Restless legs syndrome

Key points

  1. Restless legs syndrome affects about 7 to 15% of the population.
  2. It is twice as common in women than in men and is more common in the elderly than younger people. 
  3. The common symptom of restless legs syndrome is that you have a strong, overwhelming urge to move the affected part of your body, usually your leg and moving will usually make you feel better, at least for a short time. 
  4. Treatment for restless legs syndrome usually involves treating the underlying cause, and trying a few lifestyle changes for milder symptoms or a trial of medicines for severe symptoms.   

What is restless legs syndrome

  • Restless legs syndrome is a condition in which you have a unpleasant feeling or sensation, usually in the calves of the legs, that results in a strong, uncontrollable urge to move your legs.
  • Both legs may be affected or one may be worse than the other.
  • Sometimes, other parts of the body such as the arms or lower back may be affected.
  • The symptoms are usually brought on by rest and are worse at night. Movement brings about temporary relief, but the symptoms usually return once you settle into a restful state.
  • Restless legs syndrome is described as a neurological disorder (meaning that is a disorder of the nervous system).
  • Restless legs syndrome can impact your sleep and lead to tiredness, feeling sleepy or trouble concentrating. If this happens, see your doctor and get help to manage your symptoms.

Causes

The exact cause of restless legs syndrome is not known. Possible causes are:

Symptoms

  • The common symptom of restless legs syndrome is that you have a strong, overwhelming urge to move the affected part of your body, usually your leg.
  • You may also get an uncomfortable or tingling sensation such as "pins and needles," prickling, pulling, or crawling.
  • These feelings begin about 15 minutes after you lie down to sleep or to relax or when you have not moved for long periods, such as when travelling in a car or airplane.
  • Moving will usually make you feel better, at least for a short time. 
  • The severity of symptoms can range from a mild feeling of restlessness of the legs on some evenings, to a more severe problem that occurs every evening and night (and, sometimes, during the daytime) which regularly disturbs sleep. Many people fall somewhere in between these extremes.

Treatment

Treatment for restless legs syndrome usually involves treating the underlying cause, such as iron deficiency, or perhaps a change of medication may be advised if a side-effect from a medicine is thought to be responsible.

  • Sometimes a few lifestyle changes may be enough to control your symptoms such as:
    • Stop smoking
    • Limit or avoid alcohol, and caffeine.
    • Keep your bedroom cool, quiet, and comfortable, and use it only for sleeping, not for watching TV.
    • Get regular exercise and try walking, before bedtime, or try performing gentle leg stretches for five minutes before you sleep.
    • Eat a healthy diet.
    • Massage the leg or the arm, or use heat or ice packs.
  • When symptoms are more severe, medicines may help control the urge to move and help you sleep. There are different types of medicine, such as pramipexole, ropinirole carbamazepine, gabapentin, and pregabalin. You may have to try a few to find the one that works best.

Learn more

The following links provide further information on restless legs syndrome. Be aware that websites from other countries may contain information that differs from New Zealand recommendations:
Restless Legs Syndrome Patient Info, UK.
Restless Legs Syndrome Fact Sheet National Institute of Neurological Disorders and Stroke

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 22 Oct 2015