Treating restless legs syndrome 

If your restless leg syndrome (RLS) is known to be linked to an underlying cause, then treating that cause can often cure the condition.

For example, iron deficiency can be treated by taking iron supplements, and restless legs syndrome associated with pregnancy usually goes away on its own within four weeks of the birth.

If no obvious cause can be found, 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 restless legs syndrome. These include:

  • avoiding evening stimulants, such as caffeine, tobacco and alcohol
  • not smoking - read more about quitting 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 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 restless legs syndrome, 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

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 restless legs syndrome.

PRM involves holding different parts of the body in position that has been found to reduce feelings of discomfort and pain.

Medication

Not all medicines used to treat RLS are licensed in the UK. If a medicine is licensed, it means it has been approved by the Medicines and Healthcare Regulatory Agency (MHRA) as a safe and effective form of treatment.

Unlicensed medicines are not necessarily unsafe. They can be prescribed if a health professional feels that the potential benefit of the medication outweighs any possible risk.

The medicine may be unlicensed because there is not enough commercial interest in marketing it, or because it is awaiting approval for a license. If a medicine is unlicensed, it is up to your GP to decide whether they prescribe it to you.

Dopamine agonists

Dopamine agonists are usually recommended if you are having more frequent symptoms. They include:

These medications can occasionally make you feel sleepy so you should be cautious when driving or using tools after taking them.

Other side effects of these medications include:

  • nausea
  • dizziness
  • headache

Painkillers

You may need to be prescribed a mild opiate-based painkiller such as codeine or tramadol to relieve any pain associated with restless legs syndrome.

Another medication that can be used to both relieve pain and relieve symptoms 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. 

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 restless legs syndrome 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.


Cardiovascular disease

Research has found that people with restless legs syndrome are twice as likely to develop cardiovascular disease (CVD) than the population at large. It is not known exactly why.

The more severe the symptoms, the greater the increase in risk.

You can take steps to reduce your risk of CVD, such as regularly exercising, maintaining a healthy weight, quitting smoking if you smoke and eating a healthy diet.

Read more about preventing cardiovascular disease.

Page last reviewed: 18/07/2013

Next review due: 18/07/2015