Treating restless legs syndrome

Mild restless legs syndrome that isn't linked to an underlying health condition can be managed with just a few lifestyle changes.

If symptoms are more severe, medication may be needed.

Restless legs syndrome caused by an underlying health conditioncan often be cured bytreating that condition. For example, Iron deficiency anaemia can be treated by taking iron supplements.

If it's associated with pregnancy, itusually disappears on its own within four weeks of the birth.

Lifestyle changes

Anumber of lifestyle changes may be enough to ease the symptoms of restless legs syndrome . These include:

• avoiding stimulants in the evening such as caffeine, tobacco and alcohol
• not smoking read more about quitting smoking
• taking regular daily exercise but avoid exercising near bedtime
• practising good sleep habits for example, going to bed and getting up at the same time every day, not napping during the day, taking time to relax before going to bed, and avoiding caffeine close to bedtime
• avoiding medicines that trigger the symptoms or make them worse if you think medication is causing your symptoms, continue to take it and make an appointment to see your GP

During an episode ofrestless legs syndrome, the following measures may help relieve yoursymptoms:

• massaging your legs
• taking a hot bath in the evening
• applying a hot or cold compress to your leg muscles
• doing activities that distract your mind, such as reading or watching television
• relaxation exercises , such as yoga or tai chi
• walking and stretching

Asmall medical trial carried out in 2011 found a type of osteopathic exercise technique called positional release manipulation could be of benefit to people withrestless legs syndrome. It involves holding different parts of the body in positions found to reduce feelings of pain and discomfort.

Medication

Dopamine agonists

Dopamine agonists may be recommended if you're experiencing frequent symptoms of restless legs syndrome. They work by increasing dopamine levels, which are often low.

Dopamine agonists that may be recommendedinclude:

• ropinirole
• pramipexole
• rotigotineskin patch

These medications can occasionally make you feel sleepy, so you should be cautious whendriving or using tools or machinery after taking them. Other possible side effectscan include nausea, dizziness and headaches .

If you experience nausea while taking a dopamine agonist, you may be given medication to help with this (antiemitic medication).

Impulse control disorder (ICD) is a less common side effect sometimes associated with dopamine agonists.

People with ICD are unable to resist the urge to do something harmful to themselves or others. For example, this could be an addiction to alcohol , drugs , gambling , shopping, or sex (hypersexuality).

However, the urges associated with ICD will subside once treatment with the dopamine agonist is stopped.

Painkillers

A mild opiate-based painkiller, such as codeine or tramadol, may be prescribed to relieve pain associated withrestless legs syndrome.

Gabapentin and pregabalin are also sometimes prescribed to help relieve painful symptoms of restless legs syndrome. Side effects of these medicationsinclude dizziness, tiredness and headaches.

Aiding sleep

Ifrestless legs syndromeis disrupting your sleep, a short-term course of medication may be recommended to help you sleep.

These types of medication are known as hypnotics, and include temazepam and loprazolam. Hypnotics are usually only recommended for short-term use (typically no longer than a week).

You may find you still feel sleepy or "hungover" the morning after taking your medication.

Levodopa

Levodopa may be recommended if you only have occasional symptoms of restless legs syndrome. This is because if you took levodopa every day, there's a high risk it would actually make your symptoms worse.

Levodopa is available in tablet or liquid form, and you should take it once you feel the symptoms ofrestless legs syndrome coming on.

The medication will make you feel very sleepy (often suddenly), so you should never drive or use tools or machinery after taking levodopa.