What is Restless Leg Syndrome?
Having trouble controlling your leg movement?
You might have restless leg syndrome. This article breaks down everything you need to know, including what it is, symptoms, causes, & more.
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Restless leg syndrome (RLS) is a medical condition that causes the uncontrollable urge to move one’s legs.
The condition can affect the calf area, thighs, or feet; sometimes, it can even be felt in the arms.
RLS is also called Willis-Ekbom disease and can begin at any age and usually gets worse over time. This condition can interfere with daily activities because of the sleep disruption and deprivation it causes.
These compulsions toward leg movement are usually caused by uncomfortable sensations and are often experienced in the evening or at night when sitting or lying down.
Let’s examine the common symptoms sufferers experience and some of the causal factors. Then we can review how this disease is diagnosed and some treatments for restless leg syndrome.
Symptoms
The symptoms of RLS can range from being barely noticeable to incapacitating for sufferers. The primary symptom is an urge to move the legs.
Sensations Beginning While Resting
Sensations precipitating leg movement typically start after a person has been lying down or sitting for a long time.
The sensations from restless legs do not have to begin while asleep in bed, and they can occur after riding in a car, traveling on airplanes, or sitting to watch a movie.
Most people with this disease feel sensations within the limb rather than on the skin. People may describe the feelings differently - crawling, creeping, pulling, searing, throbbing, aching, itching, tingling, bubbling, or shocking.
RLS patients don't often compare their medical condition to cramps or numbness. But, the standard description does describe the urge to move one's legs.
Symptoms can change intensity over time or even disappear and reappear later.
Relief with Movement
The sensations that sufferers experience lessen with movement. Resisting the urge to move the legs can lead to tension build-up until the leg jerks uncontrollably.
Nighttime Leg Twitching
Periodic limb movement disorder (PLMD) often accompanies RLS. As many as 80% of RLS sufferers also have an intermittent limb movement disorder.
With PLMD, the leg muscles jerk or contract every 30 seconds or so during sleep. Movements can last 1-10 seconds.
PLMD and RLS differ because PLMD leg contractions do not wake the person. However, the movements may disturb partners.
Causes
While the root cause of restless leg syndrome is unknown, many factors may make a person more susceptible.
Some researchers believe that nervous system problems, such as reduced levels of the brain chemical dopamine, may give rise to the disorder.
Consider a few linking factors that could lead to a person developing RLS.
Genetics
Early-onset RLS, occurring in the teen years or earlier, tends to affect people with a family history of the disease.
This type of RLS usually happens without pain and is more commonly found in women than men.
Iron Deficiency
Iron deficiency has been observed in some people with RLS; this lack of iron may be too mild even to cause anemia.
Researchers suggest that RLS may develop because a person isn’t getting iron into cells that regulate dopamine.
Pregnancy
About 20% of women who do pregnant report having restless leg syndrome. The disorder usually diminishes within a month of delivery.
Iron and folate deficiency may be linked to the onset of RLS in pregnant women.
Magnesium Deficiency
Researchers believe that magnesium allows muscles to relax more easily. It is often used as a natural remedy for leg cramps.
It contains calcium-blocking abilities, which may help regulate nerve and muscle function. When magnesium is low, calcium isn't blocked, and nerves become overactive and trigger muscles to contract.
Chronic Diseases
RLS symptoms and treatments strongly overlap with attention deficit hyperactivity disorder (ADHD).
Up to one-quarter of children with ADHD may also suffer from RLS. Some evidence suggests that both conditions may be due to dopamine regulation.
Medications
Some drugs may provoke restless leg syndrome. These include:
- Antidepressants
- Antipsychotics
- Anti-nausea drugs
- Calcium channel blockers
- Metoclopramide
- Antihistamines
- Oral decongestants
- Diuretics
- Asthma medications
- Spinal anesthesia
In some cases, RLS may disappear after discontinuing the contributing medication.
Fibromyalgia
Fibromyalgia is often associated with RLS, but the relationship is not clear. A person may have common factors that serve as causation for both.
Anxiety
Anxiety can cause restlessness and agitation during the night. These symptoms strongly resemble RLS.
LifeStyle Factors
Environment and dietary factors can trigger or worsen RLS. This includes smoking and alcohol abuse.
Excessive caffeine intake, especially coffee drinking, has been linked to periodic limb movement disorder.
