Restless legs syndrome (RLS) – symptoms, causes, and treatments

Restless legs syndrome is a chronic neurological condition causing an irresistible urge to move your legs, often when resting at night, which can be uncomfortable and upsetting. It affects many people, not just people with Parkinson’s, and is also known as RLS and Willis-Ekbom disease (WED).

There are two types of RLS. Primary, where there is an unknown cause, and secondary, where the RLS occurs alongside another disorder like Parkinson’s disease, kidney disease or neuropathy etc.

On this page you can find information about all the signs and symptoms of restless legs syndrome, how it is diagnosed and treated, and what you can do to provide relief at home.

Restless legs syndrome symptoms:

The signs and symptoms of restless legs syndrome are characterised by an overwhelming need to move the legs, which interferes with rest and sleep. This can be accompanied by unpleasant sensations including a creepy-crawly sensation, tingling, itching, pain, burning and pins and needles. It can affect just one side of the body, or both.

These symptoms tend to occur most during quiet wakefulness, for example when watching television or when drifting off to sleep, or during sleep. People often describe having to get up out of bed at night and stand on a cold floor or tile to relieve the symptoms. Restless legs syndrome can also affect the arms, head, and other parts of the body, although this is less common.

People with restless legs syndrome may also experience involuntary movements of the legs, known as periodic limb movements (PLM). RLS may also affect your sleeping partner if you experience periodic limb movement. For this reason, some people with the condition find it easier to sleep alone.

In addition to discomfort, restless legs syndrome can also cause sleep disruption and insomnia. Sleep disruption can lead to daytime tiredness and possible irritability. For some, it can lead to anxiety and depression, although more research is needed into this.

How is restless legs syndrome diagnosed and is there a test?

In general, there are no objective tests for restless legs syndrome, so diagnosis is based entirely on the description of symptoms. If you think you might have RLS, make an appointment to see your healthcare professional.

Restless legs syndrome can be difficult to diagnose in Parkinson’s as it may come and go, and can be confused with other Parkinson’s symptoms.

A diagnosis of restless legs syndrome is made if a person displays all five diagnostic criteria set out by the International Restless Legs Syndrome Study Group:

Diagnostic criteria:

1. An urge to move the legs, usually accompanied by uncomfortable and unpleasant sensations in the legs.
2. The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying down or sitting
3. The urge to move the legs and any accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
4. The urge to move the legs and any accompanying unpleasant sensations during rest or inactivity only occur or are worse in the evening/night than during the day.
5. The above clinical features are caused by other medical conditions or behaviours (e.g. myalgia, venous stasis, leg oedema, arthritis, leg cramps, positional discomfort, habitual foot tapping).

In addition, other features that may suggest a diagnosis of RLS are periodic limb movements when asleep, improvement of symptoms on dopaminergic treatment, and a family history of the disorder.

If restless legs syndrome is diagnosed, your doctor should check that you are not taking drugs which make RLS worse.

These can include certain antidepressants, anti-allergy drugs or alcohol at night. You may also be referred for a neurological examination to see whether changes of the nerves in the legs are causing the urge to move and uncomfortable sensations.

If a diagnosis is still uncertain, or your symptoms do not respond to treatment, then you may be asked to stay overnight in a sleep laboratory so that you can be observed further and tests can be carried out during your sleep.

TIP: Information that may help your doctor understand your symptoms:

• How often do you experience these symptoms, how often, and when?
• Has anything helped reduce the symptoms?
• How uncomfortable do they make you feel?
• Do they cause you a lot of distress?
• Is it disrupting your sleep?
• Is it stopping you from doing everyday activities like watching TV?
• Has anyone in your family had restless legs syndrome?
• Do the symptoms improve or get worse when you take your Parkinson’s medication?
• Do you have any symptoms such as numbness and tingling, or a burning/shooting pain in your hands or feet?

How common is RLS?

RLS is a fairly common neurological disorder, occurring in 10% of adults, but it manifests itself clearly in only a minority of cases. It can occur at any age but tends to be more frequent with increasing age. It is as common for men as it is for women up to the age of 35. After 35, women are affected twice as often as men.

What causes restless legs syndrome?

Restless legs syndrome is thought to be caused by the reduced production of dopamine, a brain chemical that helps you move (hence the link to Parkinson’s). However, the exact cause of restless legs syndrome remains unclear, and there are many people with RLS who do not have Parkinson’s.

Possible causes of restless legs syndrome include:

• RLS appears to be strongly linked with an iron deficiency in the body and other medical conditions such as Parkinson’s, renal failure, neuropathy (numbness or weakness as a result of damaged nerve endings) and pregnancy.
• RLS is believed to arise from abnormalities in the dopamine and iron systems in the central nervous system, including the basal ganglia and spinal cord.
• Additionally, alterations in the central nervous system are thought to affect biological processes relating to our 24-hour cycle (the circadian rhythm) and the way various neurotransmitters work.
• There seems to be a genetic link, as suggested by the high frequency of positive family history of RLS in people affected by the disorder.

Is RLS always linked to Parkinson’s disease?

