Restless Legs Syndrome

  • Restless Legs Syndrome (RLS) causes discomfort and a strong urge to move your legs.
  • If you move your legs, it will feel better (at least for a short time).
  • It is always worse in the evenings, or just as you get into bed.
  • RLS may make it hard to sleep.
  • Causes include some disease, pregnancy or dietary factors.
  • There are medications that can help if your RLS is serious.

What is Restless Legs Syndrome (RLS)?

RLS is a problem where you feel significant discomfort in your limbs. People use a variety of words to talk about how it feels e.g. pulling, drawing, crawling, wormy, boring, tingling, itchy, pins and needles, prickly and painful. It tends to affect the legs much more than the arms. When it happens, you feel a very strong urge to move the affected limbs. Often there is no way to resist it.

People may experience RLS when they sit for a long time such as at a desk, in a car, seeing a movie or travelling on a plane. RLS can also affect you when you lie down to sleep.

RLS is always worse in the evenings. This may mean that it is hard to get to sleep. If you do get to sleep, you might wake up many times during the night, and not get as much sleep as you need. You can end up feeling irritable, anxious and depressed.

Who gets it?

RLS is found in 2% to 5% of people (both men and women). The risk of it goes up as you grow older, and it tends to be more serious in the elderly. But it can start at any age. It can be associated with pregnancy.

How do I know if I have it?

There is no lab test to work out if you have RLS. Tests and body examinations will not be able to pick up RLS in most cases. Your doctor is likely to ask you about your symptoms, medical and family history, and if you are on any medication.

What causes it?

  • If your parents had RLS, your risk of having it is higher (30 – 50%).
  • RLS may occur in pregnancy and is more likely in the last 6 months. RLS will usually go away after giving birth. 
  • Your diet can cause RLS. Problems may include not getting enough iron.
  • RLS has been associated with too much caffeine, smoking and alcohol.
  • Other health problems can also lead to RLS such as anaemia, kidney problems, diabetes, arthritis or Parkinson’s disease.
  • It can also be due to nerve damage in your limbs.

How can RLS be treated?

There are many ways to make the legs feel better including walking, rubbing them, massaging them, doing knee bends or just moving them. If you don’t move them, your legs will often jump by themselves. Other things that might help for mild cases are a hot bath, a leg massage and exercise. Applying either a heat pad or ice pack, or alternating the two, can also be helpful.

It can help to cut down on your caffeine, nicotine and alcohol intake.

If your RLS stems from another problem (e.g. anaemia) then the thing to do is to treat that. Your GP may do a blood test to check your levels of a number of important indicators.

In serious cases, there are medications that you can take to control your RLS. Some of these can be habit forming, but this doesn’t tend to be an issue with the small doses used to treat RLS. Drugs used to treat Parkinson’s disease can also help RLS. The down side of all of these drugs is that they might stop working after you have been on them for a while. Talk to your GP about which treatment is best for you.

Can RLS get worse or better by itself?

For most people where there is not a reversible factor (such as iron deficiency) RLS gradually gets worse with age. Occasionally RLS can go away by itself, but often it will return.


Sometimes, treating an underlying condition, such as iron deficiency, greatly relieves symptoms of restless legs syndrome. 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.

Lifestyle and home remedies

Making simple lifestyle changes can help alleviate symptoms of RLS.

  • Try baths and massages. Soaking in a warm bath and massaging your legs can relax your muscles.
  • Apply warm or cool packs. Use of heat or cold, or alternating use of the two, may lessen your limb sensations.
  • Establish good sleep hygiene. Fatigue tends to worsen symptoms of RLS, so it’s important that you practice good sleep hygiene. Ideally, have a cool, quiet, comfortable sleeping environment; go to bed and rise at the same time daily; and get adequate sleep.
  • Exercise. Getting moderate, regular exercise may relieve symptoms of RLS, but overdoing it or working out too late in the day may intensify symptoms.
  • Avoid caffeine. Sometimes cutting back on caffeine may help restless legs. Try to avoid caffeine-containing products, including chocolate and caffeinated beverages, such as coffee, tea and soft drinks, for a few weeks to see if this helps.

What to do next…

Consult with a Sleep Physician to discuss and work out a treatment plan.