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Restless Legs Syndrome Causes, Symptoms and Treatment

restless legs syndrome

Story at-a-glance -

  • Restless legs syndrome can be described as the irresistible urge to move your legs, along with tingling or crawling sensations in the calves and, sometimes, in the arms
  • Researchers are yet to determine the cause of restless legs syndrome, but it is usually hereditary or triggered by existing diseases or health conditions such as neuropathy, pregnancy, attention deficit hyperactivity disorder (ADHD), low iron levels and end-stage renal disease with dialysis
  • You may lessen the tingling sensations by moving your legs, walking, placing a hot or cold compress over your legs or gently massaging them

Some people sometimes feel fidgety before or as they sleep, tossing and turning or moving around in bed. Oftentimes, it’s brought on by anxiety, though it will eventually pass. But in some cases, it might be a sleep-related movement disorder that could affect your lifestyle and health. If you’ve been feeling the urge to move your legs, especially at night, it is important to look into your condition as you may have restless legs syndrome.

What is Restless Legs Syndrome?

Restless legs syndrome (RLS), sometimes called restless leg syndrome,1 is a neurological disorder that can be characterized by an uncontrollable urge to move your legs. Crawling or tingling sensations are felt, often at night.

Also known as the Willis-Ekbom disease,2 it affects about 7.2 to 11.5 percent of the general population3 — mostly women and people 45 years old and below, although it can occur to anyone at any age. Pregnant women are also said to be prone to this condition, according to an American Academy of Neurology study.4

The irresistible urge to move affects an individual’s quality of rest or sleep, resulting in excessive daytime sleepiness,5 reduced total sleep time, longer sleep latency and more frequent insomnia.6

What Causes Restless Legs Syndrome?

The cause of restless legs syndrome remains a mystery, as researchers are yet to determine its single unifying cause. But what they know is that it is often hereditary, which is referred to as primary or familial RLS.7

Restless legs syndrome is likely to develop if you are taking certain medications or if you are suffering from a disease.8 In some cases, underlying health conditions such as iron deficiency anemia or kidney failure may also cause secondary restless legs syndrome or uremic RLS.9 Other conditions linked to RLS are peripheral neuropathy, attention deficit hyperactivity disorder (ADHD), low iron (ferritin) levels and end-stage renal disease with dialysis.10

Other potential triggers of restless legs syndrome include:11,12

  • Medicines (anti-nausea, antidepressants, antipsychotics, antihistamines and calcium channel blockers)
  • Lack and defective use of iron
  • Increasing age
  • Frequent blood donations

Restless Legs Syndrome Symptoms to Watch Out For

The name of this condition implies its distinct symptom: the urge to move the legs. Other restless legs syndrome symptoms associated with movement include walking, jiggling of legs, tossing and turning, and stretching.13 People with RLS feel sensations of throbbing, pulling, itching or crawling in their legs. These symptoms may occur either on one side of the body, on both or alternately.14

This syndrome is also associated with insomnia, decreased quality of life, and increased morbidity and mortality in end-stage renal disease.15 According to the Restless Legs Syndrome Foundation, these are the five essential features of RLS:16

  • A strong urge to move your legs, which is caused by tingling sensations
  • Worsening of symptoms when resting or inactive
  • Fewer symptoms when moving or doing physical activities
  • Symptoms are only felt at night or worsen in the evening
  • Sleep disturbances that include failure to stay asleep and periodic limb movements (PLMs)

Most people who have restless legs syndrome also experience periodic limb movement disorder (PLMD), which can be identified by involuntary leg twitching or jerking movements during sleep. These usually occur every 10 to 60 seconds and may cause interrupted sleep.17

These symptoms may vary from one person to another — some may experience RLS once or twice a week, while for severe cases, it may occur more often.18 According to the National Health Service UK, although this condition is not life-threatening, its symptoms may worsen if the underlying cause isn’t identified and addressed.19

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Restless Legs Syndrome in Children

Because they may not always be able to explain how they feel, diagnosing restless legs syndrome in children can be difficult. If they can’t describe it, a factor that may help determine childhood RLS is having a biological parent or sibling with RLS,20 in addition to the five essential features of RLS as mentioned above.