No. Having restless legs syndrome does not mean you necessarily have Parkinson’s. While there’s a strong link between Parkinson’s and RLS, RLS is a common neurological condition in itself.

RLS can also cause night-time pain which may be mistaken for particular issues (experienced as deep joint pain) in people with Parkinson’s.

Restless legs syndrome treatments

Restless legs syndrome cannot be cured, but it is treatable. Meaning there are treatments and medications that can help your symptoms feel better.

Treatments and relief for Restless Legs Syndrome include:

• Additional medications to treat the symptoms of RLS, including drugs that modulate certain calcium-channels, dopaminergic agents, opioids, and benzodiazepines
• Your doctor adjusting your Parkinson’s medication
• An iron supplement, if your RLS is caused by iron deficiency
• A neurological exam to see if your RLS is caused by nerve damage in your legs
• In more extreme cases, an overnight stay in a sleep laboratory for further tests.

As the medical condition most commonly associated with restless legs syndrome is iron deficiency, your doctor should first check your ferritin levels (a protein that binds iron in the blood). If levels are low, you will be given an iron supplement.

For some people increasing the ferritin levels will eliminate or reduce the RLS symptoms.

For some people with Parkinson’s, their levodopa medication can worsen the RLS symptoms. The RLS symptoms may also fluctuate with the ‘wearing off’ effect and the motor fluctuations of Parkinson’s.

This then may cause a difficulty, as levodopa is considered the gold standard treatment for Parkinson’s. Dopamine agonists such as pramipexole or ropinirole tablets, or rotigotine skin patches, are mainly used when treating Parkinson’s and restless legs syndrome.

If you are already taking dopamine agonists to manage Parkinson’s symptoms and you still experience RLS symptoms, then your doctor may suggest you try other medications, such as gabapentin, pregabalin, opioids or clonazepam, although these may or may not be licensed to treat RLS in your country.

What can I do at home to relieve symptoms of restless leg syndrome?

There are many non-pharmacological ways you can help yourself. The changes you make depend on how disruptive the symptoms are, and what feels manageable for you.

Lifestyle changes you can make to reduce or eliminate RLS symptoms include:

• Establish the right level of exercise – too much worsens RLS, too little may trigger it. Some people find that a few minutes of exercise just before bedtime is particularly effective, although others find that exercise in the evening worsens the symptoms.
• Avoid stimulants, such as caffeine, alcohol and smoking, particularly in the evening.
• Eliminate from your diet foods that trigger RLS. These may include sugar, triglycerides (a form of dietary fat found in meats, dairy produce and cooking oils), gluten, sugar substitutes (aspartame), or following a low-fat diet.
• Experiment to see what works for you – but before significantly changing your diet, always check with your doctor or a dietician first.
• Create a peaceful, cool sleeping environment.
• Discuss with your doctor adding supplements such as potassium, magnesium, B-12, folate, vitamin E, and calcium to your diet. Whilst it has not been clinically proven, there is anecdotal evidence to suggest these supplements can ease RLS symptoms.

To relieve the symptoms, you could try:

• stretching and massaging the legs
• applying a hot – or cold – compress to the muscles in the leg
• taking a warm bath before going to bed
• drinking more water. Dehydration may cause the urge to move the legs, so drinking a glass of water may stop the urges for a short while
• soaking your feet in hot water just prior to going to sleep
• wearing compression stockings or tights in bed
• placing a pillow between your knees or thighs when lying in bed
• massage and chiropractic spinal manipulation
• distracting your mind – read a book or switch on the TV.

These are simply suggestions and what works for some people, won’t for others. If you have any concerns, talk to your doctor or healthcare professional first.

How can you stop restless legs immediately?

Moving the affected part of the body can temporarily stop or improve the unpleasant sensations associated with RLS and provide temporary relief. Massaging or stretching your legs can also help.

Can you have restless arm syndrome?

Yes. Despite the name, RLS can also affect the arms, head, and other parts of the body.

What vitamins help restless legs syndrome?

Some studies link RLS to deficiencies in iron and vitamin D. However, the cause of RLS is unknown, and we recommend you consult your doctor before taking any new supplements.

What should I do if I think I have restless legs syndrome?

Try the lifestyle changes suggested above, and see if they make a difference.

If the symptom does not improve, or is bothering you, start writing down a symptom tracker to show how, and how often, you experience this symptom

Make an appointment with your doctor (or Parkinson’s nurse, if you have one), to discuss it.

References and acknowledgements

Sources used in compiling this content:

• Wijemanne S, Ondo W. Restless Legs Syndrome: clinical features, diagnosis and a practical approach to management. Pract Neurol. 2017 Dec;17(6):444-452.
• Winkelman JW, Armstrong MJ, Allen RP, Chaudhuri KR, Ondo W, Trenkwalder C, Zee PC, Gronseth GS, Gloss D, Zesiewicz T. Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2016 Dec 13;87(24):2585-2593.
• RLS-UK

We would like to thank the following:

• Parkinson’s UK for permission to use the following source: RLS
• Brian Magennis, Advanced Nurse Practitioner and Adjunct Lecturer / Assistant Professor UCD, Mater Misericordiae Hospital, Ireland

Content last reviewed: July 2026