Fact sheet

Restless Legs

An urge to move your legs, often with crawling or aching, that’s worst at rest and at night and eases with movement. Common, often runs in families, and very treatable.

The restless legs ladder

Start with habits and a ferritin (iron stores) blood test. Many people never need to climb past iron.

  1. Step 1 · Self-careMove, stretch and cut the triggersWalking, stretching, massage or a warm bath when symptoms start. Less caffeine and alcohol, and enough sleep.
    Works
    Small trials only, but low risk and helps many with mild symptoms
    Cost
    Free
    How long
    Ongoing
    Watch for
    Medicines that trigger it: sedating antihistamines, some antidepressants and anti-nausea tablets. Ask your pharmacist

    Your evening espresso is not on your side.

  2. Step 2 · PharmacyIron tablets, if your iron is lowTreatment is suggested if ferritin is 75 or below: higher than the usual ‘normal’ cut-off.
    Works
    Helps when ferritin is low (iron trials: about 4 points better than a dummy treatment on a 40-point scale); slower than an infusion
    Cost
    About $10–20 a month
    How long
    3 months, then recheck your blood test
    Watch for
    Constipation, nausea, black poo. Take with vitamin C or on alternate days

    Don’t self-dose for years without a blood test. Too much iron is a problem too.

  3. Step 3 · PrescriptionIron infusionIron straight into a vein, given in a clinic.
    Works
    Symptom score about 4 points (out of 40) better than a dummy treatment; faster and more reliable than tablets
    Cost
    $25 for the iron on the PBS if eligible ($7.70 concession), plus a clinic fee of about $0–250
    How long
    One visit; effect builds over weeks and can last months
    Watch for
    Rarely, allergic reactions. Brown skin staining if it leaks. Low phosphate with some types

    Thirty minutes in a chair beats months of tablets for some people.

  4. Step 4 · PrescriptionGabapentin or pregabalinThe preferred medicines when symptoms are frequent, taken a few hours before they usually start.
    Works
    About 7 in 10 improve vs 5 in 10 on a dummy treatment
    Cost
    Private script for restless legs, about $15–40 a month
    How long
    Weeks to judge; often long term
    Watch for
    Drowsiness, dizziness, unsteadiness. Don’t drive until you know how they affect you

    Unlike the older dopamine tablets, these don’t make the problem worse over time.

  5. Step 5 · SpecialistLow-dose opioidFor severe restless legs that hasn’t responded to other treatment, with close supervision.
    Works
    In a large trial, symptom scores fell about 17 vs 10 points (out of 40) on a dummy treatment
    Cost
    Varies; PBS or private script
    How long
    Long term, with regular review
    Watch for
    Constipation, drowsiness, dependence. Never combine with alcohol or sedatives

    A last rung, not a shortcut.

Costs are rough Australian prices in October 2026 and vary by pharmacy and clinic. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials: your legs didn’t read them.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

What you can do

See your GP if

See a doctor promptly for leg weakness, numbness that doesn’t go away, or a hot, red, swollen calf. These are not typical of restless legs.

Common questions

What causes restless legs?

It often runs in families, and is common in pregnancy and with low iron, kidney disease or some medicines, such as sedating antihistamines and some antidepressants.

Does iron help restless legs?

Yes. People with restless legs benefit from higher iron levels than usual, so treatment is suggested if ferritin is 75 or below. An iron infusion works faster and more reliably than tablets.

Are ropinirole and pramipexole still used for restless legs?

They work well at first but often make symptoms worse over time (‘augmentation’), so a 2024 US guideline no longer advises them for standard use. Gabapentin or pregabalin are preferred. If you take one, don’t stop suddenly: talk to your GP.

What helps restless legs at night?

Walking, stretching, massage or a warm bath when symptoms start. Cutting back on caffeine and alcohol, and getting enough sleep, also help.

Is restless legs a sign of something serious?

Usually not, but it can be linked to iron deficiency, kidney disease, nerve damage (neuropathy) and pregnancy. Some medicines, such as sedating antihistamines, some antidepressants and anti-nausea drugs, can make it worse. Your GP can check bloods and review medicines.

Why do I get restless legs in pregnancy?

Restless legs affects about 1 in 5 pregnant women, especially in the third trimester, possibly due to low iron and hormone changes. It usually goes within weeks of the birth. Checking iron is a good first step.

Does magnesium help restless legs?

There’s no good evidence that magnesium helps restless legs in people who aren’t low in it. Correcting low iron, regular exercise, cutting back on caffeine and alcohol, and good sleep habits are better-proven first steps.

Helpful resources

Evidence and more information

Updated 28 October 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

Related

maladywise.com/restless-legs/