RLS Treatment: What Actually Works When Your Legs Won’t Stop Moving

When your legs feel like they’re crawling, tingling, or begging you to move—especially at night—you’re not just restless. You might have restless legs syndrome, a neurological disorder that triggers an irresistible urge to move the legs, often worsening during rest and at night. Also known as Willis-Ekbom disease, it’s not just discomfort—it’s a sleep killer that affects up to 10% of adults. Many people try stretching, warm baths, or caffeine cuts, but those rarely fix the root cause. Real RLS treatment starts with understanding what’s driving it: often low iron in the brain, not just low iron in the blood.

That’s why checking your ferritin levels matters more than you think. If your ferritin is below 50 mcg/L, even if your blood iron looks normal, you could still have brain iron deficiency. Iron supplements like ferrous sulfate, taken with vitamin C on an empty stomach, can cut symptoms in half for many people. But if iron doesn’t help, the next step is usually dopamine-targeting meds. Drugs like ropinirole and pramipexole are FDA-approved for RLS because they mimic dopamine, the brain chemical that’s out of balance in this condition. But here’s the catch: these meds can make symptoms worse over time if used daily. That’s called augmentation, and it’s why doctors now recommend using them only on bad nights, not every day.

Other options exist, but they’re not always talked about. Gabapentin and pregabalin, originally for seizures and nerve pain, work surprisingly well for RLS and don’t cause augmentation. They’re becoming first-line choices for many patients, especially those over 65. And if you’re on antidepressants like SSRIs? Those can make RLS way worse. Switching meds might be the simplest fix you haven’t tried. Lifestyle changes help too—cutting alcohol, quitting smoking, and avoiding heavy meals before bed. But none of this works if you’re missing the real trigger: iron or dopamine.

What you’ll find below isn’t just a list of drugs. It’s a collection of real-world insights from people who’ve been through the trial-and-error grind of RLS treatment. From how to read your lab results to why some supplements backfire, these posts give you the unfiltered details most doctors don’t have time to explain. No fluff. No hype. Just what actually helps—and what wastes your time.