Restless Leg Syndrome

Restless legs syndrome (RLS) is a condition in which your legs feel extremely uncomfortable while you're sitting or lying down. It makes you feel like getting up and moving around. When you do so, the unpleasant feeling of restless legs syndrome temporarily goes away.

Restless legs syndrome can begin at any age and generally worsens as you get older. Women are more likely than men to develop this condition. Restless legs syndrome can disrupt sleep — leading to daytime drowsiness — and make traveling difficult.

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What are the Symptoms of Restless Leg Syndrome

People typically describe restless legs syndrome (RLS) symptoms as unpleasant sensations in their calves, thighs, feet or arms, often expressed as:

  • Crawling
  • Tingling
  • Cramping
  • Creeping
  • Pulling
  • Painful
  • Electric
  • Tense
  • Uncomfortable
  • Itchy
  • Tugging
  • Gnawing
  • Aching
  • Burning

Sometimes the sensations seem to defy description. Affected people usually don't describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move or handle their legs.

It's common for symptoms to fluctuate in severity, and occasionally symptoms disappear for periods of time.

Common characteristics of RLS signs and symptoms include:

  • Starts during inactivity. The sensation typically begins after you've been lying down or sitting for an extended period of time, such as in a car, airplane or movie theater.
  • Relief by movement. The sensation of RLS lessens if you get up and move. People combat the sensation of restless legs in a number of ways — by stretching, jiggling their legs, pacing the floor, exercising or walking. This compelling desire to move is what gives restless legs syndrome its name.
  • Worsening of symptoms in the evening. Symptoms typically are less bothersome during the day and are felt primarily at night.
  • Nighttime leg twitching. RLS may be associated with another condition called periodic limb movements of sleep (PLMS). Once called myoclonus, PLMS causes you to involuntarily flex and extend your legs while sleeping — without being aware you're doing it. Hundreds of these twitching or kicking movements may occur throughout the night. If you have severe RLS, these involuntary kicking movements may also occur while you're awake. PLMS is common in older adults, even without RLS, and doesn't always disrupt sleep. More than 4 out of 5 people with RLS also experience PLMS.

When to See a Doctor

Some people with restless legs syndrome never seek medical attention because they worry that their symptoms are too difficult to describe or won't be taken seriously. Some doctors wrongly attribute symptoms to nervousness, stress, insomnia or muscle cramps. But RLS has received more media attention and focus from the medical community in recent years, making more people aware of the condition.

If you think you have RLS, call Niagara Sleep Center.

What Causes Restless Leg Syndrome?

In many cases, no known cause for restless legs syndrome exists. Researchers suspect the condition may be due to an imbalance of the brain chemical dopamine. This chemical sends messages to control muscle movement.

Heredity

RLS runs in families in up to half the people with RLS, especially if the condition started at an early age. Researchers have identified sites on the chromosomes where genes for RLS may be present.

Pregnancy

Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms. Some women experience RLS for the first time during pregnancy, especially during their last trimester. However, for most of these women, signs and symptoms usually disappear quickly after delivery.

Related Conditions

For the most part, restless legs syndrome isn't related to a serious underlying medical problem. However, RLS sometimes accompanies other conditions, such as:

  • Peripheral neuropathy. This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.
  • Iron deficiency. Even without anemia, iron deficiency can cause or worsen RLS. If you have a history of bleeding from your stomach or bowels, experience heavy menstrual periods or repeatedly donate blood, you may have iron deficiency.
  • Kidney failure. If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys fail to function properly, iron stores in your blood can decrease. This, along with other changes in body chemistry, may cause or worsen RLS.

What Restless Leg Syndrome Treatments are Available?

Sometimes, treating an underlying condition, such as iron deficiency or peripheral neuropathy, greatly relieves symptoms of restless legs syndrome. Correcting the iron deficiency may involve taking iron supplements. However, take iron supplements only with medical supervision and after your doctor has checked your blood-iron level.

If you have RLS without any associated condition, treatment focuses on lifestyle changes, and, if those aren't effective, medications.

Medication Therapy

Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs.

Do not take any medications for your Restless Leg Syndrome symptoms without first consulting a sleep specialist.

Preparing for Your Appointment

If you have signs and symptoms of restless legs syndrome, make an appointment with your doctor. After an initial evaluation, he or she may refer you to a doctor who specializes in the diagnosis and treatment of conditions affecting the nervous system (neurologist) or a sleep specialist.

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

Information to Gather in Advance

  • Write down your symptoms, including when they first started and when they tend to occur.
  • Write down your key medical information, other conditions with which you've been diagnosed and any prescription or over-the-counter medications you're taking, including vitamins and supplements. Also note whether you or anyone in your family has a history of restless legs syndrome.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask your doctor about restless legs syndrome. If any additional questions occur to you during your visit, don't hesitate to ask.

  • What is the most likely cause of my signs and symptoms?
  • Are there any other possible causes?
  • What tests are needed to make a diagnosis?
  • What treatment options are available for this condition?
  • If you're recommending medications, what are the possible side effects?
  • I have these other health conditions. How can I best manage them together?
  • What self-care steps are likely to improve my symptoms?
  • Can you recommend any educational materials for me to take home or look up on the Web?
  • Where can I find a support group for people with restless legs syndrome?

What to Expect from Your Doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth.

What You Can Do in the Meantime

In the time leading up to your appointment, consider changing your sleep patterns to try resting when your symptoms are most manageable. If your symptoms are worse at night, don't fight it. Keep active and busy with distracting activities until early morning, when you may feel comfortable enough to try sleeping.

Cutting back on or eliminating caffeine, alcohol and tobacco may help improve your symptoms. Other self-care steps that may provide relief include taking an over-the-counter pain reliever such as ibuprofen (Advil, Motrin, others) and massaging your legs while soaking in a warm bath.