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In diagnosing restless legs syndrome (RLS), a physician will typically first review the patient’s medical history and perform a physical examination. The physician will pay particular attention to the health of the nerves in the spinal cord and legs and arms, as well as blood flow to the legs and arms.

The physician will likely ask patients about the history of their symptoms, including when they first occurred and the exact nature of the restlessness. Patients may be asked about their sleeping habits and how rested they feel during the day. The physician may ask about medications and consumption levels of caffeine, tobacco, alcohol and other substances. Sleeping partners may also be questioned.

At present, there is no test available to definitively diagnose RLS. Usually a physician will try to rule out other causes before diagnosing RLS. Blood tests and urine tests may be performed to rule out medical conditions that may be responsible for a patient’s symptoms. These lab tests also may be used to help reveal the presence of certain illnesses known to cause RLS, including diabetes, kidney disease and vitamin or mineral deficiencies.

Electromyography and nerve conduction studies may be ordered to measure electrical activity in muscles and nerves. A Doppler sonography (an ultrasound that also measures blood flow) may also be used to evaluate muscle activity in the legs.  A polysomnographic recording may be ordered to document periodic movement during sleep.

Typically, RLS is diagnosed when all other conditions are ruled out and certain criteria are met. Patients with RLS usually feel the urge to move their legs or hands because of unpleasant sensations in their limbs. Symptoms worsen during periods of rest or inactivity and are at least temporarily relieved by movement, including walking or stretching. The urge to move the limbs is worse in the evening or at night, as patients are trying to get to sleep or during the early stages of sleep.