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Restless Legs Syndrome (RLS)

What is RLS?

Restless legs syndrome is a problem (disorder) that affects the nervous system and muscles. It causes unpleasant sensations in the legs. The sensations are described as:

  • Creeping

  • Crawling

  • Tingling

  • Pulling

You usually have these sensations in the calf, but they may be felt anywhere from the thigh to the ankle. One or both of your legs may be affected. Some people may have the sensations in their arms. With RLS, you have an irresistible urge to move the affected limb when the sensations occur. Moving often briefly relieves the limb discomfort.

Sleep problems are common with RLS because of the difficulty it causes in getting to sleep. Severe daytime fatigue can also be a big problem.

What causes RLS?

The cause of RLS is still unknown. Some cases are believed to be inherited. Some cases have been linked with nerve damage in the legs from diabetes, kidney problems, iron deficiency, certain medicines, pregnancy, sleep disorders, and alcoholism.

It's estimated that as many as 1 in 10 people in the U.S. may have RLS in varying degrees of severity.

What are the symptoms of RLS?

Sensations occur when you lie down or sit for a prolonged time. This causes:

  • The need to move the legs for temporary relief of symptoms by:

    • Stretching or bending

    • Rubbing the legs

    • Tossing or turning in bed

    • Getting up and pacing

  • Worsening symptoms when lying down, especially when trying to fall asleep at night, or during other forms of inactivity, including just sitting

  • A tendency to feel the most discomfort late in the day and at night

How is RLS diagnosed?

Your healthcare provider can diagnose RLS based on your signs and symptoms, a complete medical history, and a physical exam. In addition, tests, such as lab tests or a sleep study, may be done. Currently, there is not a definitive test to diagnose RLS.

How is RLS treated?

Your healthcare provider will consider your age, overall health, and other factors when advising treatment for you.

Your healthcare provider will treat any underlying disorder you have that affects RLS. An example is iron deficiency.

Treatment options for RLS may include:

  • Following good sleep habits

  • Stopping activities that worsen symptoms

  • Giving up caffeine, alcohol, and tobacco (they may make symptoms worse)

  • Regular, moderate exercise

  • Maintaining a well-balanced diet

  • Treating underlying chronic conditions

Medicines. These include:

  • Dopaminergic medicines. These are medicines that increase dopamine and are largely used to treat Parkinson disease.

  • Benzodiazepines such as clonazepam and diazepam

  • Opioids. These are used only used in severe cases. They include codeine, propoxyphene, and oxycodone.

  • Anticonvulsants such as gabapentin and pregabalin

  • Iron therapy. This is given only if iron deficiency is present (some people respond to iron therapy).

Talk with your healthcare provider for more information on how RLS is treated.

Key points about RLS

  • RLS is a disorder that causes unpleasant sensations in the legs. The cause of RLS is still unknown.

  • With RLS, you have an irresistible urge to move the affected limb when the sensations occur.

  • Your healthcare provider can diagnose RLS based on your symptoms, a health history, and a physical exam, but there is no definitive test to diagnose RLS.

  • Medicine and lifestyle changes can help ease RLS symptoms.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.

Medical Reviewers:

  • Anne Fetterman RN BSN
  • Joseph Campellone MD
  • Raymond Kent Turley BSN MSN RN