The 11 Best Treatments For Restless Legs Syndrome
What is restless legs syndrome?
Restless legs syndrome , also known as Willis-Ekbom disease, is a condition that causes uncomfortable sensations, most often in the legs. These sensations have been described as tingly, crawling, creeping feelings, and cause the overwhelming urge to move the affected limb.
RLS symptoms typically occur when the person is sitting, resting, or sleeping, and often happen at night. The movements caused by RLS are called periodic limb movements of sleep . Because of these movements, RLS can cause serious sleep problems.
For most people with RLS, symptoms are mild. But if your symptoms are moderate to severe, RLS can have a big impact on your life. It can prevent you from sleeping enough, and thus cause problems with daytime focus and thinking, your job, and your social activities.
As a result of these problems, RLS can lead to anxiety and depression. And the longer you have the condition, the worse it can get. It can even spread to other parts of your body, such as your arms .
Here we list the best treatments for RLS. Some of these you can try on your own. Others you can discuss with your doctor, who can help you create a treatment plan to help relieve your RLS symptoms.
Primary Or Idiopathic Rls
Idiopathic means that the cause is unknown.
It is the most common type and has the following characteristics:
- It usually begins before the age of 40.
- It can start as early as childhood.
- It may have a genetic cause.
- Once primary RLS starts, it tends to be lifelong.
Symptoms may be sporadic, or gradually worsen and become more prevalent over time.
In mild cases, the person may have no symptoms for a long time.
Home Remedies For Restless Legs Syndrome
Home remedies offer a simple way to improve RLS symptoms. Though more research is needed to confirm how effective these methods are, many people with mild to moderate RLS symptoms find relief from a combination of the following:
- Moving the legs: Moving the affected body part usually leads to relief from uncomfortable sensations, though symptoms may return when movement ceases.
- Implementing healthy sleep hygiene habits: RLS can cause sleep loss , but its also exacerbated by sleep problems. Try to keep a regular sleep schedule and ask your doctor for personalized sleep hygiene tips.
- Avoiding tobacco and eating a healthy diet: The Restless Legs Syndrome Foundation recommends reducing alcohol, caffeine, sugar, and salt and following a healthy diet rich in vitamins and minerals. In addition to relieving RLS symptoms, a healthy diet can help improve sleep quality.
- Exercising: Moderate exercise and stretching may help reduce RLS symptoms. That said, people with RLS should be careful with high-intensity activity, which may cause muscle cramps and stiffness that can exacerbate symptoms.
- Receiving massages or self-massaging: Some people find relief from RLS symptoms after massaging affected areas.
- Using heat or cold: RLS-related discomfort can often be tamed by applying a hot or cold compress or taking a warm bath before bed. Response to temperature may vary from person to person.
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Restless Leg Syndrome Treatment
Willis-Ekbom disease, also known as restless leg syndrome , is a disorder characterized by the uncontrollable urge to move ones legs. This is often uncomfortable and disconcerting. It can become increasingly irritating as it intensifies at night, preventing or disrupting sleep. These feelings of discomfort and the urge to move or shake suddenly predominantly occurs in the legs, although it can also happen in the arms.1 The sensation is often described as a crawling, creeping, or tingling sensations, and is relieved with the sudden movements of the limbs. As a result, people with restless leg syndrome often have difficulty sleeping, resulting in excessive tiredness throughout the day and impaired judgement, which can negatively affect work and personal life.
Levodopa And Other Dopaminergic Drugs
Dopaminergic drugs increase the availability of the chemical messenger dopamine in the brain and are one of the first-line treatments for severe RLS and PLMD. These drugs reduce the number of limb movements per hour and improve the subjective quality of sleep. People with either condition who take these drugs have experienced up to 100% initial reduction in symptoms.
Dopaminergic drugs, however, can have severe side effects . They do not appear to be as helpful for RLS related to dialysis as they do for RLS from other causes.
Dopaminergic drugs include dopamine precursors and dopamine receptor agonists.
