Peroneal nerve stimulation for the restless legs syndrome
High frequency peroneal nerve stimulation is a non pharmacological method for treating RLS with minimal side effects.
Vibrating device use in the restless legs syndrome
Using a vibrating device placed on or behind the legs is reportedly an effective, drug-free way to find relief from RLS. Many patients find it acts as a "brakes" system for the intense, uncomfortable nighttime urges to move. When the legs are placed on a vibrating pad, the physical sensation of the vibration travels up the nerve pathways much faster than the slow, agonizing RLS sensations. This effectively "closes the gate" in the spinal cord, blocking the uncomfortable RLS signals from reaching the conscious brain. RLS symptoms are worse when blood flow naturally slows down at rest. Continuous vibrations stimulate the local blood vessels and muscle spindles, increasing localized blood flow and helping muscles relax. ​On the internet there are a number of vibrating mats for RLS. However scientific evidence for leg vibration devices is scant at best.​
Peroneal nerve stimulation for the treatment of restless legs syndrome
A medically proven device is the Nidra device (TOMAC system). Rather than a flat pad, these are soft bands you wrap around your upper calves just below the knees. They use specialized electrical pulses to activate the peroneal nerve, simulating the exact muscular relief of walking throughout the night without waking you up. In adults with RLS, the American Academy of Sleep Medicine (AASM) suggests (in an article published in the Journal Clinical Sleep Medicine) the use of bilateral high-frequency peroneal nerve stimulation as a conditional treatment option. A 4-week trial suggested improvement in 45% of participants using the device, with this increasing to 73% in a 24-week open-label extension study.
Figure 1: Peroneal nerve stimulation devise
The Nidra device can be applied for 30-minutes at a time up to four times a day. It is most effective if applied before bed, on waking with RLS during the night, or in situations whereby a patient knows that they are prone to RLS (e.g. prolonged sitting). The treatment effect of Nidra use persists for several hours after the device is turned off. The device is generally well tolerated with administration site irritation being the most common side effect.
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The Nidra is FDA-cleared for moderate to severe RLS in patients who have failed to respond to at least one medication and is widely available in the United States. In Australia the Nidra device cannot be purchased over the counter. You must be evaluated by a neurologist or sleep specialist who can determine if it is right for your specific RLS symptoms.
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Peroneal nerve stimulation is an excellent tool because it carries virtually zero side effects. If you have a history of blood clots (DVT) in your legs, or have acute peripheral neuropathy, always double-check with a doctor before applying the device.
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For other treatment options see the pages:
Last reviewed: 07/09/2026