I am not sure how a doctor misdiagnoses RLS....this peeves me. If a patient has RLS....they know it. It also shows up on polysomnogram, as movements every every 8 seconds or so....with flexion of the foot, and sometimes the arms and upper back have it. RLS patients do not sleep at night especially between 7pm and 3am...some progress to daytime RLS...insomnia usually characterizes the disorder. RLS is not a vague feeling of heaviness or even pain in the legs. It is a movement disorder treated in general with dopamine agonists such as Mirapex (pramipexole) or Requip (ropinerole). Amitripiptyline and SSRIs are generally contraindicated as are drugs like zyrexa or any drug that suppresses dopamine. Lyrica is an antiseizure drug that quiets sympathetic nervous system activity, which may indirectly calm down RLS, opiates also calm RLS. Some patients with RLS are 'cured' by getting their ferritin levels up to over 60. RLS often is found with neuropathy. You can have normal nerve studies and a whopping case of small fiber neuropathy by biopsy (epidermal nerve fiber density)...which is the one that most good docs will do first these days. It is newer technology. They used to always do sural nerve biopsy and those are done less now that we have the skin biopsy...it does no damage to a nerve.

From what you say, it doesn't sound like you have RLS. There is also a condition called PLMD, Periodic Limb Movement Disorder, which is similar to RLS and most people with RLS are concurrently diagnosed with PLMD. You may not be aware you have PLMD, as it occurs during your sleep, unlike RLS which keeps you from sleeping. RLS is just like having a tic...you can't help but move your leg...or if badly affected, arms and back as well. I am blessed with both conditions along with my SFN and they do not know what is causing my SFN yet. I have had RLS since childhood.

If you are in pain to the point you need narcotics and they do not know for sure if you have SFN, that is something to be concerned about. Pain is a symptom....RLS is a symptom, and SFN is a symptom or 'sign' as they say, of a disease process....they are not end points but beginning points to a journey that will get you, hopefully to a solid diagnosis, which CAN be treated. If you find a cause, you may be able to stop, or perhaps recover from the neuropathy....if you don't you keep looking or accept it for what it is, a mystery.

I would be the most concerned about finding a cause of your pain.

Lyrica does make you more sleepy. Opiates in some people keep them awake, in most people it makes them sleepy.....(opiates keep me awake)....Lyrica makes me sleepy, tired, forgetful and grumpy....but it helps pain...so I am a troll many days. Mirapex causes sleep attacks in some people, as does Requip....(it keeps me awake)

On sleep, Ambien works well to give you a good night's sleep, if that is an issue, but more important is what is causing you to feel sick in the first place.

So long story short, yes, keep looking.