Restless legs syndrome (RLS) is a disorder of the nervous system, causing the urge to move the legs. This often occurs during the night hours and interferes with sleep. RLS affects around 10 percent of the adult population, with as many as three percent of people describing symptoms that affect their quality of life. RLS affects both sexes, but occurs more often in women. It can begin at any age, but more commonly affects middle-aged and older adults.
Symptoms of Restless Legs Syndrome
People who have RLS often report uncomfortable sensations in the legs and an irresistible urge to move the lower extremities. Symptoms are described as itchy, uncomfortable, "pins and needles," and "creepy crawly" leg sensations. The symptoms are reported as being worse while lying or sitting. The severity of these symptoms varies from person to person. Some individuals describe them as mild, while others report intolerable symptoms.
Some people with RLS describe the condition as a muscle cramp or leg numbness. Common reported patterns include:
Onset during inactivity – The sensation usually begins after lying down or sitting for an extended period of time, such as in a movie theater or on a plane.
Relief by movement – The RLS symptoms resolve when the person sits or stands or from stretching, pacing the floor, or jiggling the legs.
Worsening of symptoms in the evening – The RLS symptoms usually are worse of the evening or night hours.
Nighttime leg twitching – The RLS is associated with periodic limb movement disorder (PLMD), which causes involuntary flexion and extension of the legs while sleeping.
Causes of Restless Legs Syndrome
RLS has no known cause or causes. However, scientists suspect that genes are a factor, as well as:
Chronic conditions – Certain chronic disease appear to increase the risk of developing RLS. These include Parkinson's disease, chronic kidney failure, iron deficiency anemia, peripheral neuropathy, and diabetes.
Certain medications – These include cold and allergy medications, anti-nausea drugs, antipsychotic agents, and antidepressants.
Pregnancy – During pregnancy, many women report RLS, especially during the last trimester. This is thought to be due to hormonal changes that occur during pregnancy.
Sleep deprivation – Lack of a good night's sleep.
Alcohol use – Excessive alcohol consumption causes RLS.
Heredity – RLS often runs in families, and researchers have identified genetic markers for RLS.
Peripheral neuropathy – Damage to the nerves of the feet from chronic diseases can cause RLS.
Iron deficiency – Having a low iron level can cause or worsen RLS. This occurs in people with a history of bleeding ulcers, women with heavy menstrual periods, and those who frequently donate blood.
Kidney failure – People who have chronic kidney failure often have low iron stores and alterations in potassium levels in the bloodstream.
Diagnosis
To diagnose RLS, the doctor will take a medical history, ask about your family diseases, and do a physical examination. There is no diagnostic test used to diagnose RLS, but the doctor may do certain blood tests and scans to rule out other conditions. These include:
Blood tests – Includes anemia, iron, potassium, and other chemistry studies.
Nerve studies – Done to assess for nerve damage in the lower extremities.
Sleep study – Involves staying overnight in a sleep clinic so doctors can evaluate your leg movements during sleep.
Treatment of Restless Legs Syndrome
Treatment of RLS is aimed at alleviating symptoms, improving sleep habits, and enhancing quality of life.
Therapies
Lifestyle modifications (avoid alcohol, tobacco, and caffeine)
Begin a regular exercise program
Establish a sleep routine
Change medications if necessary
Leg massages
Hot baths and heating pads
Ice packs to the legs
Medications
Dopaminergic drugs – Includes Mirapex and Requip, which act on the brain neurotransmitter dopamine.
Benzodiazepines – Used to help with sleep, such as Xanax or Valium.
Anticonvulsants – Includes Tegretol, Neurotin, and Lyrica.
Pain relievers – Analgesics such as Ultram or narcotics.