Restless Legs Syndrome

Restless Legs Syndrome (RLS) is a neurologic disorder characterized by unpleasant sensations in the legs and an irresistible urge to move them. The sensations are strongest at night. For this reason, people with RLS generally have insomnia, which may be severe.

Causes

The exact cause of RLS is unknown. RLS may occur for no identifiable reason (primary RLS), or may be caused by other medical conditions or use of certain drugs (secondary RLS). Many people with RLS also have periodic limb movement disorder (PLMD). This is a related motor disorder characterized by involuntary, repetitive, jerking movements that interrupt sleep.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Family members with RLS
  • Pregnancy: some women have RLS during pregnancy; the symptoms usually disappear after birth
  • Low iron levels with or without anemia
  • Chronic diseases, such as:
    • Peripheral neuropathy, a complication of diabetes
    • Chronic kidney failure
  • Certain medications

Symptoms

Symptoms may include:
  • Feelings of tingling, creeping, pulling, prickling, "pins and needles", or pain, usually in the legs
  • A strong urge to relieve these uncomfortable feelings with movement
  • Restlessness, including floor pacing, tossing and turning in bed, and rubbing the legs
  • Difficulty falling asleep and staying asleep
Symptoms may begin at any age, but are most common in older people. Symptoms usually increase in the evening, and during times of rest, relaxation, or inactivity.

Diagnosis

The doctor will ask about your symptoms and medical history, and do a physical and neurologic exam. The diagnosis is based mainly on your symptoms. There is no specific test for RLS, but tests to check for conditions that may trigger RLS include:
  • Blood tests to check iron levels
  • Monitoring of leg activity during sleep

Treatment

There is no cure for this condition. Treatments are aimed at relieving or reducing symptoms.
Treatment for Mild Cases of RLS
Self Care:
  • Massage your legs.
  • Use a heating pad or ice pack.
  • Take a hot bath.
  • Take supplements of vitamins B, C, E, folate, or magnesium.
  • Refrain from using tobacco, alcohol, or caffeine.
  • Follow a consistent sleep routine.
  • Develop a regular, moderate exercise program.
  • Avoid the use of medications that may worsen RLS, such as antidepressants.
Treatment of Conditions that May Trigger RLS
Effective treatment of conditions that may trigger RLS can ease or even eliminate symptoms:
  • Anemia
  • Diabetes
  • Neuropathy
  • Kidney failure
Treatment for Severe Cases of RLS
Medication:
  • Benzodiazepines
  • Dopaminergic agents
  • Opiods
  • Anticonvulsants
Transcutaneous Electric Nerve Stimulation
This is the application of electric stimulation to the affected area of the leg. This treatment is usually done 15-30 minutes before bedtime to help reduce leg jerking.

Prevention

There are no guidelines for preventing RLS.