Restless Legs Syndrome (RLS)

Overview of Restless Legs Syndrome (RLS)

Restless legs syndrome is a neurological condition that creates an irresistible urge to move your legs in order to relieve the uncomfortable sensation.

Restless legs syndrome (RLS) is a neurological condition, which produces an unpleasant feeling in the legs and creates an irresistible urge to move your legs in order to relieve that uncomfortable sensation.
Restless leg syndrome sensations are like creeping, burning, or crawling insects inside the legs. Moving legs from a rest position eases the unpleasant sensation temporarily.
The sensation usually occurs at night or in the evening when the legs are at rest and may disrupt sleep. Sensation happens mostly in the calf but can occur at any point from the thigh to the ankle.

Occurrence

It happens with 1 in 10 people at some stage during their lifetime. The disease is more common in females than males. The majority of the cases get recovered on their own with time.
Restless legs syndrome can be mild or severe depending on the severity of symptoms and how much unpleasant sensation it can produce.

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Signs and Symptoms of Restless Legs Syndrome (RLS)

RLS symptoms are described as unpleasant sensations in one or both legs. The main symptom is an urge to move the legs accompanied by other characteristics;

  • Night time twitching – causes the legs to kick and twitch while sleeping, known as periodic limb movement of sleep.
  • Sensations that occur within the limb include;
  • Crawling
  • Throbbing
  • Creeping
  • Aching
  • Itching
  • Electric
  • Pulling

People find difficulty in explaining the RLS condition and often describe it as numbness or muscle cramps in the legs. At times, symptoms disappear and then come back after some time. Symptoms may change with severity.

Types of Restless Legs Syndrome (RLS)

There are two types of RLS based on their cause;

  • Primary RLS

Primary RLS is also known as familial RLS type. It is due to RLS family history, meaning you may have a genetic component of RLS. Primary RLS is the most common RLS type.

  • Secondary RLS

 

It occurs due to other underlying medical causes or by the use of certain medicines. Medical conditions include; kidney failure, iron deficiency, varicose veins, peripheral neuropathy, stress, and environmental factors.

 

Causes of Restless Legs Syndrome (RLS)

The exact cause of restless leg syndrome is not known. However, research showed that it may occur due to an imbalanced level of dopamine, a chemical in the brain that sends messages to control the movement of muscles.

  • Heredity

If the RLS condition occurs before 40 years of age, then you have a family history of RLS. It is believed that some genes of RLS may pass to offspring.

  • Pregnancy

Some women experience RLS during pregnancy which disappears after delivery. Hormonal changes during pregnancy may increase the RLS signs and symptoms temporarily.

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Risk Factors of Restless Legs Syndrome (RLS)

Risk factors for RLS include:

 

  • Women are at high risk than males
  • Middle age people
  • Some medicines may trigger RLS i.e. anti-nausea, antihistamines, antipsychotics, and antidepressants.
  • RLS may stimulate by other underlying medical conditions or sometimes accompany them, they include;
  • Peripheral neuropathy: nerve damage in hands and feet due to alcoholism or diabetes
  • Kidney failure: kidney failure leads to iron deficiency that in turn worsens the RLS symptoms.
  • Iron deficiency: iron deficiency due to heavy menses or blood loss for some reason can promote the RLS condition.
  • Spinal cord injury: lesions on the spinal cord due to injury produce the RLS sensations.

 

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Prevention

Although the exact cause of RLS is unknown, there are several ways to manage the symptoms and prevent them from interfering with your sleep and daily activities. Here are some tips that may help prevent or reduce the severity of restless legs syndrome:

  • Follow a regular sleep schedule: Try to go to bed and wake up at the same time every day, even on weekends. Getting enough sleep and establishing a consistent sleep routine can help reduce the symptoms of RLS.
  • Avoid caffeine, alcohol, and tobacco: These substances can worsen the symptoms of RLS, so it's best to avoid them or reduce your intake.
  • Exercise regularly: Regular physical activity, especially aerobic exercise, can help reduce the symptoms of RLS. However, avoid exercising too close to bedtime, as this can make it harder to fall asleep.
  • Practice relaxation techniques: Techniques such as yoga, meditation, or deep breathing can help reduce stress and promote relaxation, which can help alleviate the symptoms of RLS.
  • Take iron supplements: If you have iron deficiency anemia, taking iron supplements may help alleviate the symptoms of RLS.
  • Consider medications: There are several medications that can help alleviate the symptoms of RLS, including dopaminergic drugs, opioids, and anticonvulsants. Talk to your doctor to find out which medication is right for you.

Overall, the best way to prevent or reduce the symptoms of RLS is to establish healthy sleep habits, maintain a healthy lifestyle, and seek medical treatment if necessary.

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Diagnosis

The diagnosis of restless pain syndrome completely depends on the patient's explanation. A doctor will diagnose RLS by taking your medical history and noticing signs and symptoms. There is no particular test for RLS diagnosis.
The diagnosis is very difficult in children as doctors totally rely on the patient's explanation of symptoms. The children find difficulty in explaining their RLS sensations. Therefore, it may be sometimes misdiagnosed as ‘attention deficit disorder’ or ‘growing pains’.

Treatment of Restless Legs Syndrome (RLS) | When to Consult a Doctor

Treatment includes medication to treat the underlying cause: 

  • Dopamine agonist

If you feel RLS symptoms frequently, then the doctor will recommend you use dopamine agonists that will increase the dopamine level in your brain e.g. ropinirole, pramipexole, and rotigotine. These are FDA-approved medicines for treating moderate to severe RLS.

  • Opioids

Opioids are narcotic medicines that can relieve severe symptoms of RLS e.g. tramadol, hydrocodone, and oxycodone.

  • Anticonvulsants

They can reduce sensory disturbance due to RLS e.g. pregabalin and gabapentin.  

  • Sleep pills and Muscle relaxants

They will help you in better sleep and reduce RLS sensations e.g. temazepam, clonazepam, and zolpidem.

Disclaimer! Please do not use any of these medicines on your own, as they are mentioned here just for your information. Always consult your doctor for treatment of a disease 

Do home remedies work in alleviating RLS?

Yes! Home remedies will help you in reducing the symptoms of RLS. You can try these at home;

  • Relaxation techniques: RLS gets worse with stress, so stress-reducing exercises will help you i.e. yoga, tai chi, and meditation.
  • Warm baths and massages: They can relax your muscles.
  • Warm or cool packs: The use of alternating hot or cool packs will relax your muscles.
  • Exercises: Try those exercises in which legs are more often used. Walking, sports, and exercises in the gym will help you in RLS.
  • Avoid the use of tobacco, caffeine, and alcohol.
  • Intake of a well-balanced diet.
  • Develop good sleeping habits.  

However, consult a medical specialist if the condition worsens.