How to Alleviate Restless Leg Syndrome

Three Parts:Alleviating RLS Symptoms with Lifestyle ChangesTaking Medication for RLSTrying Natural Remedies for RLS

Restless legs syndrome (RLS) is a condition that involves leg discomfort and uncontrollable urges to move your legs, especially while lying or sitting down.[1] RLS affects sleep, often promoting insomnia, and makes traveling long distances in planes, trains and cars very difficult. The causes of RLS are varied and include a genetic predisposition, nutritional deficiencies (such as iron) and side effects from other chronic diseases, such as diabetes. It is important to see your doctor if you experience ongoing RLS, as she may need to test for cardiovascular disease, kidney disease, arterial hypertension, Parkinson’s disease, and other associated conditions.[2] Alleviating ALS symptoms is possible with lifestyle changes, medications and natural remedies.

Part 1
Alleviating RLS Symptoms with Lifestyle Changes

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    Focus on getting restful sleep. Although RLS often significantly disrupts sleep at night, in some cases it's the chronic lack of good sleep that can trigger the syndrome.[3] Thus, insomnia is often thought of as a result of RLS, but it can also be a cause as muscle fibers can get twitchy and over-active without enough sleep.
    • Practice good sleep hygiene by establishing a cool, quiet and comfortable sleeping environment.[4]
    • Establish a sleep schedule. Go to bed and rise at the same time each day — try not to sleep in on the weekends.
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    Avoid caffeine and alcohol. Caffeine and alcohol (ethanol) both disrupt sleep and should be avoided if you have RLS.[5] Alcohol can make you drowsy, but it prevents you from getting a deep and restful sleep. Caffeine causes greater brain activity and more thoughts, which makes it difficult to fall asleep.
    • Caffeine is found in coffee, black tea, green tea, colas, other soda pop, energy drinks and chocolate.
    • Try caffeine-free sodas or flavored, carbonated water if you want something fizzy to drink.
    • Have a non-alcoholic beer if you have RLS and have trouble sleeping.
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    Exercise your legs. RLS is felt in the legs and typically described as uncontrollable twitching, tingling, creeping, pulling and/or achy pain that's triggered by resting.[6] Exercising your legs in the afternoon or early evening may relieve some of the restlessness in the muscles and nerves and help you get to sleep easier.[7]
    • Go for a walk in your neighborhood, ride your bike, take swimming lessons or try the stair climber at your local gym.
    • Although mild-to-moderate exercise may relieve symptoms of RLS, overdoing it during the day or working out too late in the evening may actually make things worse.
    • Just prior to bedtime (or if you can't sleep during the night), walk around your bedroom for a few minutes shaking your legs — it can temporarily relieve uncomfortable sensations.
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    Stretch your legs. Although RLS is not entirely a muscle problem — it's also related to an imbalance in brain chemistry and nerve flow — treating your leg muscles can give short-term relief.[8] So in addition to exercising your legs, stretching them on a daily basis (ideally at the beginning and end of each day) can help prevent the muscles from getting tight and feeling restless and/or crampy during the night.
    • To stretch the back of your legs, bend over at the waist and try to touch your toes. Hold the stretch for 30 seconds without "bouncing."
    • To stretch the front of your legs, balance yourself against a wall and bend the knee of one leg so that your heel touches your buttocks. Hold for 30 seconds and then do the other leg.
    • To stretch the calf muscles, hold a towel in both hands and wrap it around your foot while sitting or lying on your back. Pull the towel towards your head, while feeling a stretch in the calf muscle as you pull the toes up towards your head. Hold this position for at least 30 seconds. Repeat three to five times.
    • Before stretching any muscle, make sure that it's not cold or painful. Wait until your legs feel warmed up by walking around the house for a few minutes.
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    Take warm Epsom salt baths. Another simple approach that can help relax muscles is taking a warm bath in the evenings, just prior to bedtime.[9] The warm water hydrates the tissues and improves circulation, which can trigger tight muscles to relax. Soak in the tub for about 20 minutes and then start getting ready for bed soon thereafter.
    • Adding Epsom salt to your bath may help soothe tightness and achiness because it's rich in magnesium — a mineral muscles need to stop contracting and relax.
    • Don't run your salty bath water too hot, because the combination of hot water and salt can draw water out of your body and potentially make symptoms of RLS worse. Also, don't stay in the bath for too long for the same reason.
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    Use warm or cool packs. Using the same logic as taking a warm bath, placing warm packs or bags on your legs prior to bedtime may relax the muscles and reduce RLS symptoms.[10] Buy a few small herbal bags infused with lavender or other relaxing essential oils, or a rice heating pack, and zap them in the microwave for a few minutes before applying them to your legs. Allow them to soothe your legs for 15 minutes or so while you read or watch a relaxing movie.
    • Conversely, applying cool packs might have a benefit also, although don't apply ice packs because they can cause your legs to shiver and get worse.
    • If it's warm in your room, apply cool and moist towels to your legs for relaxation.
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    Keep well hydrated. Dehydration from not drinking enough water is not a primary cause of RLS, but it can certainty make existing symptoms much worse. Muscle cramping and twitching, especially in the legs, is a common symptom of dehydration. Aim for eight 8-ounce glasses of purified water daily, or even more if you're exercising or playing sports, or spending time outdoors on hot or humid days. Avoid caffeinated beverages because they stimulate urination and can promote dehydration.
    • Other good sources of hydration include fresh fruit and veggie juices, herbal teas and low fat milk. Almond and rice milk are healthy non-dairy options.
    • Other symptoms of dehydration to look out for are fatigue, headache, extreme thirst, dry mouth, dry skin, confusion and irritability.[11]
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    Try relaxation techniques. Another strategy that can help soothe your muscles and relieve the symptoms of RLS are relaxation techniques, such as meditation, yoga or deep breathing.[12] Muscle tissue is sensitive to physical and emotional stress, so learning how to relax is helpful for RLS symptoms.
    • Your can practice relaxation techniques throughout the day, but they may be most effective for RLS is you do them just before bedtime.
    • Ask your doctor, chiropractor or massage therapist about a referral to a yoga instructor or meditation practitioner.

