What are non-pharmacological treatments for Restless Legs Syndrome (RLS)?

From the Guidelines

Non-pharmacological treatments for Restless Legs Syndrome (RLS) include establishing a consistent sleep schedule, practicing good sleep hygiene, and engaging in regular moderate exercise, as these strategies can significantly reduce symptoms and improve quality of life. When considering non-pharmacological interventions for RLS, it's essential to prioritize approaches that have been shown to be effective in reducing symptoms and improving patient outcomes. The most recent and highest quality study on this topic is from 1, which provides guidance on the management of RLS. Although this study primarily focuses on pharmacological treatments, its recommendations against certain pharmacological interventions imply the importance of non-pharmacological approaches. Some key non-pharmacological strategies for managing RLS include:

• Establishing a consistent sleep schedule and practicing good sleep hygiene to reduce fatigue, which can exacerbate symptoms
• Engaging in regular moderate exercise, such as walking, swimming, or cycling, for at least 30 minutes most days, to improve circulation and reduce muscle tension
• Applying warm or cool packs to the legs, alternating between hot and cold treatments, or taking warm baths before bed to soothe leg discomfort
• Practicing gentle leg stretches, massage, and relaxation techniques like deep breathing or meditation to calm the nervous system and reduce symptoms
• Avoiding caffeine, alcohol, and nicotine, especially in the evening, as these substances can trigger or worsen RLS symptoms
• Getting up and walking around, doing gentle stretches, or massaging the legs for immediate relief during an episode These non-pharmacological approaches can be effective in managing RLS symptoms and improving quality of life, and should be considered as part of a comprehensive treatment plan.

From the Research

Non-Pharmacological Treatments for Restless Legs Syndrome (RLS)

Non-pharmacological treatments for RLS include:

• Massage or temperate baths, which can provide adequate symptom control for some people with RLS 2
• Repetitive transcranial magnetic stimulation, exercise, compression devices, counterstrain manipulation, infrared therapy, and standard acupuncture, which have been shown to be significantly more effective for RLS severity than control conditions 3
• Vibration pads, cryotherapy, yoga, compression devices, and acupuncture, which may improve some sleep-related outcomes in RLS 3
• Regular physical activity, which should be recommended for the treatment of RLS symptoms 4
• Oral iron supplementation, which should be considered for people with RLS who have low ferritin levels 4

Lifestyle Interventions

Lifestyle interventions that may be beneficial for RLS include:

• Pneumatic compression devices (PCDs) 4
• Light therapy 4
• Cognitive-behavioral therapy (CBT) 4

Mind-Body Interventions

Mind-body interventions that may be beneficial for RLS include:

• Yoga 4
• Acupuncture 4

Other Interventions

Other interventions that have been studied for RLS include:

• Deep brain stimulation (DBS) of the globus pallidus internus (GPi), which has been reported to improve RLS symptoms in some patients 5
• Neutraceuticals, such as vitamins and Chinese herbs, which may be beneficial for RLS but require further study 4