Restless Leg Syndrome

Do you have RLS?

Restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.

Diagnosis of Restless Legs Syndrome

There is no medical test to diagnose RLS; however, doctors may use blood tests and other exams to rule out other conditions. The diagnosis of RLS is based on a patient’s symptoms and answers to questions concerning family history of similar symptoms, medication use, the presence of other symptoms or medical conditions, or problems with daytime sleepiness.

Symptoms of Restless Legs Syndrome

People with restless legs syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The condition causes an uncomfortable, “itchy,” “pins and needles,” or “creepy crawly” feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting.
The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go and severity can also vary. The symptoms are generally worse in the evening and at night. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair their quality of life.

Who Gets Restless Legs Syndrome?

Restless legs syndrome may affect up to 10% of the U.S. population. It affects both sexes, but is more common in women and may begin at any age. Most people who are affected severely are middle-aged or older.
RLS is often unrecognized or misdiagnosed. This is especially true if the symptoms are intermittent or mild. Once correctly diagnosed, RLS can often be treated successfully.

Causes of Restless Legs Syndrome

In most cases, doctors do not know the cause of restless legs syndrome; however, they suspect that genes play a role. Nearly half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure, diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from RLS symptoms.
Medications. Some types of medications, including anti-nausea drugs, anti-psychotic drugs, some antidepressants, and cold and allergy medications containing sedating antihistamines, may worsen symptoms.
Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Treatment for Restless Legs Syndrome

The first line of defense against restless legs syndrome is to avoid substances or foods that may be causing or worsening the problem. Stay away from alcohol, caffeine, and nicotine. This may help relieve your symptoms. In addition, review all medications you are taking with your doctor to determine if any of these drugs could be causing the problem.
Any underlying medical conditions, such as anemia, diabetes, nutritional deficiencies, kidney disease, thyroid disease, varicose veins, or Parkinson’s disease, should be treated. Dietary supplements to correct vitamin or mineral deficiency may be recommended. For some people, these treatments are all that is needed to relieve RLS symptoms.
You may also benefit from physical therapy and self-care treatments, such as stretching, taking hot or cold baths, whirlpool baths, applying hot or cold packs to the affected area, limb massage, or vibratory or electrical stimulation of the feet and toes before bedtime. Exercise and relaxation techniques also may be helpful.

Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.
Drugs used to treat RLS include:
Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain. Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed.
Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
Narcotic pain relievers may be used for severe pain.
Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Neurontin, and Horizant.
Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.

Doctors don’t know the cause of RLS, and there’s no cure. But certain things can trigger symptoms. Knowing your triggers and how to avoid them will help.

Here are 12 steps you can take to lessen the symptoms of RLS and get you sleeping better:

Avoid or limit alcohol, caffeine, and nicotine for at least several hours before bedtime.
Review all the medications you take (prescription and non -prescription ) with your doctor.
Exercise every day.
Stretch your legs at the beginning and end of each day.
Massage your legs regularly.
Avoid eating a heavy meal close to bedtime.
Maintain a regular sleep schedule.
Avoid daytime naps.
Use your bed only for sleeping or sex.
Try not to use bedtime as worry time.
Have your blood tested for iron levels and kidney function.
Soak your legs in warm water.