Part 2
Taking Medication for RLS

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    Talk to your doctor about potential causes of RLS. Restless leg syndrome can have many causes, including genetic and environmental causes. You speak to your doctor about RLS so she can rule out any potentially underlying causes, from an iron deficiency to kidney disease. RLS may potentially be associated with cardiovascular disease, arterial hypertension, diabetes, migraine and Parkinson’s disease.[13]
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    Ask to your doctor about dopamine agonists. When RLS symptoms become severe and significantly disrupt sleep, your doctor may prescribe medications. The preferred prescribed drugs are dopamine agonists, which replace the neurotransmitter dopamine in your brain — dopamine levels are usually too low in people with RLS.[14]
    • Dopamine agonists are also used to combat Parkinson's disease because they reduce the urge to move restless and twitching muscles.
    • Commonly used dopamine agonists include ropinirole (Requip), pramipexole (Mirapex), as well as the rotigotine patch (Neupro).
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    Consider anti-seizure drugs. Medications that can control seizures and normally used to combat epilepsy are also used to treat severe RLS symptoms because they can slow down or block the pain signals in the nerves that feed the muscles of the legs.[15] These drugs don't cure RLS, but can offer short-term relief by affecting the calcium channels within nerves.
    • The only FDA-approved anti-seizure drug for RLS is gabapentin enacarbil (Horizant), although gabapentin (Neurontin) and pregabalin (Lyrica) may also be effective.
    • Anti-seizure drugs can also make you drowsy, which can help you get a restful sleep at night.
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    Ask about sleeping medications. Sleeping medications, particularly ones called benzodiazepines, can help promote sleep at night and sometimes act as muscle relaxants, but they don't usually eliminate the annoying and sometimes painful leg sensations.[16]
    • Commonly used benzodiazepines for RLS include clonazepam (Klonopin), eszopiclone (Lunesta), temazepam (Restoril), zaleplon (Sonata) and zolpidem (Ambien).[17]
    • Sedatives such as benzodiazepines and other sleeping medications are usually reserved for more severe cases RLS because they tend to be very addictive and cause significant daytime drowsiness.
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    Be careful with opioids. Opioids are strong narcotic drugs that can relieve severe symptoms of pain, cramping and restlessness associated with RLS, but they can be addictive, especially if taken in larger doses.[18] Commonly prescribed opioids include codeine, oxycodone (Oxycontin, Roxicodone), oxycodone w/ acetaminophen (Percocet, Roxicet), and hydrocodone w/ acetaminophen (Norco).
    • If your RLS symptoms are mild or moderate, it's best to try other medications or remedies first.
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    Avoid certain medications. Some medications can make the symptoms of RLS worse, so they should be avoided, or dosages reduced under the supervision of your doctor. These include some antidepressants, antipsychotic medications, anti-nausea pills and cold and allergy remedies.[19] Ask you doctor which ones are most problematic.
    • If you need to take any of these drugs due to another condition, then your doctor may recommend adding drugs to help combat RLS symptoms.

