Restless legs syndrome during pregnancy?

Some people get restless legs syndrome in pregnancy, usually in the 3rd trimester. This can be uncomfortable. It can’t be treated with medication, but there are some things you can do to try to ease the symptoms.

What is restless legs syndrome?

Restless legs syndrome, also known as Willis-Ekbom disease, is a common condition of the nervous system. It causes an overwhelming urge to move your legs.

What are the symptoms of restless legs syndrome?

The main symptom is the overwhelming urge to move your legs. But you may also have unpleasant feelings in your legs. Some people describe these feelings as:

  • tingling
  • burning
  • itching
  • 'crawling’, like ants moving up and down the legs
  • like fizzy water in the veins

These feelings are often worse just below the knee, but you may also feel it in your thighs, feet and arms. Symptoms of restless legs syndrome can range from mild to severe and may sometimes even be painful. 

Some people have symptoms of restless legs syndrome every day, whereas others only have them sometimes.

Your symptoms may be worse when you’re resting, such as in the evening or at night, or if you have been sitting down for a long time. Your symptoms may also feel better when you start to move about again.

Restless legs syndrome should not affect your health or pregnancy. However, the symptoms can sometimes make it harder to get a good night’s sleep. A lack of sleep will not hurt your baby, but it can make your life harder. We have some tips that may help you sleep better.

Restless legs syndrome caused by pregnancy usually occurs during the third trimester (the last 3 months of pregnancy). 

How is restless legs syndrome diagnosed?

There isn’t a test that can confirm whether you have restless legs syndrome. Instead, your doctor or midwife will talk to you about your symptoms and medical history.

What causes restless legs syndrome?

Sometimes the cause for restless legs syndrome is not known. These cases are known as idiopathic.

Pregnancy

It can be brought on by pregnancy in people who have never had it before. About 1 in 5 pregnant women and birthing people develop restless legs syndrome, most often in the 3rd trimester. This might be caused by a change in hormones.

Iron-deficiency anaemia

Anaemia (a blood condition) can sometimes cause restless leg syndrome. Iron-deficiency anaemia can be common in pregnancy.  

You’ll be checked for anaemia as part of your routine antenatal care, but you can have a test at any time during your pregnancy if there are any concerns.

If you have anaemia, you’ll probably be prescribed iron supplements as tablets or as a liquid to take daily. Eating a healthy balanced diet will also help you get the iron you need, to either prevent anaemia, or manage your symptoms if you have it.

Medications linked to restless legs

Some medications may cause restless legs syndrome or make it worse:

  • antidepressants
  • some antipsychotics and lithium
  • some antiepileptic drugs
  • antihistamines
  • dopamine receptor blocking agents such as metoclopramide and prochlorperazine
  • beta-blockers.

But you should not stop taking any medications without speaking to your doctor first.

Diet and restless legs

Some people think that drinking too much alcohol or caffeine, or eating too much chocolate, can cause restless legs syndrome. This has not yet been proved to be true. 

We do know for certain that drinking alcohol while pregnant can be harmful. The more you drink, the greater the risk. There is no known safe level for drinking during pregnancy, so the safest approach is not to drink at all while you're pregnant.

Caffeine is found in coffee, tea, some soft drinks, energy drinks and chocolate.

Drinking a lot of caffeine in pregnancy has also been linked to miscarriage and low birth weight, so the advice is to limit your intake to 200mg a day at most.

You can check your caffeine intake with our pregnancy caffeine calculator.

What is the treatment for restless legs syndrome during pregnancy?

Medication for restless legs syndrome isn’t generally recommended during pregnancy or while you are breastfeeding. But there are other things you can try. You may not be able to stop the symptoms, but you may be able to reduce them.

