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Restless Leg Syndrome

Last Updated September 2020 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

What is restless legs syndrome (RLS)?

Restless legs syndrome (also called RLS) is a condition in which your legs feel very uncomfortable when you’re sitting or lying down. It usually happens in the evening or night. It can affect both men and women and occur at any age (including during childhood). It often worsens with age and becomes a problem for older adults. RLS can make sleeping and traveling difficult and uncomfortable.

Symptoms of restless legs syndrome

People who have RLS often say it’s difficult to describe their symptoms. If you have RLS, you may have a “creepy-crawly” feeling in your legs that makes you want to move around. You may experience achy, tingly, or burning sensations in your legs, which can make it difficult to sleep or sit for long periods of time. Moving your legs makes the feeling go away for a few minutes, but it comes back after you sit or lie still again. Your legs may also twitch when you try and sleep (also called periodic limb movements of sleep or PLMS).

What causes restless leg syndrome?

Doctors don’t know what causes RLS. Some cases are related to other conditions, such as pregnancy, iron deficiency anemia, or kidney failure. Other cases of RLS have no known cause. RLS may be hereditary, which means it can run in your family.

There are some types of medications that can worsen RLS symptoms. These include antidepressants, antinausea drugs, antipsychotic drugs, and cold and allergy medications that contain antihistamines.

How is restless leg syndrome diagnosed?

Tell your doctor about the restless sensations. He or she will ask you questions about your symptoms, such as when they start and whether you’re able to do anything to make them go away. He or she may also ask if any other people in your family have similar symptoms. Tell your doctor about any medicines (including over-the-counter medicines) you’re taking. You could be taking a medicine that makes RLS worse. If so, your doctor may be able to recommend another medicine.

Can restless leg syndrome be prevented or avoided?

RLS can’t be prevented because doctors aren’t sure what causes it. But there are some things you can do to help lessen your symptoms.

Lifestyle changes to treat RLS:

  • For mild symptoms, use an over-the-counter pain reliever to reduce twitching and restless sensations.
  • Cut back on alcohol, caffeine, and tobacco.
  • Try taking a hot bath and massaging your legs before bedtime to help you relax.
  • Relaxation techniques, such as meditation and yoga, can help you relax before bed.
  • Apply warm or cool packs to your legs, which can help relieve sensations.
  • Try to distract your mind by reading or doing a crossword puzzle while you wait for sleep to come.
  • Moderate exercise may help, but don’t overdo it. Exercising vigorously or late in the day may make symptoms worse.
  • Try to go to bed at the same time every night and wake up at the same time every morning. Also try to get a sufficient amount of sleep each night.

Treatment of restless legs syndrome

Treatment for RLS includes medicines and lifestyle changes. Medicines used to treat Parkinson’s disease can help reduce tremors and twitching in the legs. If your iron levels are low, your doctor may prescribe an iron supplement.

In some cases, an anticonvulsant medicine (usually used to stop seizures) can be helpful. Historically, sleep aids, muscle relaxants (called benzodiazepines), and pain medicines (called opioids) have been prescribed by doctors to relieve symptoms. Use of these medicines is becoming more and more limited for RLS because of their known side effects and potential drawbacks. Opioids, if not taken exactly as instructed by your doctor, can be addictive.

For many cases of RLS, a combination of medicines is usually needed to best treat the condition. Your doctor may prescribe several trials of medicine before finding one that works best for your case of RLS.

Living with restless leg syndrome

Keep your doctor posted on how you’re feeling. He or she can suggest different relaxation techniques and can change your medicine if it’s not helping. You may want to join a support group to talk to other people who are suffering from RLS. Also, because RLS tends to run in families, you may want to talk to your relatives about your RLS and see if they have similar symptoms.

Questions for your doctor

  • What types of medicines do you recommend to treat my restless legs syndrome (RLS)?
  • Could there be another condition causing my RLS?
  • Are there any lifestyle changes I could make that might help my RLS?
  • Can you recommend an RLS support group?
  • I’ve heard smoking may cause RLS. Can you help me quit?

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