One of the common effects of RLS in children is sleep disturbance, as found by a 2007 study.21 Periodic limb movement disorder is also likely to happen in children with restless legs syndrome.22

Be Cautious if You Experience Restless Legs Syndrome During Pregnancy

Restless legs syndrome during pregnancy is usually temporary, but it is considered a risk factor in developing chronic idiopathic restless legs syndrome.23 According to NHS, 1 in 5 pregnant women may experience the symptoms of RLS in their third trimester, but the condition wanes after they give birth.24 Aside from the symptoms mentioned, pregnant women with transient RLS exhibit lower hemoglobin levels and mean corpuscular volumes (smaller blood cells25).26

How to Get Rid of Restless Legs Syndrome: Treatment Options You Can Consider

One of the easiest ways to get rid of restless legs syndrome is through exercise, which was found to be effective in minimizing its symptoms.27 One study found that aerobic exercises may help alleviate RLS symptoms in people undergoing chronic hemodialysis,28 while yoga was found to help reduce stress and improve the mood and sleep quality of women with restless legs syndrome.29

Here are some lifestyle changes that you can follow to reduce the symptoms of restless legs syndrome:30,3132,33,34,35

  • Create and implement a sleeping schedule — Listen to your body so you would know when to schedule your best sleeping time — possibly when the symptoms are least pronounced. You may also check this article, “Military Method for Falling Asleep in Two Minutes, ” to learn how to fall asleep faster.
  • Do moderate-intensity aerobic and leg-stretching exercises — Since inactivity may prompt the sensations caused by RLS, doing exercises such as hip rotation, hamstring stretch, straight leg stretch and knee-to-chest stretch may help alleviate the uneasy feeling.36 As found by a 2008 study, aerobic exercises may also help boost the functional ability, sleep quality and exercise capacity of people with RLS and on hemodialysis.37
  • Find an activity to distract your mind from RLS — To lessen the discomfort caused by the tingling sensations, keep yourself busy with activities such as solving puzzles, playing board games or doing needlework.
  • Squeeze in quick leg exercises during breaks — If you’re working in an office, take a five-minute walk or do stretches at least every hour.

Additionally, here are some restless legs syndrome medications or approaches that were found to help ease its symptoms:

  • Rotigotine transdermal patch — In a 2010 study, rotigotine transdermal patches were found to help lessen the symptoms of RLS38 because of their dopamine agonist content, which are needed by the brain for movement control.39
  • Intravenous (IV) iron — The symptoms of RLS usually occur at night because this is when iron and dopamine levels dip.40 IV iron may help alleviate this,41 but remember to consult a health care professional first for proper dosing and to avoid the risk of Alzheimer’s disease due to a high iron level.42
  • Pneumatic compression devices (PCDs) — One study43 found that PCDs, which inflate to supply high pressure around the foot and calf, and then deflate, may help minimize RLS symptoms as they help increase blood flow.44

Before trying any of these, remember to seek your health care provider’s recommendations because some medications, such as opioids and benzodiazepines, may actually have more severe effects to your health.45

How to Stop Restless Legs Syndrome Immediately

One of the easiest ways to stop restless legs syndrome immediately is by moving your legs. Constant movements such as walking back and forth, swaying your legs while sitting, and tossing and turning in bed may help minimize the sensations.46 Here are other ways on how to stop restless legs syndrome47,48

  • Place a cold or warm compress on your legs so you can be distracted from the tingling or crawling feeling
  • Take a walk to the bathroom, or simply get out of the bed
  • Gently massage your legs

Can Essential Oils Work for Restless Legs Syndrome?

Certain essential oils are known to be natural sleep inducers when used through aromatherapy,49 potentially helping counter the side effects of RLS, such as daytime sleepiness and insomnia.