As well as reducing your caffeine intake and not drinking alcohol, you can try:

  • getting into good sleep habits (such as a having a night-time routine and sleeping regular hours)
  • stopping smoking (this can also reduce the risk of serious pregnancy complications)
  • doing moderate exercise (such as swimming)
  • walking and stretching your legs
  • relaxation 
  • using heat pads on the legs, or having a warm bath
  • distraction techniques, such as reading
  • giving your legs a massage

If doctors think your restless legs syndrome might be caused by iron-deficiency anaemia, they may recommend you start taking iron supplements. These may help improve symptoms of anaemia and restless legs syndrome, but you should always talk to your healthcare team before taking any supplements whilst pregnant.

Will restless legs syndrome go away after I give birth?

Yes. If your symptoms are caused by pregnancy, it’s likely that they will go away soon after giving birth.

Some people who have restless legs syndrome during pregnancy have an increased risk of having it again in later life.

Other conditions with similar symptoms to restless legs syndrome

Some other health conditions may be confused with restless legs syndrome because they have the same sorts of symptoms. If you have symptoms of restless legs syndrome, your healthcare team will need to rule out some of these other conditions. 

Blood clots

The symptoms of restless leg syndrome can sometimes be confused with the symptoms of blood clots (deep vein thrombosis).

Deep vein thrombosis (DVT) can happen for no clear reason. It is not common for pregnant people to develop DVT, but you are more at risk during pregnancy and just after having your baby, compared to people of the same age who are not pregnant.

Call 111 or arrange an urgent call with your GP if you have these symptoms in your leg:

  • throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
  • swelling in 1 leg (rarely both legs)
  • warm skin around the painful area
  • red or darkened skin around the painful area
  • swollen veins that are hard, or sore to touch

These symptoms also happen in your arm or tummy if that's where the blood clot is.

Your risk of having DVT during pregnancy is even greater if you:

Call 999 or go to your nearest A&E if you have any symptoms of DVT with chest pain or you also feel breathless. This may mean that the DVT has travelled to your lungs, which can be life threatening.

If you do get DVT while pregnant, you will likely need some jabs of medicine called heparin, to stop the blood clot getting bigger and to help your body dissolve it.

Staying as active as you can during pregnancy can help reduce the risk of a DVT.

Meralgia paraesthetica

Another condition that can cause uncomfortable or painful feelings in the leg is meralgia paraesthetica.

This is a common problem caused by a trapped nerve in the thigh. The most common cause for this is recent weight gain, or pregnancy.

This causes a painful patch of burning, numbness or pins and needles on the outer side of the thigh (although the affected area can vary from person to person).

This should get better after pregnancy but talk to your GP or midwife if you have this kind of pain. 

1. NHS Choices. Restless legs syndrome https://www.nhs.uk/conditions/restless-legs-syndrome/ (Page last reviewed 23/03/2022 Next review due 23/03/2025)

2. Clinical Knowledge Summaries. Restless leg syndrome https://cks.nice.org.uk/restless-legs-syndrome (Page last reviewed July 2022)

3. NHS Choices. Iron deficiency anaemia https://www.nhs.uk/conditions/iron-deficiency-anaemia/ (Page last reviewed 19/01/2021 Next review due 19/01/2024)

4. Royal College of Obstetricians & Gynaecologists (2015) Alcohol in pregnancy https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-alcohol-and-pregnancy.pdf

5. NHS Choices. Foods to avoid in pregnancy. https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/ (Page last reviewed 19/05/2023 Next review due 19/05/2026)

6. Royal College of Obstetricians & Gynaecologists (2015) Reducing the risk of venous thrombosis in pregnancy and after birth patient information leaflet https://www.rcog.org.uk/for-the-public/browse-our-patient-information/treatment-of-venous-thrombosis-in-pregnancy-and-after-birth-patient-information-leaflet/

7. NHS Choices. Deep vein thrombosis (DVT) https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/ (Page last reviewed 22/03/2023 Next review due 22/03/2026)

8. Patient. Meralgia Paraesthetica https://patient.info/doctor/meralgia-paraesthetica-pro (Page last reviewed 21/09/2022 Next review due 20/09/2027

Review dates
Reviewed: 22 January 2024
Next review: 22 January 2027