What to Know About Medical Marijuana and Restless Legs Syndrome

Restless legs syndrome (RLS) is a treatable neurologic disorder that can affect your sleep. It affects 3 to 15 percent of the population. People living with RLS feel an intense urge to move their legs. People with RLS also report uncomfortable or painful sensations in their legs.^1,2

Some have described these sensations as “crawling, burning, aching” or as an “energy” that needs to be released. These symptoms are at their worst during rest or when trying to sleep.¹

How is restless legs syndrome (RLS) treated?

If you are diagnosed with RLS, there are many possible treatments. Often, doctors first recommend non-pharmacologic therapies. These include good sleep hygiene, exercise, eliminating caffeine or drugs that may worsen your symptoms, and massage. If this is not effective, your doctor may prescribe drugs like gabapentin, pregabalin (Lyrica), or pramipexole (Mirapex).¹

As more states legalize marijuana for medical and recreational purposes, researchers are studying how it may help treat many different conditions. As of early 2021, it is approved to treat multiple sclerosis, glaucoma, epilepsy, and HIV/AIDS in some states. Early studies have shown that marijuana may improve RLS symptoms but more research must be done.¹

How does marijuana work?

The name “marijuana” refers to the cannabis sativa plant. It is often simply called “cannabis.” It contains 2 important active ingredients: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is psychoactive. It is responsible for the “high” associated with marijuana. CBD is not psychoactive. When they are combined, CBD can reduce the high from THC.³

Cannabis is illegal on a federal level, but as of early 2021 more than 30 states have legalized it for medical use. Some of these states have also legalized cannabis for recreational use. CBD on its own is legal in all states. CBD products are now common because they are effective at reducing anxiety, reducing pain, and improving sleep.⁴

CBD and THC are molecules called “cannabinoids.” The human body creates its own cannabinoids, called endocannabinoids. The brain is full of receptors for these molecules. Endocannabinoids regulate sleep, inflammation, and pain. When marijuana is smoked or eaten, CBD and THC can bind to these receptors and mimic endocannabinoids. Research shows that this can improve sleep, reduce inflammation, and reduce pain.⁴

What research has been done on cannabis?

Unfortunately, no studies have been done looking at the effect of cannabis on RLS. However, other research on cannabis’ effect on pain and sleep may be helpful.

A 2009 meta-analysis reviewed multiple studies on cannabis and chronic pain. They found that cannabis had moderately reduced the participants’ pain. Another study in 2010 showed that cannabis not only reduced pain but also improved quality of sleep.¹

More recently, a 2014 study examined 39 clinical trials looking deeper into cannabis and sleep. The studies were all very different, so it was difficult for researchers to come to a strong conclusion. However, they were able to conclude that cannabis improved sleep by decreasing sleep disturbances.¹

More research is needed

Doctors may also use first-hand accounts from people living with RLS who have tried cannabis. Most people who have tried cannabis report that even their most severe symptoms are relieved after smoking a small amount of marijuana. The relief occurs in minutes but only lasts for 1 to 2 hours. This suggests that cannabis might be best soon before bed.¹

There is still work to be done to understand if cannabis can help those living with RLS. While these studies are helpful, researchers need more data. In particular, there is not enough information on the long-term effects of cannabis use. Cannabis affects each person differently. More studies must also be done to find the best dose.^1,3

Talking with your doctor

If you are living with RLS and want to try cannabis, speak to your doctor. If it is legal in your state, they can give you a medical marijuana card that you can use in dispensaries. If recreational marijuana is legal in your state but you wish to use it medically, it is still important to check with your doctor. Cannabis may interact with other drugs or supplements, and it is not recommended for people who are pregnant or breastfeeding.^1,4

Before beginning treatment for RLS, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.