RLS therapy: Practical treatments for restless legs you can try today
Waking up at night with crawling, tingling legs? RLS therapy is a mix of simple habits and medical options. Start with easy changes at home, check a few blood tests, and then talk to a doctor if symptoms keep you awake or get worse.
Quick fixes and self-care that actually help
Cut caffeine and nicotine, especially in the afternoon and evening. Both can make leg restlessness worse. Try a short walk or light stretching before bed — 10 minutes of calf stretches or a brief walk often calms symptoms. Warm baths, a heating pad, or a cold pack can give fast relief for a few hours.
Regular sleep habits matter. Go to bed and wake at the same time, reduce screen time before bed, and keep the bedroom cool and dark. Compression socks or pneumatic compression devices help some people by improving blood flow — they’re worth trying if you want a non-drug option.
Check your iron. Low iron stores are a common, treatable cause of RLS. Ask your doctor for ferritin and complete blood count. If ferritin is low (often <50 ng/mL for RLS), iron supplements or an IV infusion may reduce symptoms. Don’t self-prescribe high-dose iron without testing and medical guidance.
Medical treatments and when to see a doctor
If lifestyle changes don’t cut it, or RLS wakes you nightly and causes daytime tiredness, see a specialist. Common medicines include dopamine agonists (pramipexole, ropinirole) and gabapentin or pregabalin. Dopamine drugs can work fast but can cause augmentation — symptoms come back sooner and stronger over time — so doctors often prefer alternatives for long-term care.
Gabapentin, pregabalin, and gabapentin enacarbil help nerve-related symptoms and are often used when sleep is the main problem. For severe, treatment-resistant cases, short-term opioids are sometimes used under close supervision. Benzodiazepines can help sleep but don’t reliably treat leg movements and carry fall and dependence risks.
Some medications and conditions make RLS worse — common culprits are certain antidepressants, antihistamines, antipsychotics, and lithium. If you take any of these, ask your prescriber whether changing medication might help. Pregnant people often get RLS in the third trimester; symptoms often ease after birth, but discuss safe options with your provider.
Keep a simple symptom log: when symptoms start, what makes them better or worse, and how sleep is affected. That helps your doctor choose the right therapy faster. If symptoms are new, sudden, very asymmetric, or come with pain or swelling, seek medical evaluation to rule out other causes like circulation or nerve problems.
RLS therapy usually combines self-care, checking iron levels, and tailored meds. Small changes often bring big relief — but persistent or worsening symptoms deserve a medical plan. Got questions about a specific medicine or device? Bring your list to your next appointment and get a clear plan you can follow at home.
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