Restless Legs Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Restless Legs Syndrome?
A neurologist (a doctor who treats the brain and nerves) or a sleep medicine doctor (a doctor who treats sleep problems) usually treats restless legs syndrome. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is restless legs syndrome?
Restless legs syndrome (RLS), also known as Willis-Ekbom Disease, is a neurological condition that causes an irresistible urge to move the legs. RLS is a sleep disorder triggered by resting and attempting to sleep. It is also a movement condition, because people with RLS move their legs to find relief. Moving stops the unpleasant feeling for a short time.
Symptoms
People with RLS feel an irresistible urge to move, along with uncomfortable feelings in the legs. The feelings may be aching, throbbing, pulling, itching, crawling, or creeping. Common features include:
- Symptoms start when you are inactive and sitting for a long time, such as on a plane trip.
- Moving or walking gives relief for a short time, but the feelings often return when you stop.
- Symptoms are worse at night and can interfere with sleep.
RLS can badly interrupt sleep. It can be hard to fall asleep or go back to sleep after waking up. People with RLS may have daytime sleepiness, trouble concentrating, and changes in mood.
Causes and who gets it
In most cases, the cause of RLS is unknown. RLS often runs in families, and specific gene variants are associated with the condition. Low levels of iron in the brain also may be responsible. Problems with dopamine, a brain chemical that helps with muscle movement, may also play a part. RLS can develop at any age, but it most often begins in middle age. It occurs in men and women but is more common in women. RLS may happen alongside other conditions, such as:
- Diabetes.
- Iron deficiency.
- Parkinson's disease, which raises the risk of RLS.
- Neuropathy, which means nerve damage.
- Pregnancy, especially in the last trimester.
In most cases, symptoms linked to pregnancy usually disappear after delivery. Certain medicines may make RLS worse, such as some anti-nausea drugs, antipsychotic drugs, antidepressants that increase serotonin, and some antihistamines.
How doctors diagnose it
There is no specific test to diagnose RLS. A provider reviews your symptoms, medical history, medicines, and family history. Your provider may also do physical and nerve exams. Usually, your provider decides whether you have RLS based on your symptoms. Blood tests may help rule out other conditions, such as kidney failure and low iron levels. Sleep studies are not needed to diagnose uncomplicated RLS. Doctors sometimes mistake RLS in children for growing pains or ADHD.
Treatment
RLS has no cure, but treatment can help manage some symptoms. The first step is to address anything that could be making RLS worse, such as diabetes, neuropathy, sleep apnea, or iron deficiency. Use iron only under a doctor's care, because too much iron can sometimes be harmful. Lifestyle changes may give some relief, such as:
- Avoiding or cutting back on alcohol, nicotine, and caffeine.
- Keeping a regular sleep schedule.
- Exercising moderately and consistently.
- Massaging the legs or taking a warm bath.
The first-line medicines (the ones tried first) are drugs that bind to calcium channels. These include gabapentin, pregabalin, and gabapentin enacarbil. These may cause sleepiness, dizziness, unsteadiness, a sense of mental fog, depression, and weight gain. Ropinirole, pramipexole, and the rotigotine patch act like dopamine. The FDA has approved them for RLS. They may be used if the first-line medicines are unhelpful or cause unwanted side effects. With time, RLS may worsen in 40 to 80% of people using these medicines. They can also cause impulse control problems, such as compulsive shopping or gambling. Opioids are usually kept for RLS that does not respond to other drugs. They carry a risk of dependence. The FDA has also approved a device called TOMAC (tonic motor activation). It helps reduce RLS symptoms and improve sleep quality.
When to see a doctor
Contact your provider for an appointment if you have symptoms of RLS. Also call if your sleep is disrupted or your symptoms get worse.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your symptoms and medicines. They can also check for causes such as low iron and refer you to a specialist.
Common questions
Can restless legs syndrome be cured?
No, RLS has no cure. Treatment can help manage some symptoms.
Do restless legs symptoms get worse at night?
Yes, symptoms are worse at night. They also start or get worse when you lie down or sit for long periods.
Is restless legs syndrome dangerous?
No, RLS is not dangerous. However, it can be uncomfortable, making it hard to sleep and affecting your quality of life.
Can restless legs syndrome happen during pregnancy?
Yes, RLS may happen during pregnancy, especially in the last trimester. In most cases, symptoms usually disappear after delivery.
Sources
- National Institute of Neurological Disorders and Stroke - Restless Legs Syndrome
- MedlinePlus - Restless legs syndrome
- National Organization for Rare Disorders - Restless Legs Syndrome
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
