Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention

Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention


What Is Restless Legs Syndrome?


Restless legs syndrome is a sleep disorder in which a person experiences unpleasant sensations in the legs described as creeping, crawling, tingling, pulling, or painful. These sensations usually occur in the calf area but may be felt anywhere from the thigh to the ankle. One or both legs may be affected; for some people, the sensations are also felt in the arms. These sensations occur when the person with Restless Leg Syndrome lies down or sits for prolonged periods of time, such as at a desk, riding in a car, or watching a movie. People with Restless Leg Syndrome describe an irresistible urge to move the legs when the sensations occur. Usually, moving the legs, walking, rubbing or massaging the legs, or doing knee bends can bring relief, at least briefly. 


Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention

Restless Leg Syndrome symptoms worsen during periods of relaxation and decreased activity.Restless Leg Syndromesymptoms also tend to follow a set daily cycle, with the evening and night hours being more troublesome for Restless Leg Syndrome sufferers than the morning hours. People with Restless Leg Syndrome may find it difficult to relax and fall asleep because of their strong urge to walk or do other activities to relieve the sensations in their legs. Persons with Restless Leg Syndrome often sleep best toward the end of the night or during the morning hours. Because of less sleep at night, people with Restless Leg Syndrome may feel sleepy during the day on an occasional or regular basis. The severity of symptoms varies from night to night and over the years as well. For some individuals, there may be periods when Restless Leg Syndrome does not cause problems, but the symptoms usually return. Other people may experience severe symptoms daily. 

Many people with Restless Leg Syndrome also have a related sleep disorder called periodic limb movements in sleep (PLMS). PLMS is characterized by involuntary jerking or bending leg movements during sleep that typically occur every 10 to 60 seconds. Some people may experience hundreds of such movements per night, which can wake them, disturb their sleep, and awaken bed partners. People who have Restless Leg Syndrome and PLMS have trouble both falling asleep and staying asleep and may experience extreme sleepiness during the day. As a result of problems both in sleeping and while awake, people with Restless Leg Syndrome may have difficulties with their job, social life, and recreational activities. 

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 Restless Leg Syndrome also have a family member with the condition.

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

Chronic diseases


Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention

Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure, anemia, diabetes, and peripheral neuropathy often include symptoms of Restless Leg Syndrome. Treating these conditions often gives some relief from Restless Leg Syndrome symptoms.

Medications


Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing sedating antihistamines may worsen symptoms.

Pregnancy


Some women experience Restless Leg Syndrome during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

What are the symptoms of restless legs syndrome?


Many people with Restless Leg Syndrome find it difficult to describe the feeling that they get in their legs. It may be like a crawling sensation, or like an electric feeling, or like toothache, or like water running down your leg, or like itchy bones or just fidgety, jumpy or twitchy legs, or just uncomfortable. Some people describe a deep painful feeling in their legs. The unpleasant feelings make you have an urge to move. Typically, when the unpleasant feelings occur they occur every 10-60 seconds and so you become quite restless.

Some common symptoms of Restless Leg Syndrome include:

  • Unpleasant sensations in the legs (sometimes the arms as well), often described as creeping, crawling, tingling, pulling, or painful;
  • Leg sensations are relieved by walking, stretching, knee bends, massage, or hot or cold baths;
  • Leg discomfort occurs when lying down or sitting for prolonged periods of time;

Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention
Restless Leg Syndrome Symptoms

The symptoms are worse in the evening and during the night


Other possible characteristics include:
  • Involuntary leg (and occasionally arm) movements while asleep;
  • Difficulty falling asleep or staying asleep;
  • Sleepiness or fatigue during the daytime;
  • Cause of the leg discomfort not detected by medical tests;
  • Family members with similar symptoms.

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, even in young children. Most people who are affected severely are middle-aged or older.

Restless Leg Syndrome is often unrecognized or misdiagnosed. This is especially true if the symptoms are intermittent or mild. Once correctly diagnosed, Restless Leg Syndrome can often be treated successfully.

How Is Restless Leg Syndrome Diagnosed?


There is no laboratory test that can make a diagnosis of Restless Leg Syndrome and, when someone with Restless Leg Syndrome goes to see a doctor, there is usually nothing abnormal the doctor can see or detect on examination. Diagnosis therefore depends on what a person describes to the doctor. The history usually includes a description of the typical leg sensations that lead to an urge to move the legs or walk. These sensations are noted to worsen when the legs are at rest, for example, when sitting or lying down and during the evening and night. The person with Restless Leg Syndrome may complain about trouble sleeping or daytime sleepiness. In some cases, the bed partner will complain about the person's leg movements and jerking during the night. 

Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention

To help make a diagnosis, the doctor may ask about all current and past medical problems, family history, and current medications. A complete physical and neurological exam may help identify other conditions that may be associated with Restless Leg Syndrome, such as nerve damage (neuropathy or a pinched nerve) or abnormalities in the blood vessels. Basic laboratory tests may be done to assess general health and to rule out anemia. Further studies depend on initial findings. In some cases, a doctor may suggest an overnight sleep study to determine whether PLMS or other sleep problems are present. In most people with Restless Leg Syndrome, no new medical problem will be discovered during the physical exam or on any tests, except the sleep study, which will detect PLMS if present.

Treatment for Restless Legs Syndrome


In mild cases of Restless Leg Syndrome, some people find that activities such as taking a hot bath, massaging the legs, using a heating pad or ice pack, exercising, and eliminating caffeine help alleviate symptoms. In more severe cases, medications are prescribed to control symptoms. Unfortunately, no one drug is effective for everyone with Restless Leg Syndrome. Individuals respond differently to medications based on the severity of symptoms, other medical conditions, and other medications being taken. A medication that is initially found to be effective may lose its effectiveness with nightly use; thus, it may be necessary to alternate between different categories of medication in order to keep symptoms under control. 

Home Remedies - non-drug Restless Leg Syndrome treatments may include:

Restless Leg Syndrome Causes, Symptoms, Diagnosis, Treatment, Prevention
Home Remedies for Restless Leg Syndrome

  • Leg massages
  • Hot baths or heating pads or ice packs applied to the legs
  • Good sleep habits
A nondrug approach called transcutaneous electric nerve stimulation may improve symptoms in some Restless Leg Syndrome sufferers who also have PLMS. The electrical stimulation is applied to an area of the legs or feet, usually before bedtime, for 15 to 30 minutes. This approach has been shown to be helpful in reducing nighttime leg jerking. 

Anxiety may trigger or increase Restless Leg Syndrome symptoms according to some investigators. Consequently, many over-the-counter items such as lavender soap fumes or acupuncture, or other home remedies and natural treatments may reduce anxiety and thus reduce symptoms of Restless Leg Syndrome, according to anecdotal claims. However, there is no known cure for Restless Leg Syndrome and, in most people, any underlying cause should be ruled out by medical tests.

Medications may be helpful as Restless Leg Syndrome 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 Restless Leg Syndrome 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 Restless Leg Syndrome. 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.

Due to recent advances, doctors today have a variety of means for treating Restless Leg Syndrome. However, no perfect treatment exists and there is much more to be learned about the treatments that currently seem to be successful.

Prevention for Restless Leg Syndrome


Although there is no way to prevent restless legs syndrome, it may help to avoid caffeine, alcohol and cigarette smoking.