Restless Legs Syndrome
Restless legs syndrome (RLS) is a neurologic disorder. It is characterized by:
- Unpleasant sensations in the legs
- An irresistible urge to move your legs
The sensations are typically worse during periods of inactivity and usually strongest at night. The symptoms are improved with activity. For this reason, people with RLS generally have insomnia]]> , which may be severe.
Restless Legs Syndrome
The exact cause is unknown. RLS may occur for no identifiable reason. This is called primary RLS. Or, it may be caused by other conditions or certain drugs. This is called 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
- Interrupted sleep because of movement
These factors increase your chance of developing RLS. Tell your doctor if you have any of these risk factors:
- Family members with RLS
- Pregnant—Some women have RLS during pregnancy. The symptoms usually go away after giving birth.
- Low iron levels (with or without anemia]]> )—may happen if you give blood a lot.
- Northern European descent
- Chronic disease (which can lead to secondary RLS):
- Certain medications (eg, tricyclic antidepressants)
- Withdrawing from certain drugs (eg, selective serotonin reuptake inhibitors [SSRIs], lithium, caffeine, dopamine antagonists, sedating antihistamines)
Symptoms may include:
- Feelings of tingling, creeping, pulling, prickling, "pins and needles," or pain in the legs during periods of rest or inactivity—may also be this feeling in the arms.
- Symptoms typically get worse at night
- 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
- Hypersomnia—recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep
Symptoms may begin at any age. But, they are most common in people older than 60 years old. Symptoms usually increase in the evening and during times of rest, relaxation, or inactivity.
The doctor will ask about your symptoms and medical history. She will also 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 and the functioning of the kidneys
- Monitoring of leg activity during sleep ("sleep study", polysomnogram [PSG])
- Study of leg muscles, such as electromyography (EMG)]]> and ]]>nerve conduction studies]]>
Nerves of the Leg
There is no cure for RLS. Treatments are aimed at relieving or reducing symptoms.
Treatment for Mild Cases of RLS
- Massage your legs.
- Use a heating pad or ice pack.
- Take a hot bath.
- Talk to your doctor about taking supplements that might be helpful, such as:
- Refrain from using tobacco, alcohol, or caffeine.
- Follow a sleep routine.
- Begin a safe ]]>exercise program]]> with the advice of your doctor.
- Avoid the use of medications that may worsen RLS.
Treatment for Conditions That May Trigger RLS
Effective treatment of conditions that may trigger RLS can ease or even eliminate symptoms:
Treatment for Severe Cases of RLS
Transcutaneous Electric Nerve Stimulation
During this treatment, electric stimulation is done to the affected area of the leg. This is usually done 15-30 minutes before bedtime to help reduce leg jerking.
National Sleep Foundation
Restless Legs Syndrome Foundation
Canadian Sleep Society
Bradley WG, Daroff RB. Neurology in Clinical Practice . Philadelphia, PA: Butterworth Heiemann; 2004.
Cui Y, Wang Y, Liu Z. Accupuncture for restless legs syndrome. Cochrane Database of Systematic Reviews. 2008;CD006457.
Current Medical Diagnosis and Treatment . 45th ed. McGraw-Hill; 2006.
National Sleep Foundation website. Available at: http://www.sleepfoundation.org .
Restless legs syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed May 27, 2008.
Restless Legs Syndrome Foundation website. Available at: http://www.rls.org/ .
Shannon, Kathleen. Restless Legs Syndrome In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corp. MedLink website. Available at: http://www.medlink.com . Accessed May 12, 2008.
Worldwide Education and Awareness for Movement Disorders website. Available at: http://www.wemove.org/ .
Last reviewed January 2010 by ]]>Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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