How Is Restless Legs Syndrome Treated?

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Restless legs syndrome (RLS) is one of the most common sleep disorders. It causes unpleasant sensations in the legs and the irresistible urge to move the legs. People describe these sensations as aching, throbbing, itching, pulling, twitching, or tingling. There are many ways to treat RLS.1,2

If you have RLS, the type of treatment you will receive depends on what your doctor believes is the underlying cause. The basic types of treatments for RLS are:1-7

  • Lifestyle changes, including better sleep habits
  • Iron supplements if your ferritin is low or on the lower end of normal (Ferritin is a protein in your blood that contains iron.)
  • Prescription drugs
  • Devices
  • Home remedies

Lifestyle changes for restless legs syndrome

Many people find simple lifestyle changes improve their symptoms of RLS. It may take some trial and error to find the combination of lifestyle changes that works for you.

Regular exercise such as walking or yoga helps many people. Others find that reducing or cutting out caffeine, alcohol, or smoking helps. If you work in an office, asking to stand more often or do your job at a standing desk can help relieve daytime leg sensations.2,3,8

People with RLS often find that their symptoms get worse when they have not been getting enough sleep. Making sure to set aside enough time for sleep every night helps many people with RLS.2,3,8

Certain drugs can trigger RLS, such as antihistamines, anti-nausea medicines, over-the-counter sleep aids, and some antidepressants. Your doctor may be able to prescribe a different medicine that does not aggravate your RLS.1,2

Iron supplements for restless legs syndrome

Many people with RLS have low iron levels in their blood or brain. Because of this, taking iron pills sometimes helps relieve the symptoms of RLS.1-3,8,9

Iron supplements can cause side effects including an upset stomach and constipation, so not everyone can take iron. Eating more red meat, lentils, spinach, and other foods high in iron may help too. Due to the dangers of iron overload and iron’s side effects, you should take iron only with a doctor’s supervision.1-3,8,9

Prescription drugs for restless legs syndrome

If RLS occurs nearly every night and causes serious issues with your quality of life, your doctor may suggest a prescription drug. These drugs include:2,3,8,9

  • Alpha-2-delta calcium channel ligands (gabapentin enacarbil, pregabalin, and gabapentin)
  • Dopamine agonists (pramipexole, ropinirole, rotigotine)
  • Levodopa
  • Benzodiazepines
  • Opioids

All of these drugs may have side effects. They also may lose their effect for you over time. When RLS symptoms get worse even when taking higher doses, it is called augmentation. This typically requires a conversation with your doctor who may look for other causes or change your medicines.2,3,9

Devices for restless legs syndrome

A few devices may be used to treat RLS. Two devices – Restiffic foot wraps and the NTx100 Tonic Motor Activation System – are approved by the US Food and Drug Administration (FDA) to treat RLS. Both require a prescription from your doctor.5-7

Many other devices are sold online and provide pressure or vibration to the legs. Some of these devices have been studied and found to help with RLS, while others have not. Costs range from $20 to $2,500.5-7

Home remedies for restless legs syndrome

People reach for a wide variety of home remedies when it comes to finding relief from RLS symptoms. These include:3,8

  • Stretching, walking, or massage
  • Hot or cold packs
  • Vitamin or mineral supplements
  • Evening bath or shower
  • Weighted blankets
  • Relaxing creams and oils
  • Avoiding tobacco, caffeine, alcohol, dairy, or sugar before bed

Any stretching or exercise before bedtime should be gentle. Vigorous exercise stimulates the system rather than relaxing it. Some people with RLS distract themselves from the leg sensations until sleep comes on. For example, you can distract yourself with:3,8

  • Crossword puzzles
  • Knitting
  • Reading

Most home remedies carry low or no risk of causing another health problem and are affordable. However, it is always a good idea to talk with your doctor or pharmacist before taking any new supplements.3,8

Treating secondary restless legs syndrome

There are 2 types of RLS, primary and secondary. Doctors believe primary RLS is caused by a combination of genetics and the environment. Sometimes, though, RLS is caused by another health condition. This is called secondary RLS. In these cases, treating the underlying cause relieves the RLS symptoms. Conditions that are known to cause RLS in some people include:1,2,9

  • Pregnancy
  • End-stage kidney disease
  • Diabetes
  • Multiple sclerosis
  • Rheumatoid arthritis
  • Parkinson’s disease
  • Heart disease

About 1 in 4 pregnant people develop RLS, usually in the third trimester. It often disappears in the weeks after birth.1,2,9

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