The dopamine precursor levodopa was once a popular drug for severe RLS, although today it is usually recommended only for patients with occasional symptoms who may take it nightly as needed. It may also be helpful for long car rides or plane trips. The standard preparations combine levodopa with carbidopa, which improves the action and duration of levodopa and reduces some of its side effects, particularly nausea. Levodopa combinations are well tolerated and safe.
Levodopa acts fast, and the treatment is usually effective within the first few days of therapy.
A rebound effect causes increased leg movements at night or in the morning as the dose wears off, or as tolerance to the drug builds up.
Long-term use of dopaminergic drugs can lead to tolerance, in which the drugs become less effective.
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Abnormalities Of Iron Metabolism
Iron deficiency, even at a level too mild to cause anemia, has been linked to RLS in some people. Some research suggests that RLS in some people may be due to a problem with getting iron into cells that regulate dopamine in the brain. Some studies have reported RLS in a quarter to a third of people with low iron levels.
Transcutaneous Electrical Nerve Stimulation
With transcutaneous electrical nerve stimulation , a device sends small electrical currents to parts of your body to help relieve pain.
Theres not a lot of research on the use of TENS to treat RLS, but it could work.
The idea is that like the Relaxis vibrating pad, it uses counterstimulation. One study showed that regular use of TENS along with a vibration treatment completely relieved one mans RLS symptoms (
However, more research is needed to confirm acupuncture as a reliable treatment for RLS.
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Repetitive Transcranial Magnetic Stimulation
A noninvasive procedure thats typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising (4, 41,
Repetitive transcranial magnetic stimulation sends magnetic impulses to certain areas of the brain.
Its not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS .
In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended .
Periodic Limb Movement Disorder
PLMD is a similarly related sleep disorder, sometimes called periodic limb movement during sleep . In people with PLMD, the limbs twitch or jerk uncontrollably while sleeping. It is also considered a type of sleeping disorder. The movement may cause the individual to wake up frequently during the night, and this can undermine the quality and length of sleep. It can lead to RLS.
Lifestyle changes and common medications that may help alleviate RLS symptoms include:
- Warm baths and massages: These can relax the muscles and reduce the intensity of symptoms.
- Warm or cool packs: Some people prefer warm, some cold, and others say that alternating hot and cold is helpful.
- Relaxation techniques: Stress can make RLS worse, so exercises such as yoga, meditation, and tai chi may help.
- Exercise using legs more can help alleviate symptoms. If the patient has a sedentary lifestyle, walking instead of driving, taking up a sport, or exercising the legs in a gym can help.
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Surgery For Varicose Veins
Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency , which means your body cant properly circulate blood. As a result, the blood pools in your legs.
In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery .
Again, more research is needed on this surgery as a treatment for RLS.
If youre interested in any of these less-researched treatments, ask your doctor about them. Of course, you can try hot and cold treatments on your own, but your doctor can tell you more about the other treatments and whether they might be able to help you.
What Are Common Signs And Symptoms Of Restless Legs
People with RLS feel the irresistible urge to move, which is accompanied by uncomfortable sensations in their lower limbs that are unlike normal sensations experienced by people without the disorder. The sensations in their legs are often difficult to define but may be described as aching throbbing, pulling, itching, crawling, or creeping. These sensations less commonly affect the arms, and rarely the chest or head. Although the sensations can occur on just one side of the body, they most often affect both sides. They can also alternate between sides. The sensations range in severity from uncomfortable to irritating to painful.
Because moving the legs relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations. They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.
A classic feature of RLS is that the symptoms are worse at night with a distinct symptom-free period in the early morning, allowing for more refreshing sleep at that time. Some people with RLS have difficulty falling asleep and staying asleep. They may also note a worsening of symptoms if their sleep is further reduced by events or activity.
People with RLS can sometimes experience remissionsspontaneous improvement over a period of weeks or months before symptoms reappearusually during the early stages of the disorder. In general, however, symptoms become more severe over time.
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What Is The Treatment For Restless Leg Syndrome Is There A Cure
Treatment of restless leg syndrome is first directed toward any underlying illness, if known. For example:
- Blood testing to reveal underlying iron deficiency anemia may reveal the underlying cause.
