Restless Leg Syndrome (RLS)

What Is Restless Leg Syndrome?

An overwhelming need to continually move ones legs is called restless leg syndrome (RLS). RLS is not life-threatening and does not necessarily indicate a serious medical condition.

People with RLS complain of extremely uncomfortable sensations in their legs (thighs, calves, and feet) and occasionally in their arms. These sensations, which are sometimes difficult to describe, could include:

  • throbbing
  • aching
  • itching
  • creeping
  • crawling
  • pulling
  • cramping
  • burning

Movement usually relieves the discomfort.

Symptoms are more acute during the night and can interrupt sleep. In the long term, this can lead to fatigue, exhaustion, and anxiety.

As many as 10 percent of people in the United States may have RLS, according to the National Institute of Neurological Disorders and Stroke (NINDS, 2010). This neurological condition is classified as a movement disorder.

Signs of Restless Leg Syndrome

Symptoms of RLS include:

  • uncomfortable sensations in your legs
  • irresistible urge to move one or both legs
  • feelings that increase at night or when lying down or sitting for long periods of time
  • nighttime leg twitching
  • sleep interruption

Causes of Restless Leg Syndrome

Most of the time, the cause of RLS is unknown. Anyone can develop RLS, but your risk increases with age. Other factors that make RLS more likely include:

  • having family members who developed RLS before the age of 40
  • having a chronic condition, such as diabetes, kidney disease, Parkinsons disease, or peripheral neuropathy
  • pregnancy
  • sleep deprivation
  • use of alcohol or caffeine
  • certain medications, including lithium and neuroleptics (medications used to treat mental illnesses)
  • sedative withdrawal
  • iron deficiency (anemia)

RLS does not necessarily indicate the presence of any other serious medical condition. Seek medical attention if your RLS becomes chronic or if you are suffering from insomnia, sleep deprivation, or anxiety.

Diagnosing Restless Leg Syndrome

There is no specific diagnostic test for RLS. A doctor can diagnosis RLS based on patient symptoms, medical history, and a physical examination. Diagnostic criteria includes:

  • a strong need to move the leg or legs
  • symptoms triggered by sleep or rest
  • symptoms that improve with movement
  • symptoms that increase during the night and subside in the morning

Your doctor may order a sleep test before making a diagnosis. This test usually involves sleeping overnight at a sleep clinic. A sleep specialist will monitor you for signs of RLS or other sleep conditions (like sleep apnea).

Your doctor may also order additional testing, including blood and nerve tests, to rule out other conditions. Blood tests can identify:

  • kidney problems
  • diabetes
  • vitamin deficiencies (including iron-deficiency anemia)

Nerve testing, also called a neurological examination, can help your doctor determine whether peripheral neuropathy (nerve injury) is the problem. Common tests include electromyography (EMG) and nerve conduction velocity (NCV).


The doctor will insert a very thin needle into the problem muscle. He or she will ask you to contract the muscle. The needle acts as an electrode. It enables your doctor to monitor the muscles electrical activity and how well its responding to nerve stimulation.

Nerve Conduction Velocity

The doctor will place electrodes on the skin over the problem area. A mild electrical current will be used to stimulate the nerves. This test measures the speed at which the nerves are stimulated. Slower speeds can be an indication of nerve injury.

Treating Restless Leg Syndrome

Treatment for RLS involves first treating any underlying medical conditions. Then, your doctor may suggest home-care techniques to relieve symptoms. Techniques may include:

  • massage
  • yoga
  • warm baths
  • leg-stretching exercises
  • a heating pad or ice pack
  • maintaining a steady sleeping and waking schedule
  • cutting down on the use of caffeine, alcohol, and tobacco products

Some doctors prescribe medications designed to treat other disorders if RLS symptoms are severe. Be sure to discuss the potential benefits and side effects with your doctor. Dopaminergic agents, which are occasionally prescribed, should only be taken for the short-term. Long-term use of this medication, which is often given to Parkinsons disease sufferers, may make RLS symptoms worse.

Other examples of these medications include:

  • pain relievers
  • medications to treat insomnia
  • muscle relaxants
  • medications for the treatment of epilepsy
  • narcotics (can be addictive)

Living with Restless Leg Syndrome

Treatment for underlying medical conditions, lifestyle changes, and home remedies may improve symptoms of RLS. RLS may come and go in some individuals. In particular, RLS brought on by pregnancy generally goes away on its own.

Symptoms sometimes increase with age, and RLS can become chronic. The disorder itself is not dangerous and it isnt necessarily a sign of another medical condition. However, chronic RLS can result in insomnia, anxiety, and depression.

Seek medical care if your RLS becomes chronic. Support groups can also help you cope with the emotional toll of chronic RLS.