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Restless legs syndrome (RLS) is also known as Willis-Ekbom disease. It's a widespread condition that affects the nervous system and gives you an overwhelming urge to move your legs (and other body parts).

This condition affects about 7 percent to 10 percent of people in the United States. The symptoms of RLS can lead to exhaustion, which can have a further effect on mood, concentration, performance and relationships.

The cause of RLS remains unknown, and it can simply happen for no reason. In medical terms, this is described as idiopathic, which refers to any disease or condition that arises spontaneously or for which the cause is unknown. However, restless legs syndrome is known to run in families and specific gene variants are associated with the disease. It usually occurs before age 40 if it is connected to your family history.

Some evidence suggests restless legs syndrome is caused by a problem with the basal ganglia, a part of the brain. The basal ganglia uses the chemical neurotransmitter dopamine to control muscle activity. Damaged nerve cells can reduce dopamine in the brain, leading to muscle spasms and involuntary movements. Therefore, if you have a condition that affects the basal ganglia's dopamine pathways, you may have an increased chance of developing RLS.

Several conditions are associated with developing RLS. The most common are:

• Chronic kidney disease
• Fibromyalgia
• Iron deficiency anemia
• Parkinson's disease
• Peripheral neuropathy
• Pregnancy (particularly in the last trimester)
• Rheumatoid arthritis
• Underactive thyroid

Along with these conditions, specific medications are also linked to RLS.

In recent years, RLS has also been linked to long COVID-19, also known as post-COVID conditions. A 2022 study in the Journal of Clinical Sleep Medicine identified an increased prevalence of RLS in women with long COVID.

The National Institute of Neurological Disorders and Stroke states that the following medications can aggravate RLS symptoms:

• Antidepressants, such as fluoxetine and sertraline
• Antinausea drugs, such as prochlorperazine and metoclopramide
• Antipsychotic drugs, such as haloperidol and phenothiazine derivatives
• Cold and allergy medications that contain antihistamines, such as diphenhydramine

Other triggers for RLS symptoms include excessive caffeine, excessive alcohol, smoking, stress and obesity.

Symptoms of RLS vary from person to person and can range from very mild to overwhelming. The core symptom most people experience is the overwhelming urge to move their legs. But RLS can also cause uncomfortable sensations such as:

• Burning
• Cramping (particularly in the calves)
• Crawling or creeping feeling
• Itching
• Tingling or throbbing

Many people find it difficult to describe the sensations they feel. RLS can also affect other parts of the body, such as the arms. People may feel it on just one side of the body or both sides. The symptoms are usually worse at night, and moving the affected limb tends to give some relief from the discomfort.

There are no specific tests used to diagnose RLS, and in most cases, the diagnosis is made based on clinical symptoms. Your doctor asks about your symptoms, medical history and family history, and conducts a physical examination and some basic tests to rule out other conditions.

The main signs doctors look for to make a diagnosis include:

• Activation or worsening of symptoms when resting or inactive
• An overwhelming urge to move your legs associated with other uncomfortable sensations
• Relief of symptoms by moving
• Worsening of symptoms at night
• No other medical or behavioral condition causing the symptoms

If restless legs syndrome is associated with another medical condition, sometimes getting that condition under control can help relieve the symptoms. If symptoms are more severe, there are several other interventions to explore:

• Benzodiazepines. These are medications used to help with anxiety, muscle spasms and insomnia. They can be prescribed for certain people to lessen RLS symptoms but are usually a last resort.
• Dopamine agonists. These work by increasing dopamine levels. Ropinirole, pramipexole and rotigotine are approved to manage moderate to severe RLS symptoms, but they can cause daytime sleepiness, so caution needs to be taken when driving, working or operating machinery.
• Lifestyle changes. Quitting smoking, reducing stress, increasing exercise, sleeping well and avoiding stimulants like caffeine in the evening might help with the management of RLS. Hot baths, warm compresses, walking and stretching can assist with relieving symptoms when they are happening.
• Iron. Supplements are the first line of treatment for people with iron deficiency anemia and restless legs syndrome. Usually, tablets are prescribed or can be purchased in over-the-counter form, but if they aren't working to boost iron levels, your healthcare provider can prescribe iron infusions intravenously.
• Magnesium. People often recommend magnesium supplementation anecdotally to manage RLS symptoms, but current evidence is conflicting. A 2019 article in Sleep Medicine Reviews concluded that more research is needed to determine if magnesium helps with restless legs syndrome. Always talk to your doctor before starting any new supplement.
• Painkillers and opioids. Mild opiate painkillers, such as codeine, can be used to treat severe symptoms of RLS.

General movement, stretching and massaging the limbs can provide some symptom relief. Relaxation activities, such as yoga and tai chi, are beneficial, and distraction techniques such as watching TV or reading a book can also help.

There is no cure for restless legs syndrome. However, there are many treatment options and lifestyle changes to control the symptoms and help you get a good night's sleep.

Although RLS is a chronic condition, people often experience extended periods of symptom-free time that can stretch for days, weeks, months and even years.

When symptoms are present, the primary goal is to stabilize symptoms and improve sleep consistency.

How can you stop restless legs at night?

Lifestyle changes such as taking a warm bath before bed, reducing stress and getting some exercise during the day can help manage restless legs syndrome. Avoiding stimulants—nicotine, alcohol, caffeine—close to bedtime can help reduce RLS symptoms.

If symptoms are severe, your healthcare provider can prescribe specific medications to help relieve them.

What is your body lacking when you have restless legs syndrome?

Anecdotally, many people report a lack of magnesium when they have restless legs syndrome, but more research is needed to understand if taking magnesium can be an effective treatment for RLS.

If you have low iron levels (iron deficiency anemia), then a lack of iron could be the cause. In this case, iron supplements can help relieve RLS symptoms as iron levels are increased.

What are the triggers for restless legs syndrome?

Triggers for RLS include specific medications, excessive caffeine, excessive alcohol, smoking, stress and obesity. They can all worsen symptoms, especially if you smoke, drink alcohol or have a stimulant, such as coffee, close to bedtime.