Part 3
Trying Natural Remedies for RLS

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    Supplement with iron. Many people with RLS have low levels of iron in their system, which is called anemia.[20] A lack of iron reduces the body's capacity to deliver oxygen to cells, which makes you feel very tired and causes muscles to act up and become symptomatic. Get a blood test to see if you're deficient in iron and ask your doctor if you're a good candidate for iron supplements.
    • Since iron deficiency is a potentially reversible cause of RLS, many sleep specialists recommend over-the-counter (OTC) supplements that contain ferrous sulfate.[21]
    • Iron dosages typically range from 10-30mg daily, although don't exceed the upper tolerable limits of 45mg. Ask your doctor what is appropriate for you.
    • While taking iron supplements, monitor your body's iron levels via regular blood tests.
    • Foods that are naturally high in iron include: red meat (especially beef liver), pork, poultry, most seafood, beans, spinach and dried fruit.
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    Take magnesium supplements. Magnesium deficiency is a growing concern in the U.S. due to mineral depletion of soil and dietary shifts away from eating fresh veggies (and legumes) and more towards fast food. Some of the side effects of magnesium deficiency include RLS, sleep disorders (insomnia), muscle spasm and weakness.[22] Experimenting with a magnesium supplement for a few weeks or so and seeing how it impacts your RLS is inexpensive and very safe.
    • Typical doses of magnesium citrate supplements range from 300-500mg daily.
    • It's a good idea to take a B-vitamin complex also because vitamin B6 helps with magnesium absorption in your body.
    • Foods that are rich in magnesium include: beans and legumes, most nuts, whole grains, and most green leafy vegetables.
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    Get regular massages. RLS is not really caused by muscle strains, pulls or tightness, which are all common reasons to get a professional deep-tissue massage. However, regularly massaging the muscles of your restless legs, particularly your calves and feet, may alleviate RLS symptoms for short periods of time.[23] Start with a 30-minute massage for your legs three times per week and see if it makes a positive difference.
    • Your health insurance policy may cover professional massage if your doctor prescribes it for medical benefit.
    • If you can't afford massage therapy, ask your spouse, partner, friend, or a family member for a leg rub. Watch education videos online to learn the basics.
    • Always drink lots of water after massaging muscles in order to flush out toxins that may make your feel sore or nauseous.
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    Consider other alternative therapies. Research shows that 65% of people with restless leg syndrome use alternative therapies to conventional medical treatments.[24] Using acupuncture, Chinese herbal therapy and near infrared light therapy are some of the treatments being sought. However, there is little current evidence that they can be of benefit. Further high quality studies may be warranted to evaluate whether any of these alternative therapies can be of benefit.[25]


  • Pregnant women and those who take antidepressants are especially susceptible to RLS.
  • Nicotine in tobacco products disrupts sleep, but second-hand smoke can also make symptoms of RLS worse.
  • ALS affects people of any age, including children, but it's more common in older adults and women.
  • There is no test that diagnoses RLS. It's based on severity and timing of leg symptoms.
  • It's estimated that about 5-10% of the U.S. population has RLS.[26]

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