At Living With RLS, our goal has always been to provide support and evidence-based guidance for those living with Restless Legs Syndrome — especially for those who feel overlooked or unheard. Today, we’re honoured to share insights from Professor Claudia Trenkwalder, a leading voice in the field of RLS research and treatment. Professor Trenkwalder is the former chair of the International RLS Study Group and a senior neurologist at the Paracelsus Elena-Klinik in Germany — a clinic known for its groundbreaking work with RLS patients. She kindly took the time to answer a few of our questions about misunderstood symptoms, treatment approaches, and what she hopes for the future of RLS care.
Interview with Professor Trenkwalder
Q: What is the most commonly overlooked or misunderstood aspect of RLS by patients or general practitioners?
One of the most overlooked aspects is augmentation, related to the dopaminergic system in RLS, and iron deficiency. Both of these factors must be taken seriously in the treatment of RLS, as they can lead to severe consequences if not properly managed.
Q: What treatment or management approach tends to be the most effective early intervention for newly diagnosed patients?
This cannot be answered generally, as there are many different forms and phenotypes of RLS. It’s important to consider the underlying reason symptoms have appeared now. Possible causes include psychiatric conditions, iron deficiency, pregnancy, hypoxia due to heart disease, recent surgery with blood/iron loss, pain, diabetes, or polyneuropathy.
Q: Are there any emerging treatments, therapies, or research directions that you feel hold promise for the future of RLS care?
Unfortunately, not at this time. I hope that advances in genetics will help uncover the underlying mechanisms of RLS, leading to better treatment options in the future.
Q: Do you believe lifestyle and non-pharmaceutical strategies (e.g. supplements, sleep hygiene, stress management) can play a meaningful role in managing symptoms?
Yes, these strategies may help in patients with mild symptoms, but once symptoms become severe, they are usually not sufficient on their own.
Q: What is one piece of advice or reassurance you would give to someone newly diagnosed with RLS and feeling overwhelmed?
Manage your overall health as best you can — avoid being overweight, do not smoke, limit alcohol, eat healthy, and stay physically active. Try to avoid surgeries if possible.
If you can manage your RLS without medication, do so for as long as possible. If you do require medication, take it only intermittently to reduce the risk of augmentation.
📘 Glossary – Terms in This Article
Dopaminergic
Relating to the brain chemical dopamine. Dopaminergic medications are often used to treat RLS, but can lead to complications like augmentation if not carefully managed.
Phenotypes
Different versions or forms of a condition. In RLS, symptoms can vary greatly between individuals — these variations are referred to as different phenotypes.
Polyneuropathy
Damage to multiple nerves, often in the hands and feet. It can cause numbness, tingling, or pain, and may overlap with RLS in some cases.
💙 Final Thoughts:
We are deeply grateful to Professor Trenkwalder for taking the time to share her knowledge and perspective with the Living With RLS community. Her insights underline how complex and personal RLS can be — and how important it is to approach treatment holistically, with care and patience.
If you’re newly diagnosed or still searching for answers, we hope her words bring clarity — and remind you that you’re not alone.
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