Painful legs and moving toes

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Painful legs and moving toes is a condition that causes continuous, involuntary movements of the toes associated with pain in the feet and legs.(1-4) The condition is sometimes a manifestation of peripheral neuropathy or radiculopathy, but the responsible cause in many is not clear. In a series of 14 patients the condition was bilateral in 12.(2) In this case, the condition was unilateral and probably due to radiculopathy. For another example see Mhoon.(3)

Pain occurs first in most cases and is more distressing to patients than the movements. The toe movements decrease but persist in sleep. Variants are painful arms and moving fingers, and painless legs and moving toes. Jumpy stump is involuntary movements of an amputated limb. Neurophysiologic findings suggest a central generator at the spinal cord or brainstem level.(1)


1. Hassan, A, Mateen, FJ, Coon, EA, et al. Painful legs and moving toes syndrome: a 76-patient case series. Arch Neurol. 2012; 69:1032-1038. 2. Alvarez MV, Driver-Dunckley EE, et al. Case series of painful legs and moving toes: clinical and electrophysiologic observations. Mov Disord 2008;23:2062-2066. 3. Mhoon JT, Nandigam K, Juel VC. Teaching video NeuroImages: painful legs and moving toes syndrome. Neurology 2010; 75(2):e6. 4. Renard D, Taieb G, Castelnovo G, Labauge P. Teaching Video NeuroImages: Painful legs, moving toes associated with partial transverse myelitis. Neurology 2010; 75(18):e74.