Restless legs syndrome and growing pains in childhood: understanding the link

IntroductionRestless Legs Syndrome (RLS), known as Willis–Ekbom disease, is a common neurological condition that often goes undiagnosed, especially in children. Characterized by an irresistible urge to move the legs, it is typically more pronounced in the evening and at rest. Growing Pains (GP), com...

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Main Authors: Alexandra E. V. Rosen, Fabiana Ursitti, Nausica Stella, Laura Papetti, Martina Proietti Checchi, Alessandra Voci, Luigi Mazzone, Massimiliano Valeriani, Romina Moavero
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1603694/full
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author Alexandra E. V. Rosen
Fabiana Ursitti
Nausica Stella
Laura Papetti
Martina Proietti Checchi
Alessandra Voci
Luigi Mazzone
Luigi Mazzone
Massimiliano Valeriani
Massimiliano Valeriani
Massimiliano Valeriani
Romina Moavero
Romina Moavero
author_facet Alexandra E. V. Rosen
Fabiana Ursitti
Nausica Stella
Laura Papetti
Martina Proietti Checchi
Alessandra Voci
Luigi Mazzone
Luigi Mazzone
Massimiliano Valeriani
Massimiliano Valeriani
Massimiliano Valeriani
Romina Moavero
Romina Moavero
author_sort Alexandra E. V. Rosen
collection DOAJ
description IntroductionRestless Legs Syndrome (RLS), known as Willis–Ekbom disease, is a common neurological condition that often goes undiagnosed, especially in children. Characterized by an irresistible urge to move the legs, it is typically more pronounced in the evening and at rest. Growing Pains (GP), common in childhood and associated with migraine, present apparently overlapping symptoms with RLS, making it sometimes difficult to distinguish between the two. Understanding their relationship is important to make correct diagnosis and treatment.MethodsWe performed a literature review on PubMed using combinations of terms such as “Restless Legs Syndrome,” “Growing Pains,” and “children” to explore diagnostic criteria and the relationship between RLS and GP. Studies included those from 2000 to 2024 that involved individuals under 18 with diagnosis of RLS or GP, written in English language.ResultsThe 24 studies we included in our analysis showed that RLS and GP share common physiological factors, including serotonin dysfunction, iron deficiency, and low vitamin D levels. Evidence from genetic studies suggests a familial link in the development of both conditions. These findings suggest that GP might be an early form of RLS. Both conditions are linked with headaches, sleep disorders, and neuropsychiatric conditions like ADHD. Treatment for both conditions includes iron supplements, dopamine agonists, and non-medical approaches such as stretching or physical exercise. Our narrative review shows that, though distinct, RLS and GP might share common underlying causes.DiscussionRLS and GP are common in pediatric populations, but diagnosis can be challenging due to symptom overlap. This review offers an updated and integrative framework for understanding RLS and GP, highlighting the need for more specific, evidence-based diagnostic criteria. Further research is needed in order to clarify their relationship, refine diagnostic criteria, and explore their genetic and neurobiological mechanisms.
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spelling doaj-art-8b533cb334d44e0c97c166b218301f502025-08-22T08:31:17ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.16036941603694Restless legs syndrome and growing pains in childhood: understanding the linkAlexandra E. V. Rosen0Fabiana Ursitti1Nausica Stella2Laura Papetti3Martina Proietti Checchi4Alessandra Voci5Luigi Mazzone6Luigi Mazzone7Massimiliano Valeriani8Massimiliano Valeriani9Massimiliano Valeriani10Romina Moavero11Romina Moavero12Unit of Child Neurology and Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, ItalyUnit of Developmental Neurology, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyUnit of Child Neurology and Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, ItalyUnit of Developmental Neurology, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyUnit of Developmental Neurology, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyUnit of Developmental Neurology, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyUnit of Child Neurology and Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, ItalyUnit of Child Neurology and Psychiatry, Department of Wellbeing of Mental and Neurological, Dental, and Sensory Organ Health, Policlinico Tor Vergata Hospital, Rome, ItalyUnit of Child Neurology and Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, ItalyUnit of Developmental Neurology, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyTranslational Pain Neuroscience and Precision Medicine, CNAP, Department of Health Science and Technology, School of Medicine, Aalborg University, Copenhagen, DenmarkUnit of Child Neurology and Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, ItalyUnit of Developmental Neurology, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyIntroductionRestless Legs Syndrome (RLS), known as Willis–Ekbom disease, is a common neurological condition that often goes undiagnosed, especially in children. Characterized by an irresistible urge to move the legs, it is typically more pronounced in the evening and at rest. Growing Pains (GP), common in childhood and associated with migraine, present apparently overlapping symptoms with RLS, making it sometimes difficult to distinguish between the two. Understanding their relationship is important to make correct diagnosis and treatment.MethodsWe performed a literature review on PubMed using combinations of terms such as “Restless Legs Syndrome,” “Growing Pains,” and “children” to explore diagnostic criteria and the relationship between RLS and GP. Studies included those from 2000 to 2024 that involved individuals under 18 with diagnosis of RLS or GP, written in English language.ResultsThe 24 studies we included in our analysis showed that RLS and GP share common physiological factors, including serotonin dysfunction, iron deficiency, and low vitamin D levels. Evidence from genetic studies suggests a familial link in the development of both conditions. These findings suggest that GP might be an early form of RLS. Both conditions are linked with headaches, sleep disorders, and neuropsychiatric conditions like ADHD. Treatment for both conditions includes iron supplements, dopamine agonists, and non-medical approaches such as stretching or physical exercise. Our narrative review shows that, though distinct, RLS and GP might share common underlying causes.DiscussionRLS and GP are common in pediatric populations, but diagnosis can be challenging due to symptom overlap. This review offers an updated and integrative framework for understanding RLS and GP, highlighting the need for more specific, evidence-based diagnostic criteria. Further research is needed in order to clarify their relationship, refine diagnostic criteria, and explore their genetic and neurobiological mechanisms.https://www.frontiersin.org/articles/10.3389/fneur.2025.1603694/fullrestless legs syndromegrowing painschildrenWillis-Ekbom diseasemigraine equivalentssleep disorders
spellingShingle Alexandra E. V. Rosen
Fabiana Ursitti
Nausica Stella
Laura Papetti
Martina Proietti Checchi
Alessandra Voci
Luigi Mazzone
Luigi Mazzone
Massimiliano Valeriani
Massimiliano Valeriani
Massimiliano Valeriani
Romina Moavero
Romina Moavero
Restless legs syndrome and growing pains in childhood: understanding the link
Frontiers in Neurology
restless legs syndrome
growing pains
children
Willis-Ekbom disease
migraine equivalents
sleep disorders
title Restless legs syndrome and growing pains in childhood: understanding the link
title_full Restless legs syndrome and growing pains in childhood: understanding the link
title_fullStr Restless legs syndrome and growing pains in childhood: understanding the link
title_full_unstemmed Restless legs syndrome and growing pains in childhood: understanding the link
title_short Restless legs syndrome and growing pains in childhood: understanding the link
title_sort restless legs syndrome and growing pains in childhood understanding the link
topic restless legs syndrome
growing pains
children
Willis-Ekbom disease
migraine equivalents
sleep disorders
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1603694/full
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