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Restless Leg Syndrome: Symptoms, Causes, Diagnosis, and Treatment

Medically reviewed by Smita Patel, DO, Susan Kerrigan, MD and Marianne Madsen on January 19, 2023

Restless leg syndrome (RLS) is a disorder that causes an uncontrollable urge to move one’s legs while at rest. This sensation typically occurs in the evening and is relieved by simply standing up or moving around. RLS affects up to 10 percent of the US population and is, in and of itself, benign. But it can interfere with sleep and thus impact quality of life. Let’s talk about the symptoms of restless leg syndrome, what it’s caused by, and how it’s treated.


Symptoms of restless leg syndrome


An individual with restless leg syndrome primarily feels the need to move their legs at rest, such as while sitting or lying down. Moving their legs will satisfy the urge, which can present as a burning, throbbing, or itching sensation. The exact type of urge experienced will vary among individuals.


Symptoms of RLS will typically occur at night, even during sleep. Restless leg syndrome is also associated with a condition called periodic limb movement of sleep, which causes the legs to twitch and kick during sleep.


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Restless Leg Syndrome - Overview

Restless Leg Syndrome - Overview

Diagnosing restless leg syndrome


There are five criteria that must be met for a diagnosis of restless leg syndrome:

  • A strong and often overwhelming need or urge to move the legs that is often associated with abnormal, unpleasant, or uncomfortable sensations.
  • The urge to move the legs starts or gets worse during rest or inactivity.
  • The urge to move the legs is at least temporarily and partially or totally relieved by movement. 
  • The urge to move the legs starts or is aggravated in the evening or night.
  • The above four features are not due to any other medical or behavioral condition.


If a person is experiencing any of the symptoms listed above and suffering from a reduced quality of life, they should consult their doctor for a proper diagnosis.


Causes of restless leg syndrome


Experts think RLS is caused by an imbalance of dopamine in the brain leading to involuntary muscle movements, but the exact trigger is unknown. However, there are several risk factors for RLS. These include iron deficiency; use of drugs such as caffeine, nicotine, or alcohol; pregnancy; and use of certain prescription medications  such as anti-nausea drugs, antipsychotics, or antihistamines. Some more serious risk factors include kidney disease and spinal cord injury.


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Restless Leg Syndrome - Treatment

Restless Leg Syndrome - Treatment

Treating restless leg syndrome


If your RLS is caused by an underlying factor such as an iron deficiency, treating that underlying factor can lead to an improvement in symptoms. Otherwise, various medications are available to treat RLS. These may include dopamine-increasing drugs, such as ropinirole or rotigotine, and calcium channel-altering drugs, such as gabapentin. If your RLS is affecting your sleep, muscle relaxants or sleeping pills may be prescribed. Lastly, opioid drugs can be used if other treatments prove ineffective. Talk to your doctor to see which treatment options may work for you.


Living with restless leg syndrome


Living with restless leg syndrome can be challenging at times, and you may feel that other people don’t understand how RLS impacts your life. Luckily, support groups are available, both online and in-person, where you can meet others going through the same thing. Organizations such as the Restless Legs Syndrome Foundation provide support meetings across the United States for RLS sufferers, while forums on the internet can be of help if there aren’t any in-person groups near you.


Written by Natan Rosenfeld

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