Painful legs and moving toes syndrome is characterized by spontaneous causa
lgic pain in the lower extremities associated with peculiar involuntary mov
ements of the lower extremities, especially the toes and feet. The pain is
diffuse, intractable, aching, and deep. The movements consist of persistent
writhing movements in the digits that cannot be limited voluntarily. The s
yndrome has been observed after a variety of abnormalities affecting the po
sterior nerve roots, the spinal ganglia, and the peripheral nerves. This ar
ticle reviews commonly reported findings and current concepts in the etiolo
gy and management of this condition.