Alcohol and Restless Leg Syndrome: How Are They Connected?

Picture this. You wake up after a night out — well, it was actually mostly a night “in.” You were at a friend’s housewarming party and you shared a bottle of red (or three), chatting about the cute neighbor across the hall (“Are they single?”) and ending the night with a marathon of Friends (“Could this be any more typical?”). Oh well, you think, no harm done — right? Just a few drinks with friends watching Friends.

And yet, the next day, you get an unpleasant surprise — your legs feel achy or restless. What gives? 

You scan your memories of the night in search of clues. After the 5-minute tour of your friend’s new digs, you were confined to the living room area, mostly in the sitting (then reclining) position. No Twister. No climbing down the fire escape (that was Ross and Joey in one of the episodes). The sushi was delivered (by someone other than you).

Is it possible that leg pain after drinking alcohol — as well as symptoms of restless leg syndrome (an urge to move your legs) — isn’t a random fluke? If you’re frequently waking up with your legs sore after drinking, the connection is worth exploring.

Alcohol: A “Pain in the Legs”

When we think of sore legs, alcohol might not be the first culprit that comes to mind. Instead, we’re more likely to associate leg pain with activities that, well, require the use of our legs — riding that new Peloton bike, walking up to our 9th floor apartment, and so forth. But drinking? That seems like a reach.

Still, both leg soreness in general and restless leg syndrome in particular might have a common cause — booze. So let’s retrace our steps and see how that trip to the bar the night before led us to wake up with leg pain (even though we took an Uber to get there and back).

Leg Pain After Drinking: Retracing the Steps

What’s behind leg pain after drinking alcohol? There are several factors at play.

• Dehydration. It’s an undisputed fact: alcohol dehydrates us. Yes, it’s a beverage, and yes, it can appear to quench our thirst for a bit, but that’s largely an illusion. Give it a few hours and we’ll likely be standing in line for the restroom at the bar or waking up to drag our (aching) feet to the bathroom in our house. The reason for this unpleasant effect comes down to the fact that alcohol suppresses vasopressin, a hormone that tells the kidneys to hold on to water. Without this natural stop cap, we end up losing too much fluid and wake up feeling parched and achy. The reason? Dehydration decreases the fluid available for joint lubrication and muscle function, which can cause muscle cramps and soreness.
• Lousy sleep. In spite of what we might believe about alcohol’s power to send us off into dreamland, it’s unlikely to be a smooth ride in the end. While we might initially doze off, we’re likely to wake up groggy after a night of disrupted sleep (all those bathroom trips don’t help) that doesn’t allow us to take full advantage of the restorative REM phases. One type of restoration that normally happens during sleep has to do with our muscles. Science shows that sleep is the prime time for our body to repair muscle tissue through protein synthesis. Poor sleep, in turn, leads to protein breakdown — and unhappy muscles the morning after.
• Nocturnal leg cramps. More specifically, booze can cause our muscles to stiffen during the night, waking us up with a painful jolt or leaving us with a dull ache in the morning. A study by a French team of scientists found an association between nocturnal leg cramps and finishing the day with a nightcap. So it might be time to rethink how much that glass of wine before bed really helps us relax!
• Nutrient depletion. Alcohol can interfere with the body’s ability to absorb vital nutrients like potassium and magnesium, which are crucial for muscle health and function. Deficiencies in these nutrients can lead to muscle cramps and soreness.
• Increased inflammation. Alcohol can increase inflammation in the body. Chronic inflammation can exacerbate muscle stiffness and pain.

As we can see, alcohol’s connection to leg pain might seem like a stretch, but it’s very real! Even if we’re wearing slippers and lounging on the couch, a night of drinking can end up being a real “pain in the legs.”

Alcohol and Restless Leg Syndrome: Tracking the Connection

While general leg pain after drinking is all about muscle fatigue, cramps, or inflammation, restless leg syndrome (RLS) is a whole other beast. And, once again, while alcohol might seem like an odd player in this game, it has a sneaky way of making it worse. 

What Is Restless Leg Syndrome?

“She’s got the Jimmy legs.” — Kramer

Those who’ve never experienced restless leg syndrome have a tendency to write it off as a pesky fidgeting habit or even accuse us of doing it on purpose. Remember that teacher who’d always get mad when someone in the class started tapping their foot? There’s a chance they simply weren’t into isosceles triangles and were fidgeting out of boredom. 

But there’s also a chance they truly couldn’t help it. RLS is a chronic neurological disorder marked by an irresistible urge to move our legs. It can feel like an itch, an ache, or just an overwhelming urge to jump out of our own skin. RLS is related to malfunctions in the basal ganglia — the part of the brain that controls movement.

And then there’s the nighttime RLS, which can be even worse (especially for those sharing a bed with a partner). Remember the Seinfeld episode where Kramer looks more disheveled than usual because of his girlfriend’s “Jimmy legs”? The tossing, turning, and (yikes!) kicking in our sleep are all typical manifestations of RLS in our sleep.

What Causes RLS?