Lack of exercise, stress, and fatigue may also be factors. Additionally, prolonged exposure to colds can worsen symptoms.
Diagnosis
Let’s examine the diagnosis process for restless leg syndrome. As we will see, the journey of diagnosis and treatment may be extended and convoluted, but it can result in improvement for patients.
The Long-Term Outlook for Restless Leg Treatment
Restless leg syndrome itself isn’t directly connected to the onset of other medical conditions. Many people find that RLS makes it difficult to fall or stay asleep.
This can disrupt regular sleep patterns, resulting in other medical problems. Insomnia can lead to severe drowsiness.
Depression is a high-risk factor for extreme cases as sufferers may feel their life is impaired by this condition.
Likelihood Of Improvement with Treatment
RLS is usually a life-long condition. While there is no cure for restless leg syndrome, treatments are available to ease symptoms.
Doctors may try various treatments before finding a solution that provides maximum benefits to a sufferer.
Process Of Diagnosis and Treatment by Doctors
Diagnosis relies mainly on a person's description of their symptoms. A person's sleep history is studied through a questionnaire to determine the extent of their symptoms.
Doctors suggest keeping a sleep diary for two weeks in which the patient records all sleep-related issues.
An overnight study at a sleep center may reveal whether a patient’s issues are due to RLS or another disorder like sleep apnea.
Treatment
Treatments generally focus on improving sleep and removing the root causes of RLS in a patient.
Lifestyle Changes
If the cause of RLS is unknown, a non-drug approach is an excellent first step. A doctor may suggest the following lifestyle changes to try to improve symptoms:
- Hot baths or cold compresses
- Smoking cessation
- More daily exercise
- Calf stretching before bedtime
- Sleep pattern modification
- Caffeine and alcohol avoidance
- Foot wrapping
- Acupuncture or massage
Medication
Treatment may include over-the-counter medications such as iron supplements where iron deficiency has been identified. The US Food and Drug Administration (FDA) has identified a few drugs as approved to treat RLS:
- Ropinirole
- Pramipexole
- Rotigotine
- Gabapentin enacarbil
These and other drugs used off-label fall into various classes: dopaminergic agonists, hypnotics, opioids, nonopioids, antiepileptics, and antidepressants.
Long-term use of dopaminergic agonists may result in reduced effectiveness or worsening symptoms.
Medication treatment should always be supervised by a trained healthcare professional who can find solutions that best fit a patient's symptoms and severity.
Complementary Therapies
The FDA has approved the use of vibratory counter-stimulation devices for the treatment of restless leg syndrome.
The patient wears these electric devices at night, delivering vibrations through the skin to improve sleep quality.
Deep brain stimulation (DBS) is being studied as a treatment for RLS. It is invasive and requires surgery to place wire electrodes in the brain, and it is only used after many other treatments have failed.
Cannabis has been shown to relieve symptoms in some people. Local laws may prevent access for some.
Prevention
Some things can help a person avoid RLS. Consider these general steps to prevent the onset of restless leg syndrome.
Healthy Diet
A healthy diet that naturally keeps the body’s nutrient levels of iron, magnesium, and folic acid balanced can help prevent conditions like restless leg syndrome.
Regular Exercise
Exercise early in the day may improve night symptoms of RLS. Brisk walking for 30 minutes 4 times a week may improve symptoms after a few months.
However, exercise in the evening (1 to 2 hours before sleep) may worsen restless legs.
Avoid Caffiene or Alcohol
Because caffeine and alcohol consumption have been linked to RLS, avoidance may prevent this disorder in some instances.
Related Resources
About the Author
Brandon Landgraf is the Digital Marketing Manager for Carex Health Brands. He finds passion and fulfillment in creating content that enhances, improves, and enlivens others' quality of life. All of his written work is formulated to not only offer essential advice and tips but back it with proven studies and experts. His mission is to connect with readers and provide steps to make their lives better.
You can connect with him on LinkedIn here.
About Carex Health Brands
Carex is your one-stop shop for home medical equipment and for products that assist caregivers with providing the best possible support and care for their loved ones. Carex Health Brands has been the branded leader in in-home, self-care medical products for over 35 years. Our goal is to improve the lives of our customers by bring them quality products that bring dignity back to their lives. With our three nationally distributed brands, Carex Health Brands serves national, regional and independent food, drug and mass retailers along with wholesalers, distributors and medical dealers.