Restless Leg Syndrome (RLS) is a chronic, progressive movement disorder characterized by abnormal sensations and the urge or need to move the legs.

Patients with Restless Leg Syndrome often struggle to describe their characteristic symptoms. They typically express an irresistible urge to move their legs, often described as an uncomfortable sensation of pain, burning, or tingling. While not intensely painful, these sensations can be extremely distressing. The discomfort manifests at rest, intensifies during the night, and can be severe enough to awaken individuals from sleep, leading to chronic sleep disruption and emotional stress. Patients often report being unable to sleep at night, sometimes resorting to getting up and moving around or even trying to relieve discomfort by applying pressure to their legs. It can also manifest during situations requiring prolonged sitting, such as long journeys or watching movies/theatre performances. Due to the sleep disruption it causes, it impairs the quality of life by leading to fatigue, weakness, difficulty concentrating, and similar conditions.

It is more common in women and becomes more prevalent with age, affecting approximately 5-7 individuals out of 100.

Causes of Restless Leg Syndrome

Restless Leg Syndrome is a clinical condition characterized by disturbances in pain perception and belongs to the category of “central sensitization syndromes.” It is reported to stem from disturbances in the dopamine system similar to Parkinson’s disease.

Restless Leg Syndrome can occur in two ways:

  1. Primary Restless Leg Syndrome with no identifiable cause

No issues are detected in any examination, laboratory tests, or imaging methods. While it could have a genetic basis, this is not the case for all patients.

  1. Secondary Restless Leg Syndrome developing due to another condition

Iron deficiency, pregnancy, kidney failure, inflammatory rheumatic diseases, diabetes, multiple sclerosis. In secondary Restless Leg Syndrome, when the underlying cause is identified and treated (such as iron deficiency), complete resolution of the syndrome may be possible.

Diagnosis of Restless Leg Syndrome

The diagnosis of Restless Leg Syndrome is established when a patient’s description of their symptoms aligns with the characteristics of the syndrome, and there is no other identifiable cause for their leg discomfort. Neurological examination is conducted to differentiate from other movement disorders, check for neuropathy, assess for problems in the lower back, hips, knees, and ankles, observe for signs related to both veins and arteries, and consider lymphatic system problems. Given that Restless Leg Syndrome is commonly associated with metabolic (diabetes, obesity, B12 deficiency, iron deficiency) and endocrine (thyroid-goiter dysfunction, hypothalamus, pituitary, adrenal axis problems) diseases, as well as organ failures (kidney failure, dialysis, liver cirrhosis), an evaluation from these perspectives is essential. Considering that Restless Leg Syndrome is more frequent in pregnancy, multiple sclerosis, and some inflammatory rheumatic diseases (such as rheumatoid arthritis), these factors should also be evaluated. The medications the patient is taking should also be assessed, as similar issues can be seen in individuals taking neuroleptics.

Differential diagnosis should also be performed for clinical pictures that closely resemble Restless Leg Syndrome. One of these is nocturnal leg cramps. They typically affect the muscles at the back of the lower leg and are relieved by stretching. Another is “painful leg moving toe syndrome.” In this case, severe pain and burning in one or both feet are accompanied by repeated movements. Unlike Restless Leg Syndrome, it doesn’t worsen at night and doesn’t improve with movement.

Diagnostic Criteria for Restless Leg Syndrome:

Main diagnostic criteria Unpleasant or uncomfortable sensations in the legs, with an urge to move the legs The urge to move the legs or uncomfortable sensations begin or worsen during periods of rest The urge to move the legs or uncomfortable sensations are partially or totally relieved by movement, such as walking or stretching The urge to move the legs or uncomfortable sensations worsen in the evening or at night compared to the daytime, or only occur in the evening or at night The above features cannot be solely accounted for as symptoms primary to another medical or behavioral condition (e.g., myalgia, venous stasis, leg edema, leg cramps, habitual leg swinging). Supportive clinical features Family history Response to dopaminergic therapy Periodic limb movements (while awake or during sleep) Lack of expected daytime sleepiness Markers associated with clinical course

a. Chronic/persistent Restless Leg Syndrome: Symptoms occurring at least twice a week on average over the past year in the absence of treatment b. Intermittent Restless Leg Syndrome: Symptoms occurring at least twice a week on average per year in the absence of treatment and at least five attacks in the individual’s lifetime

Markers associated with clinical significance

Symptoms of Restless Leg Syndrome cause significant distress and impairment in sleep, energy/vitality, daily activities, behavior, cognitive state, and mood, affecting social, educational, occupational, and other major functional domains.

Treatment of Restless Leg Syndrome Medication Therapy

The most preferred group of drugs are dopaminergic drugs (used for Parkinson’s disease). Other options include anticonvulsants (used for epilepsy), opioids, and benzodiazepines.

Complementary Medicine Methods: Acupuncture

Acupuncture affects energy systems in the body, regulating pain control, sleep control, and psychological well-being.

Neural therapy

Neural therapy, using local anesthesia to regulate the nervous system and activate the patient’s own healing mechanisms, is successfully used in Restless Leg Syndrome patients. In our clinic, treatment is usually a combination of acupuncture and neural therapy.

Ozone therapy

Ozone therapy, which stimulates the antioxidant mechanism and regulates circulation in Restless Leg Syndrome patients, can yield successful results. 3. Relaxation Techniques: Relaxation training and biofeedback can be applied to patients.


Exercise maintains joint movement, stretches shortened muscles, and strengthens the stability of the legs. Aerobic exercises (swimming, walking, running, cycling, dancing, etc.) are required to improve respiratory and heart functions and increase resistance. Additionally, regular aerobic exercises can increase the release of pain-relieving and happiness-inducing substances (endorphins, serotonin). To achieve this effect, the patient must exercise regularly for at least 8 weeks. Consistency in performing all exercises and making it a lifestyle is crucial.


Yoga, with its unique postures, breathing exercises, and relaxation methods, provides both stretching and strengthening benefits as well as relaxation.


It can be recommended for promoting muscle relaxation.


Patients are advised to avoid alcohol, smoking, caffeine, and chocolate, as these can exacerbate symptoms.

Ensuring Sleep Hygiene

As Restless Leg Syndrome typically worsens at night, patients often experience distressing times of waiting for sleep after getting into bed. Therefore, pre-sleep warm showers, going to bed at the same times, not having electronic devices such as TVs, phones, tablets in the bedroom, avoiding beverages that could disrupt sleep such as tea and coffee after 7 PM, and instead consuming calming teas like melissa and chamomile are recommended.