Lavender oil was found to be one of the effective essential oils for restless legs syndrome. In a 2015 study, participants undergoing hemodialysis were given simple effleurage massages using lavender oil an hour after their dialysis sessions. The results showed the oil’s effectiveness in helping minimize the symptoms of restless legs syndrome without side effects.50

Another option is cannabidiol (CBD) oil, which may help improve sleep51 and minimize excessive daytime sleepiness52 as it brings tissues back into balance.

Foods to Limit on a Restless Legs Syndrome Diet

While it may offer certain cognitive benefits53 to some people, caffeine, which stimulates the nervous system, may cause insomnia, anxiety and even depression among sensitive individuals. It was also found to be one of the major causes of restless legs syndrome.54 If you suffer from RLS, it’s best to limit your intake or completely avoid drinks and foods with caffeine such as tea, soft drinks and coffee.

Sugar intake must also be regulated to lessen the sensations felt at night,55 especially if the underlying cause of RLS is nerve damage induced by diabetes.56

Are There Supplements for Restless Legs Syndrome?

Aside from the remedies and lifestyle changes mentioned, some studies found that supplemental vitamin D,57 and magnesium in form of oral therapy58 and intravenous magnesium sulfate (for pregnant women)59 may be beneficial in minimizing the symptoms of RLS.

However, I recommend seeking your health care provider’s advice before considering supplementation. They may suggest certain supplements, especially if the underlying cause of your restless legs syndrome is vitamin deficiency.60

Herbs for Restless Legs Syndrome

Aside from the mentioned lifestyle changes, herbs may also help minimize the symptoms of RLS. Valerian, commonly known as “nature’s valium,” is a plant with a sedative effect. Considered safe by the U.S. Food and Drug Administration (FDA), many people use this to get rid of anxiety and sleeplessness,61 making it a helpful herb to reduce the symptoms of RLS.

To add, a 2009 study found that valerian root intake may help alleviate the symptoms of this condition, as it helped decrease the participants’ daytime sleepiness.62

St. John’s wort, an herb used to help relieve depression,63 is also known to help alleviate nervousness, tiredness and sleep problems.64 In another study, it was found that a daily dose of St. John’s wort concentrated extract may help minimize the symptoms and improve the sleep quality of people with RLS.65

Frequently Asked Questions (FAQs) About Restless Legs Syndrome

Q: What triggers restless legs syndrome?

A: Restless legs syndrome may be triggered by the following factors: medicine, nerve damage, lack of iron or defective use of iron, kidney failure, increasing age, pregnancy and frequent blood donations.

Q: Can anxiety cause restless legs syndrome?

A: One study found anxiety symptoms in people with RLS, but it was not the implied underlying cause.66

Q: Does restless legs syndrome hurt?

A: According to people with RLS, only unpleasant feelings like throbbing, pulling, itching or crawling sensations in their legs may be felt.

Q: How do I stop restless legs syndrome at night?

A: Because movements may help lessen the sensations, I recommend taking a short walk to your kitchen, bathroom or any part of the house. You may also gently rub or massage your legs when you’re having symptoms.67

Q: What vitamins help restless legs syndrome?

A: Studies have found that vitamin D and magnesium may help minimize the symptoms of restless legs syndrome.

Q: What foods should you avoid if you have restless legs syndrome?

A: Generally, food and beverages with caffeine content must be avoided.

Q: Do bananas help minimize the symptoms of restless legs syndrome?

A: Yes. Bananas are rich in magnesium,68 which may help alleviate the crawling sensations and other symptoms of RLS.

Q: How do you calm restless legs naturally?

A: You may reduce the tingling or crawling sensations by moving constantly. You may simply walk, sway your legs or gently massage them.

Q: Can ibuprofen help restless legs syndrome?

A: Yes, ibuprofen may help ease its symptoms,69 but I advise you to follow the home remedies and lifestyle changes mentioned instead, because this medication may expose you to other dangers, such as increasing your risk of heart attack.70

+ Sources and References