- If varicose veins are thought to be the cause, then surgery to repair the circulation may be considered.
- Reduction or elimination of caffeine, nicotine, and alcohol from a person’s diet can be very helpful.
- Stopping smoking can significantly diminish or prevent symptoms.
- Getting better sleep and exercise can help some persons affected by restless legs.
- Pregnant women who do not sleep well at night and other people with sleep disorders may develop RLS.
There is no cure for restless leg syndrome however, the condition usually responds well to home remedies and medications. The outlook is excellent for people with restless leg syndrome as long as it does not weaken or damage the function of the legs.
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How Do Medications Treat Restless Legs Syndrome
The nerve pathway in the brain that helps control voluntary movements may not work normally in people with restless legs syndrome. This pathway uses certain chemicals that keep your movements normal.
Its believed that people with restless legs syndrome have changes in the normal function of these chemicals. These changes may cause the involuntary movement thats typical of restless legs syndrome.
Certain drugs can help treat the symptoms of restless legs syndrome by acting like the chemicals in this pathway or by helping these chemicals function normally.
The drugs that are used first to treat restless legs syndrome most often include ropinirole, pramipexole, and rotigotine. The drug gabapentin enacarbil is also used, but usually only when the other drugs dont provide relief.
Easing Restless Legs At Home
Help for restless legs comes in many forms including a variety of at home treatments to relieve symptoms. This is particularly beneficial for those who suffer from mild to moderate cases of restless leg syndrome.
Iron deficiency is believed to contribute to restless leg syndrome. Taking a blood test can determine whether you have low levels of iron, and if so, you can take oral supplements to correct this. In some cases, people do not respond well to oral supplements and may need an IV drip containing iron.4 Adding iron supplements to your diet should always be done under the supervision of a doctor.
Basic lifestyle changes can also reduce the impact of restless leg syndrome on your life. Exercising regularly in combination with good sleep habits has been known to decrease the effects of restless legs in many people. For day-to-day relief, hot or cold baths, heat or ice packs, or massaging the leg can help.
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Discussing A Change Of Medication
Some people take medications that can trigger or exacerbate RLS symptoms. If this is the case, a person should ask their doctor if it is possible to change the dosage or change the medication altogether.
People should not stop taking any medications unless their doctor tells them to.
There is currently no cure for RLS. However, certain medications and supplements can help a person to manage the condition and reduce the severity and frequency of their symptoms. Examples include:
Treatments For Underlying Health Conditions
Many health conditions may cause RLS. Treating these conditions may help to reduce the severity and frequency of RLS symptoms.
A person who experiences RLS should see a doctor to determine whether there is an underlying cause and to receive any necessary treatments.
RLS is a nervous system disorder that causes uncomfortable sensations in the legs. These sensations lead to an overwhelming urge to move the legs.
Some sensations that a person may feel in their legs include:
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Performing Regular Calf Stretches
Stretching the calf muscle may help to prevent or alleviate cramping sensations associated with RLS.
Below are some steps for performing a calf stretch:
Tips For Coping With Restless Legs Syndrome
Learning to recognize and avoid your personal triggers can help you manage RLS over time.
Effective techniques for minimizing RLS symptoms vary from person to person. Many people find relief from keeping active throughout the day and using acupuncture, massage, stretching, or relaxation techniques at night. During the day, you may be able to ward off RLS symptoms by keeping your mind busy even when you are sitting still with activities like reading or chatting to a friend.
Though RLS is not life-threatening, the frustration of not being able to sleep well can take a toll on mental health. Cognitive behavioral therapy, support groups, or reaching out to family and friends may provide additional emotional resources for coping with RLS.
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Environmental And Dietary Factors
The following environmental and dietary factors can trigger or worsen RLS:
- Iron deficiency. People who are deficient in iron are at risk for RLS, even if they do not have anemia.
- Folic acid or magnesium deficiencies.
- Caffeine. Coffee drinking is specifically associated with PLMD.
Drugs that may worsen or provoke RLS include:
- Calcium channel blockers
- Spinal anesthesia