NP-only and the co-occurrence of RLS and NP were associated with lower perceived walking performance in pwMS, while RLS severity showed small-to-moderate correlations with gait and balance outcomes.
No significant differences were found between the four groups (NP, RLS, NP+RLS, and controls) on objective timed walking and mobility measures.
Significant differences were found between groups on subjective walking perception, balance confidence, and single-leg standing measures.
The NP+RLS group showed significantly lower Single-Leg Stand Test performance compared to other groups.
Neuropathic pain, both alone and combined with RLS, was associated with higher perceived walking impairment as measured by the MSWS-12.
All symptomatic groups (NP, RLS, and NP+RLS) showed significantly lower balance confidence scores compared to controls.
RLS severity showed small-to-moderate correlations with gait and balance outcomes.
No significant differences were found between the four groups regarding MRI results.
This research examined how two common symptoms in multiple sclerosis (MS) — neuropathic pain (burning or electric-type pain caused by nerve damage) and restless legs syndrome (an uncontrollable urge to move the legs, especially at night) — affect a person's ability to walk and maintain balance. Over 1,100 people with MS were divided into four groups based on whether they had neuropathic pain only, restless legs syndrome only, both conditions together, or neither condition. The researchers then tested their walking speed, mobility, balance confidence, and ability to stand on one leg. The study found that while objective timed tests of walking speed and mobility showed no differences between groups, people with neuropathic pain — whether alone or alongside restless legs syndrome — reported significantly greater difficulty walking in their daily lives. People with all three symptomatic conditions (neuropathic pain alone, restless legs alone, and both together) reported lower confidence in their balance. Those with both conditions combined had the most difficulty with single-leg standing, a measure of static balance. Notably, brain MRI results did not differ between the groups, suggesting these functional differences are not easily explained by visible brain lesion differences. This research suggests that neuropathic pain in particular has a meaningful impact on how people with MS perceive their own walking ability, and that having both neuropathic pain and restless legs syndrome together may compound balance difficulties. Clinicians managing MS may benefit from actively identifying and treating these co-occurring symptoms, as they appear to negatively affect patients' functional confidence and balance even when standard objective walking tests do not detect differences.
Upload your bloodwork. We'll cross-reference your results against this study and 4,700 others.
Upload Your LabsOzdogar A, Kaya E, Ozcelik S, Ünal G, Ozakbas S. (2026). Neuropathic pain versus restless legs syndrome: distinct and combined effects on balance and walking performance in multiple sclerosis.. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. https://doi.org/10.1007/s10072-026-09365-x