Background: Restless leg syndrome (RLS) is common with musculoskeletal pain conditions and has been associated with small fiber neuropathy. There are few reports of non pharmacological management of RLS. The purpose of this paper was to report the use nerve mobilization exercises in a group of patients with primary RLS with and without co-morbid chronic non specific low back pain (LBP). Methods: 26 consecutive patients (11M/14F) with primary RLS and LBP attended a mean of 12 physiotherapy sessions (range 4-16). Patients were given 3 neural mobilization exercises to do twice daily 15-20 repetitions. Outcome measures were: Global Rating of Change Scale (GROC); Restless Legs Syndrome Rating Scale (RLS-RS); and RLS Ordinal Scale (RLS-OS). Based on the RLS-RS 1 was very severe, 8 were severe and 17 were moderate. Results: Follow up was a mean of 14 months (range12-16). Mean baseline for the RLS-RS was 22.8. The mean change was 20.3 (range 14-26). The mean baseline for the RLS-OS was 4.3. The mean score at follow up was 1.2 (range 1-4). GROC changed a mean of 6.2 (range 3-7). Conclusions: The results suggest that targeted exercises may be useful in managing primary RLS. A level 1 clinical trial is warranted. Further research is needed to identify the mechanism of action.