Many people occasionally feel the need to stretch their legs after sitting for long periods. But for those with Restless Legs Syndrome (RLS), the urge to move the legs is persistent and often distressing. These uncomfortable sensations usually occur when the body is at rest, while sitting quietly, watching television, or lying down to sleep and relief comes only with movement. Because symptoms tend to worsen in the evening or at night, the condition frequently interferes with sleep and can leave people fatigued and irritable during the day.
A condition triggered during rest
RLS is a neurological disorder. . “It is a condition where a person feels an uncomfortable urge to move their legs, especially while resting,” said Sruthi Degapudi, consultant neurologist at Prashanth Hospitals, Chennai. Patients often describe the sensations as crawling, tingling, pulling or burning. These usually occur while sitting or lying down, and moving the legs — walking, stretching or shaking them temporarily relieves the discomfort.
According to P. Vijayashankar, senior consultant, neurology at Apollo Hospitals, Chennai, the condition typically begins with symptoms appearing at bedtime; symptoms often worsen at night, which is why many patients struggle to fall asleep or remain asleep, but in later stages they may also occur during the day when a person sits for extended periods.
Neurologists say the disorder is linked to brain systems that regulate movement, particularly those involving dopamine. Low iron levels in the brain may interfere with how dopamine functions, contributing to the development of symptoms.
Shubha Subramanian, senior consultant, neurology, Kauvery Hospital, Vadapalani, Chennai., said research has shown abnormalities in both central and peripheral nervous system pathways. Increased sensitivity to pain– known as hyperalgesia and altered blood flow or oxygen levels in muscles may also contribute to the sensations experienced in RLS.
Risk factors
Doctors say several medical conditions and lifestyle factors can increase the likelihood of developing RLS.
Iron deficiency is considered the most common risk factor. “Iron is needed for proper dopamine function in the brain,” Dr. Degapudi explained. Low iron stores, particularly when ferritin levels fall below about 75 micrograms per litre, are strongly associated with the condition.
Pregnancy is another known trigger. Symptoms often worsen during the later months of pregnancy, particularly the third trimester. According to Dr. Elanthiraiyan, up to 25% of pregnant women may experience symptoms during this period.
Chronic conditions such as diabetes, kidney disease, peripheral neuropathy and Parkinson’s disease have also been associated with RLS. Also, medications such as antidepressants, antihistamines and dopamine-blocking drugs may aggravate symptoms.
Lifestyle habits such as excess caffeine, alcohol consumption, smoking, insufficient sleep and prolonged sitting may also worsen symptoms and influence the condition.,
Genetics too play a role–. around 40 to 60% of patients report a family history of similar symptoms.
The condition can also occur in children. Padma Balaji, senior consultant in paediatric neurology at Rainbow Children’s Hospital, Chennai, said that children with RLS often have a parent with the condition. Nutritional deficiencies such as low vitamin B12, vitamin D or folate may contribute. In some children, RLS may also coexist with attention deficit hyperactivity disorder (ADHD) and may worsen symptoms of hyperactivity.
Diagnosis and treatment
There is no single test for this. Diagnosis is primarily based on symptoms and clinical evaluation.
Doctors look for these key features: a strong urge to move the legs, symptoms appearing during rest, relief with movement and worsening of symptoms during the evening or night.
“A careful history, neurological examination and blood investigations are important,” said Dr. Degapudi.
Doctors prescribe blood tests to check iron levels and to identify underlying conditions such as diabetes, kidney disease or vitamin deficiencies. They may recommend a sleep study to distinguish RLS from other sleep-related movement disorders such as Periodic Limb Movement Disorder, which involves involuntary leg movements during sleep. And treatment may start with checking the underlying cause.
Medications will be prescribed if symptoms persist. These include gabapentin or pregabalin, which help reduce uncomfortable sensations and improve sleep, as well as dopamine-based medicines such as pramipexole, ropinirole or rotigotine.
The disorder, if left untreated, can significantly affect sleep and may lead to daytime fatigue, poor concentration, irritability and mood changes. Doctors recommend regular exercise, good sleep hygiene, reducing caffeine and alcohol, and following a consistent bedtime routine. Additionally, warm baths, stretching exercises and leg massage before sleep may provide relief for some.
Doctors advise seeking medical care if symptoms occur frequently, interfere with sleep or worsen over time, as early treatment can help improve both sleep and daily functioning.
Published – March 21, 2026 07:21 pm IST
