Restless Leg Syndrome (RLS) In Pregnancy: Symptoms, Causes And Treatment

Restless Leg Syndrome (RLS) In Pregnancy: Symptoms, Causes And Treatment

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Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a sleep disorder (1). It is a common sensory-motor neurological disorder described as an unpleasant creeping sensation in the lower limbs, leading to an irresistible urge to move the leg and relieve the sensation (2).

Restless legs syndrome is not uncommon in pregnancy, and 10 to 34% of all pregnant women experience restless legs syndrome (1). Read this post to learn more about the symptoms, causes, home remedies, and management of restless legs syndrome during pregnancy.

Is RLS Bad For Pregnancy?

While RLS can be uncomfortable and may hamper sleep, it does not cause any adverse effects on the fetus or the mother during pregnancy. (3) However, pregnant women with RLS may also experience periodic limb movements of sleep (PLMS), nocturnal leg cramps, and sleepiness during the day.

Some women may have insomnia due to RLS. Sleep duration and sleep quality could influence maternal mental health, the type of delivery, length of labor, the neonate’s APGAR scores, and birth weight.

In rare cases, women with RLS may be at a higher risk of developing pregnancy complications such as abortion, premature labor, difficult delivery, preeclampsia, and intrauterine growth retardation (1).

When Does RLS Start During Pregnancy?

Symptoms of RLS begin to appear in the third trimester. The symptoms mostly disappear after delivering the baby (2). For women who already experience RLS, pregnancy may worsen the condition (4).

Symptoms Of Restless Legs Syndrome

The primary complaint of women with RLS is the overwhelming urge to move the legs. Pregnant women may generally describe the unpleasant sensation in the legs as (3):

  • Tingling
  • Burning
  • Itching
  • Creeping or crawling, like ants moving up and down the legs
  • Feeling like fizzy water is flowing through the veins

These sensations are worse below the knee and may also be painful at times. Some women complain of the symptoms getting worse when they rest and feel better when they walk. The symptoms might worsen in the evening or at night. RLS may make it difficult for the affected woman to get a good night’s sleep.

Causes Of RLS

The exact cause of RLS in pregnant women is unknown. Hormonal changes might be responsible for causing RLS in pregnant women. The following factors may put one at a higher risk of developing RLS (1) (2) (3).

  • Iron-deficiency anemia; a common condition in pregnancy that may worsen RLS
  • Excess consumption of alcohol, caffeine, or chocolate
  • Neurological conditions such as Parkinson’s disease and multiple sclerosis
  • Circulatory changes
  • Rheumatoid arthritis
  • Diabetes
  • Hypothyroidism
  • High BMI
  • Decrease in dopamine levels
  • Psychological or mechanical factors
  • Strain on the lumbosacral nerve root due to the growing size of the fetus
  • Peptic ulcer disease before pregnancy
  • Vitamin D deficiency
  • Smoking
  • Genetic factors
  • High levels of estradiol, prolactin, and increased progesterone during pregnancy

The following medications may also lead to or worsen the symptoms of RLS.

  • Antidepressants
  • Antipsychotic drugs
  • Lithium
  • Antiepileptic drugs
  • Antihistamines
  • Dopamine receptor blocking agents such as metoclopramide and prochlorperazine
  • Beta-blockers

Treatment For RLS

Pharmacological management of RLS is usually avoided in pregnant women. The doctor may recommend the following measures for relief from RLS (3).

  • Regular mild exercises such as walking and stretching
  • Relaxation exercises
  • Elastic compression stockings
  • Heat pad application on legs
  • Distraction techniques such as reading or listening to music
  • Leg massages
  • Oral supplementation to help with iron deficiency
  • Cessation of smoking and alcohol consumption
  • Reduction or avoidance of caffeine intake

In case conservative approaches do not work, the doctor might prescribe the following medications, depending on the woman’s health, stage of pregnancy, severity of the symptoms, and presence of other problems (3).

  • Antiepileptics
  • Benzodiazepine
  • Dopaminergic
  • Opioids
  • Blood pressure medications
  • Anticonvulsants
  • Clonazepam
  • Clonidine

The doctor will prescribe medicines for the shortest possible duration and at the lowest dosage. Avoid taking any OTC drugs and contact your healthcare provider if you wish to have a medicine to reduce symptoms of RLS in pregnancy.

Things That Worsen RLS

The following substances and lifestyle choices may worsen RLS symptoms.

  • Caffeine
  • Smoking
  • Certain medicines such as antihistamines in cold and allergy remedies
  • Lying in bed for too long apart from when you sleep
  • Watching television or reading while lying in the bed

Restless leg syndrome in pregnancy can be tiring for the mother, but any adverse effects of RLS on the developing fetus are rare. Most cases of RLS are manageable with conservative treatment without the need for medication. If you wish to have medicine or the symptoms worsen, contact your healthcare provider for a prescription.


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  1. Restless legs syndrome and pregnancy: prevalence possible pathophysiological mechanisms and treatment.
  2. Prevalence of Restless Leg Syndrome in Pregnancy.
  3. What can I do about restless legs syndrome during pregnancy?.
  4. RLS in pregnancy.
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Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. Dr. Shah's deep interest in the well-being of babies and children... more