New and Emerging Treatments for Restless Legs Syndrome (RLS)

Overview

Restless Legs Syndrome (RLS), also called Willis-Ekbom disease, is a common neurological condition that causes an uncontrollable urge to move your legs, usually when you are resting or trying to sleep. Symptoms often get worse in the evening and night, which can make it hard to fall or stay asleep, leading to daytime fatigue and reduced quality of life. While RLS is a chronic condition, new and emerging treatments can help most people manage their symptoms effectively.

Signs & Symptoms

RLS symptoms vary from person to person, but common signs include:

• An overwhelming, uncontrollable urge to move your legs, often paired with uncomfortable sensations like crawling, tingling, aching, pulling, or itching deep in the legs
• Symptoms that get worse when you are at rest (sitting or lying down) and improve temporarily when you move your legs
• Symptoms that are most severe in the evening or at night, and much milder during the day
• In some cases, similar uncomfortable sensations in the arms, torso, or even phantom limbs after amputation
• Disrupted sleep that leads to daytime drowsiness, irritability, difficulty concentrating, or mood changes

Causes & Risk Factors

Most cases of RLS are primary, meaning the exact cause is unknown, though it often runs in families. Researchers have identified several genetic variants linked to primary RLS. Secondary RLS is caused by an underlying health condition or trigger, including:

• Low iron levels in the brain (even if you do not have anemia, low ferritin levels can trigger RLS)
• Chronic health conditions like kidney disease, diabetes, or peripheral neuropathy (nerve damage in the hands and feet)
• Pregnancy, especially in the third trimester (symptoms usually resolve within a few weeks of delivery)
• Certain medications, including some antidepressants, antipsychotics, anti-nausea drugs, and over-the-counter cold or allergy medications
• Lifestyle factors like frequent caffeine, alcohol, or tobacco use

Diagnosis

There is no single lab test or scan to diagnose RLS. Your healthcare provider will make a diagnosis based on your symptom history, a physical exam, and tests to rule out other conditions. They will likely order a blood test to check your ferritin (iron storage) levels, and may recommend a sleep study if your symptoms are severe or if you have other sleep disorders like sleep apnea.

Treatment & Management

Treatment for RLS is tailored to the severity of your symptoms and whether an underlying cause is found. The first step is often addressing reversible triggers, like correcting iron deficiency or switching off medications that worsen RLS. For ongoing symptoms, newer and emerging evidence-based treatments include:

Living With It

Small, consistent lifestyle changes can make a big difference in managing RLS symptoms alongside medical treatment. Try to keep a consistent sleep schedule, avoid caffeine and alcohol in the afternoon and evening, and do moderate daily exercise like walking or swimming. Stretching your legs, massaging them, or using a heating pad or ice pack before bed can also provide temporary relief. Support groups for people with RLS can help you connect with others who understand your experience and share practical coping tips.