documented chronic  venous disease.  It is becoming apparent that the two diseases are so intertwined, that the cause, perhaps of both, may be realized soon. The data that endovenous laser ablation of venous insufficiency in the RLS patient is effective in eliminating RLS symptoms is good news for our patients. At Vein Specialists of Tampa, our treatment of RLS patients who have venous insufficiency has been quite successful.  I am no longer a skeptic.  Finally, we can offer a treatment for the RLS patient that requires no chronic medication and is effective and safe.