If your restless leg syndrome (RLS) is known to be linked to an underlying cause, then treating that cause can often lead to a complete cure.
For example, iron deficiency can be treated by taking iron supplements, and RLS associated with pregnancy usually goes away on its own within four weeks of the birth.
If RLS has no obvious cause, then treatment falls into one of two categories:
- lifestyle changes
- medication
Lifestyle changes
A number of lifestyle changes may be enough to ease the symptoms of RLS. These include:
- avoiding stimulants, such as caffeine, tobacco and alcohol
- not smoking
- taking regular, daily exercise – but avoid exercising near bedtime
- establishing a regular sleeping pattern – for example, going to bed and getting up at the same time every day; not napping during the day; taking time to relax before going to bed; avoiding caffeine close to bedtime
- avoiding medicines that trigger the symptoms of RLS or make them worse – if you think your medication is causing your symptoms, continue taking it and make an appointment to see your GP.
During an attack of RLS, you may find the following measures helpful in relieving symptoms:
- massaging your legs
- taking a hot bath in the evening
- applying a hot or cold compress to your leg muscles
- doing activities that distract your mind, such as reading or watching television
- relaxation exercises such as yoga or tai chi
- walking and stretching
On this last point a small medical trial carried out in 2011 found that a type of osteopathic exercise technique called positional release manipulation (PRM) could be of benefit to people with RLS.
PRM involves holding different parts of the body in position that has been found to reduce feelings of discomfort and pain.
Though larger studies will be required before it is clear that PRM is an effective treatment for most cases of RLS.
(Osteopathy is a complementary or alternative medicine that claims to be a way of detecting, treating and preventing health problems by moving, stretching and massaging a person’s muscles and joints.)
Medication
Levodopa
Levodopa may be recommended if you only have symptoms now and again. This is because if you took levodopa every day, there is a high risk that it would actually make your symptoms worse.
Levodopa is available in tablet or liquid form and you should take it once you feel the symptoms of RLS coming on.
The medication will make you feel very sleepy, often very suddenly, so you should never drive or use tools or machinery after taking levodopa.
Levodopa can cause nausea, so it is usually combined other medications to reduce the nausea.
Dopamine agonists
Dopamine agonists are usually recommended if you are having more frequent symptoms. They include:
These medications can make you feel very sleepy so you should never drive or use tools after taking them.
Other side effects of these medications include:
- nausea
- dizziness
- headache
Another dopamine agonist called cabergoline has proved to be effective in the treatment of RLS but tends only to be used if the medications mentioned above prove ineffective. This is because it can cause a range of serious side effects, which your GP will discuss with you.
Painkillers
You may need to be prescribed a mild opiate-based painkiller such as codeine or tramadol to relieve any pain associated with RLS.
Side effects of these types of painkillers include:
Another medication that can be used to both relieve pain and relieve symptoms of RLS is gabapentin. Side effects of gabapentin include dizziness and feeling tired and sleepy.
Aiding sleep
If you are having a particularly severe flare-up of symptoms that is disrupting your sleep, it may be recommended that you take a short-term course of medication to help you sleep.
These types of medications are known as hypnotics and include temazepam and loprazolam.
Hypnotics are usually only recommended to be used on short-term basis (typically no longer than week).
You may find you still feel sleepy or 'hungover' the next morning after taking your medication.
