Painful Legs And Moving Toes Syndrome

Painful legs and moving toes (PLMT) syndrome is an adult-onset, rare disorder characterized by pain in the feet or legs and  twisting movements of one or more toes. The patients usually seek medical attention because of the pain. The syndrome may be unilateral or bilateral. Identical toe movements may occur without pain, referred to as: "painless legs-moving toes," and a similar condition affects the upper limbs: "painful arms-moving fingers." The cause of PLMT and its variants is not known but most reports suggest an association with a peripheral lesion, usually at the level of the root or nerve, though in many cases no cause is found. Treatment is often unsatisfactory and may include medication for neuropathic pain (gabapentin), spinal blocks, spinal cord stimulation, and local injection of botulinum toxin. It is a debilitating clinical syndrome, not because of the movements but rather because of the pain.