Those hoping for a clear answer might be disappointed — nobody knows exactly what’s behind RLS. It’s a biological glitch turned on by what feels like a flip of an invisible switch. Awareness about RLS is generally poor among medical professionals, and it is rarely diagnosed.

That said, it’s extremely common. In fact, as much as 10% of the U.S. population has RLS, with women bearing the brunt of the burden. RLS can affect anyone, but tends to get worse with age. 

While the exact cause might be a medical mystery, scientists have pinpointed some additional risk factors. Other than nerve damage and pregnancy, most of them are lifestyle-related and include poor sleep hygiene, smoking, and a diet high in processed foods. The human body isn’t designed to consume foods full of sugar and trans fats, and the effects of these foods shouldn’t be taken lightly.

And — yes — there’s also alcohol.

Alcohol: Juice for the “Jimmy Legs”

While a glass of wine or a beer might seem like a good way to unwind, if you suffer from RLS, alcohol could be making your symptoms worse.

1. Sleep Disruption

As we already know, alcohol disrupts our sleep. For someone with RLS, sleep disruption can exacerbate symptoms, making the urge to move the legs more pronounced and sleep even more elusive. Whether the “Jimmy legs” wake us up or not, our sleep quality suffers (in addition to that of anyone sharing our bed!) 

2. Neurological Impact

Alcohol has a depressant effect on the nervous system, which can affect the neurotransmitters that regulate muscle movements and nerve signals. This disruption can aggravate RLS symptoms by increasing sensory disturbances in the legs.

3. Dopamine Disruption

Remember how we said RLS is linked to the basal ganglia? It’s no coincidence that this area is linked to dopamine regulation. Dopamine release is required for our muscles to move, and disruptions in the process can affect our motor functions, causing the jerky movements characteristic of diseases such as Parkinson’s.

Alcohol, in turn, can throw a major wrench in this delicate system. It floods the brain with dopamine, creating those pleasant rewarding feelings that keep us coming back and hook us into dependence if we’re not careful. And since what goes up must come down, there’s a rebound effect: our dopamine levels plummet as the alcohol wears off.

(For a closer look, check out “How Does Alcohol Affect Dopamine Levels?”)

Stop Soreness in Its Tracks

Finally, here are some tips to prevent leg pain after drinking alcohol while kicking RLS to the curb.

• Take a step back from drinking. Alcohol can fuel muscle pain and RLS, so that glass of wine (or three) might be doing more harm than good. Well, in fact, it’s probably doing no good at all: based on the most recent data, there’s no safe amount when it comes to booze. Drinking before bed, especially, can set us up for a night of trouble and a morning of regrets.
• Track the patterns. Put on your detective hat and become an investigator of your symptoms. When do they tend to get worse? How does alcohol factor into the picture? You might be surprised at the results; the key is to keep a consistent log and be completely honest. (There’s no math teacher to answer to — and no “right answer.”) 
• Don’t skimp on sleep. Quality sleep is key to keeping RLS symptoms and leg soreness in general at bay. Just remember to skip the nightcap. Better yet, have some soothing chamomile tea to drift off naturally while relieving inflammation and muscle spasms! 
• Take a bath. Time for bubbles, scented candles — or, if you prefer, a simple tub full of warm water. Many who struggle with RLS find that it improves their symptoms. Just don’t fall asleep or make the water too hot by accident!
• Get a massage. Gentle leg massages can reduce discomfort and are a great way to relax before bed without alcohol.
• Get (and keep) moving. Being active can work wonders for building strength and flexibility while keeping RLS symptoms at bay. Pick an activity you enjoy and stick with it. Running, hiking, swimming, or dancing in your living room — whatever floats your boat!
• Take iron supplements. Restless leg syndrome may be a sign of iron deficiency, and some research suggests that iron supplements may help.
• Talk to a doctor. If leg pain persists, gets worse, or interferes with your daily activities, talk to your doctor. They know your medical history best and will be able to advise you.

With these steps, you can get a “leg up” on the problem and feel some much-needed relief!

Stepping Into Change

Leg pain after drinking alcohol is no fun, but there’s an optimistic way to look at it. What if we see it as a signal our body is sending us to drink less? Listening to our body instead of ignoring its pleas for attention will ultimately leave us feeling better physically. It will also improve our emotional well-being, since we’ll know we’re giving ourselves the care we truly deserve. Our legs work tirelessly for us day after day, so let’s do what we can to keep them healthy!

The first step to change might be the hardest, but after we gain momentum, we’ll be running along the track of our new life with ease. And who knows, we might even throw in a few laps around the actual track in the park outside since our leg muscles will be feeling better!

The great news is, once we start tuning in to our body’s signals, we can tweak our lifestyle in ways that leave us feeling better than we ever had before. As Gretchen Rubin writes in Better Than Before: What I Learned About Making and Breaking Habits — To Sleep More, Quit Sugar, Procrastinate Less, and Generally Build a Happier Life, “Nothing is more exhausting than the task that’s never started, and strangely, starting is often far harder than continuing.”