Treating restless legs syndrome

Medication can help, as can exercise, massage

Dear Mayo Clinic: Is restless legs syndrome hereditary? Is there an effective treatment, or does a diagnosis mean I will have it for life?

A: Restless legs syndrome (RLS) is not always hereditary, but it does run in some families and several genetic links have been found. While restless legs syndrome is most often a chronic condition, treatment is available that often can effectively control its symptoms.

RLS is characterized by an unpleasant or uncomfortable urge to move your legs. The sensation is temporarily relieved when you get up and move around, especially by walking, or when you shift or stretch your legs. RLS symptoms typically begin after you have been sitting or lying down for some time. Symptoms also tend to get worse in the evenings and at night.

In many cases of RLS, the cause is unknown, but RLS appears to be hereditary in about half the people who have it. Familial RLS symptoms often begin earlier in life — usually before age 40 — than they do in forms of the disease that are not hereditary.

In some cases, RLS may be related to another underlying medical condition. For example, some people with symptoms are found to have iron deficiency. In these situations, taking iron supplements may eliminate symptoms.

Treatment for RLS usually focuses on relieving the symptoms. A variety of simple steps you can take at home may help. Taking a warm bath, massaging your legs, applying warm or cool packs, and trying relaxation techniques, such as yoga or meditation, can all be useful. Exercising at a moderate level on a regular basis and establishing good sleep habits can help, too. For some, caffeine, alcohol and tobacco can trigger RLS symptoms or make them worse.

If lifestyle changes are not enough, your doctor may prescribe medication. Medications that have been helpful for RLS include several that affect a chemical in your brain called dopamine. Researchers suspect RLS may be linked to an imbalance in dopamine.

Using drugs that stimulate dopamine receptors in the brain, such as ropinirole, pramipexole or rotigotine, can help control RLS symptoms. Side effects may include nausea, sedation or, rarely, compulsive behaviors, such as shopping or gambling. Caution and long-term follow-up for the use of these medications is necessary.

If RLS disrupts your daily life or hurts your quality of life, consider specialty care. A sleep medicine physician or a neurologist can evaluate your condition and work with you to create a treatment plan that fits your situation.