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Q
Relief for Restless Legs?

What can I do about restless legs syndrome? It's driving me crazy. I would prefer not to take drugs.

A
Answer (Published 10/2/2006)

Restless legs syndrome is a movement disorder that causes unpleasant sensations in the legs - tingling, prickling, crawling, pulling, drawing, and sometimes pain. The symptoms typically come on at night when you're trying to get to sleep, but they can also occur during the day when you're seated and inactive for a length of time - during a meeting, perhaps, at a movie, or while traveling by plane or train.

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The strange sensations are accompanied by an irresistible urge to move the legs - and changing their position may help a bit, but the unpleasant feelings usually return, making it difficult to fall asleep. As a result, people with this disorder may not get much sleep at all.

Although most cases have no known cause, restless legs syndrome can sometimes occur during pregnancy (if it does, it usually disappears soon after the baby is born) and in people with diabetes, rheumatoid arthritis, kidney failure, varicose veins, or peripheral neuropathy (nerve damage in the hands and feet). Researchers suspect a genetic influence, because between 40-60 percent of first degree relatives of patients with restless legs syndrome also develop the problem. Some cases have been traced to iron deficiency anemia. If so, iron supplements might help, but don't try this on your own; no one should take iron supplements except under a doctor's supervision (a doctor can diagnose iron deficiency anemia with some simple blood tests).

No reliable cure is available, but the following measures may help relieve the symptoms:

  • If you smoke, stop. Smoking may impair blood flow to leg muscles.
  • Avoid caffeine and alcohol, both of which can make symptoms worse.
  • Take a calcium/magnesium supplement at bedtime. Try 500 mg of calcium citrate and 250 to 500 mg of magnesium to calm nerves and muscles.
  • Exercise, stretch or massage your legs (this can help when symptoms are mild).
  • Take a hot bath to relax your legs.

Several types of drugs are used to treat RLS:

  • Dopaminergic agents to relieve discomfort and promote sleep (Sinemet, Permax, Mirapex and Requip).
  • Benzodiazepines to promote sleep (Valium, Halcion, Restoril and Klonopin). Be careful! These are addictive and interfere with cognition and memory.
  • Opioids for pain relief (codeine, Darvon, OxyContin, and others).
  • Anticonvulsants for pain relief (Neurontin, Tegretol, Depakote and others).

I wish I could give you a sure-fire way to deal with restless legs syndrome, but no study to date has had completely positive outcomes. To learn about ongoing research and clinical trials recruiting volunteers to explore new approaches to treatment visit www.rls.org for information.

Andrew Weil, M.D.

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