Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily.
Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.
Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS.
The chief symptom is an urge to move the legs. Common accompanying characteristics of RLS include:
People typically describe RLS symptoms as abnormal, unpleasant sensations in their legs or feet. They usually happen on both sides of the body. Less commonly, the sensations affect the arms.
The sensations, which generally occur within the limb rather than on the skin, are described as:
Sometimes the sensations are difficult to explain. People with RLS usually don't describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move their legs.
It's common for symptoms to fluctuate in severity. Sometimes, symptoms disappear for periods of time, then come back.
Some people with RLS never seek medical attention because they worry they won't be taken seriously. But RLS can interfere with your sleep and cause daytime drowsiness and affect your quality of life. Talk with your doctor if you think you may have RLS.
Often, there's no known cause for RLS. Researchers suspect the condition may be caused by an imbalance of the brain chemical dopamine, which sends messages to control muscle movement.
Sometimes RLS runs in families, especially if the condition starts before age 40. Researchers have identified sites on the chromosomes where genes for RLS may be present.
Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms. Some women get RLS for the first time during pregnancy, especially during their last trimester. However, symptoms usually disappear after delivery.
RLS can develop at any age, even during childhood. The disorder is more common with increasing age and more common in women than in men.
RLS usually isn't related to a serious underlying medical problem. However, it sometimes accompanies other conditions, such as:
Although RLS doesn't lead to other serious conditions, symptoms can range from barely bothersome to incapacitating. Many people with RLS find it difficult to fall or stay asleep.
Severe RLS can cause marked impairment in life quality and can result in depression. Insomnia may lead to excessive daytime drowsiness, but RLS may interfere with napping.
Your doctor will take your medical history and ask for a description of your symptoms. A diagnosis of RLS is based on the following criteria, established by the International Restless Legs Syndrome Study Group:
Your doctor may conduct a physical and a neurological exam. Blood tests, particularly for iron deficiency, may be ordered to rule out other possible causes for your symptoms.
In addition, your doctor may refer you to a sleep specialist. This may involve an overnight stay at a sleep clinic, where doctors can study your sleep if another sleep disorder such as sleep apnea is suspected. However, a diagnosis of RLS usually doesn't require a sleep study.
Sometimes, treating an underlying condition, such as iron deficiency, greatly relieves symptoms of RLS. Correcting an iron deficiency may involve receiving iron supplementation orally or intravenously. However, take iron supplements only with medical supervision and after your doctor has checked your blood-iron level.
If you have RLS without an associated condition, treatment focuses on lifestyle changes. If those aren't effective, your doctor might prescribe medications.
Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs. These include:
Medications that increase dopamine in the brain. These medications affect levels of the chemical messenger dopamine in your brain. Ropinirole (Requip), rotigotine (Neupro) and pramipexole (Mirapex) are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.
Short-term side effects of these medications are usually mild and include nausea, lightheadedness and fatigue. However, they can also cause impulse control disorders, such as compulsive gambling, and daytime sleepiness.
It may take several trials for you and your doctor to find the right medication or combination of medications that work best for you.
Sometimes dopamine medications that have worked for a while to relieve your RLS become ineffective, or you notice your symptoms returning earlier in the day or involving your arms. This is called augmentation. Your doctor may substitute another medication to combat the problem.
Most drugs prescribed to treat RLS aren't recommended during pregnancy. Instead, your doctor may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during your last trimester, your doctor may approve the use of certain drugs.
Some medications may worsen symptoms of RLS. These include some antidepressants, some antipsychotic medications, some anti-nausea drugs, and some cold and allergy medications. Your doctor may recommend that you avoid these drugs, if possible. However, if you need to take these medications, talk to your doctor about adding drugs to help manage your RLS.
Making simple lifestyle changes can help alleviate symptoms of RLS:
RLS is generally a lifelong condition. Living with RLS involves developing coping strategies that work for you, such as:
If you have symptoms of RLS, make an appointment with your doctor. After an initial evaluation, he or she may refer you to a doctor who specializes in conditions affecting the nervous system (neurologist) or a sleep specialist.
Here's some information to help you get ready for your appointment.
Some basic questions to ask your doctor about RLS include:
Your doctor is likely to ask you a number of questions, including:
To ease your symptoms, try:
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