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Chinese Medicine Treatment for Restless Legs Syndrome (RLS)

According to Chinese Medicine theory, restless legs syndrome (RLS) is resulted from both internal weakness, and excess pathogenic disturbances. The internal weakness includes dysfunction of the liver and kidney, and insufficiency of blood and qi (vital energy); the excess pathogens can be wind, coldness, dampness, and
blood stasis etc. Middle-aged or elderly individuals are more likely to be due to internal weakness, while young individuals are likely to be due to excess pathogenic disturbances.

Since RLS symptoms vary from person to person, treatment based on
disharmony patterns can be an effective option for the individuals. Common disharmony patterns and the herbal prescriptions of RLS are:

astragalus root cassia twig liquorice root
astragalus root cassia twig liquorice root

Blood and qi deficiencies

Unpleasant sensations in the lower limbs such as soreness, distending, numbness, heaviness, weakness or aching that can be alleviated by patting and massage. The situation is more apparent at night. Individuals usually accompany with fatigue, limb coldness, general weakness, a sallow face, loose bowels, poor appetite, a pale tongue and a thready pulse.

The remedy should aim to replenish qi, nourish blood, calm spirit and unblock the collaterals of the legs. Sample prescriptions are:

Restore the Spleen Decoction
The Five Substances Decoction with Astragalus Root and Cassia twig
Honey Processed Liquorice Root Decoction plus sour jujube seed and costus root


Liver and kidney deficiencies

Unpleasant sensations in the lower limbs such as soreness, distending, numbness, heaviness or aching that need constant moving the legs to relieve the discomfort. The situation is more apparent at night or during rest. Individuals usually accompany with irritability, insomnia, night sweats, dizziness, ear ringing, a bitter taste in mouth, throat dryness, lumbar soreness, knee weakness, a red tongue, and taut and thready pulse.

The remedy should aim to nourish and reinforce liver and kidney, loosen tendons and arrest cramps in the legs. Sample prescriptions are:

Restore the Left (kidney) Pill
Six-ingredient Rehmannia Pill
True Warrior Decoction


Blood stasis blocking collaterals

Unpleasant sensations in the lower limbs such as numbness, heaviness and pain, that need constant moving the legs to relieve the discomfort. Individuals may also have abnormal limb movements, localized stabbing pain, insomnia, palpitations, rough and coarse skin, a darkened and pale tongue, and the pulse is deep and hesitant.

The remedy should aim to activate blood, resolve stasis and unblock the collaterals of the legs. Sample prescriptions are:

Peach Pit and Safflower with Four-Substance Decoction plus cathula root and earthworm
Removing Blood Stasis Decoction for Painful Body
Effective and Miraculous Pills for Activating Collaterals plus cathula root


Coldness and dampness blocking meridians

Unpleasant sensations in the lower limbs such as soreness, numbness, distending, heaviness or aching that create a strong urge to move the legs. The discomfort can be alleviated by kneading and rubbing the muscles of the lower legs. Individuals may also have cold and painful legs. The situation tends to be aggravated in rainy or cold weather, while feel relieved in hot days. The tongue is pale and covered by white coating, and the pulse is slow.

The remedy should aim to expel coldness and dampness, unblock meridians and ease pain in the legs. Sample prescriptions are:

Removing Painful Obstruction Decoction
Coix Seed Decoction plus poria and largehead atractylodes rhizome
Liquorice, Ginger, Poria and Atractylodes Decoction


Damp-heat accumulating in lower burner

Unpleasant sensations in the lower limbs such as soreness, distending, burning, or heaviness that create a strong urge to move the legs and can be temporary relieved by moving the legs. Individuals may also have leg swelling, irritability, insomnia, chest stuffiness, a bitter taste in mouth, no appetite, yellow and scanty urine, a red tongue with yellow and greasy coating, and rolling and rapid pulse.

The remedy should aim to clear heat, induce urination and unblock the meridians in the legs. Sample prescriptions are:

Three Kernels Decoction
Four-Wonder Pills plus fourstamen stephania root, honeysuckle stem, plantain seed, flowering quince fruit, peony root and liquorice root
Dispelling Painful Obstruction Decoction

coix seed cyathula root siegesbeckia herb
coix seed cyathula root siegesbeckia herb

During clinical applications, physicians adopt the above as primary formulae and will modify according to individual conditions. For example, they will add some other herbs or a higher dose of certain herbs to relieve particular disturbing symptoms.

Herbs used for calming the body and promoting sleep are:
ye jiao teng tuber fleeceflower stem Caulis Polygoni Multiflori
long gu fossil bone Os Draconis
yuan zhi Chinese senega Radix Polygalae
suan zao ren sour jujube seed Semen Ziziphi Spinosae
Herbs used for relieving muscle spasm and pain in the limbs are:
mu gua flowering quince fruit Fructus Chaenomelis
bai shao white peony root Radix Paeoniae Alba
gan cao liquorice root Radix Glycyrrhizae
shen jin cao common clubmoss herb Herba Lycopodii
Herbs used for relieving limbs coldness are:
gui zhi cassia twig Ramulus Cinnamomi
zhi fu zi prepared aconite root Radix Aconiti Praeparata
xi xin Manchurian wildginger Herba Asari
tu si zi dodder seed Semen Cuscutae
Herbs used for numbness in the limbs are:
hai tong pi erythrina bark Cortex Erythrinae
xi xian cao Siegesbackia herb Herba Siegesbackiae
Herbs used for burning sensation in the limbs are:
mu dan pi peony root bark Crotex Moutan
huang bai amur corktree bark Cortex Phellodendri
Herbs used for dryness and weakness in the limbs are:
nu zhen zi glossy privet fruit Fructus Ligustri Lucidi
ma han lian yerbadetajo herb Herba ecliptae
ji xue teng suberect spatholobus stem Caulis Spatholobi