What is restless leg syndrome? Restless Leg Syndrome is a disorder characterized by an urge to move the legs while at rest or when trying to sleep. The feeling can range from mild to very uncomfortable and can be described as tingling, creeping, pulling, or crawling sensations in the legs. Other symptoms that may accompany RLS include pain in the legs; cramps in the legs; inability to sleep because of leg discomfort; and numbness or pins and needles sensations in the legs.
Restless leg syndrome is a neurological disorder in which a person has an uncontrollable urge to move their legs in order to get relief from unpleasant sensations. The sensation can be numbness, tingling, creeping on the skin, or even itchiness. This disorder is most common in adults over the age of 40 and it affects 15% of people with Parkinson’s Disease. Restless leg syndrome can be caused by many conditions including iron deficiency, peripheral neuropathy, diabetes mellitus type 2, chronic kidney disease, and multiple sclerosis. It also can be attributed to side effects from medications such as antidepressants, painkillers, and opioids. Restless leg syndrome is a disorder that affects people of all ages. It is also called Willis-Ekbom disease.
It causes sensations of uncomfortable feelings in the limbs, which are relieved by movement.
Common symptoms are:
- Intense urge to move their legs in order for the uncomfortable feelings to stop
- Inability to sleep because of sensations in their legs
- Pain in the limbs, often described as aching, burning and prickling.
- Stiff or jerky movements of the legs
- Cramps in the limbs
- Numbness or pins and needles sensation
- Numbness in the legs
- Numbness or pins and needles sensations in the limbs.
- Sensation of tingling or creeping movement sensation in the legs and feet
- Lying still or sitting for long periods make symptoms worse.
Leg discomfort can also be felt in the back, thighs, calves, and feet. The sensations may feel like insects crawling on or under the skin. During sleep, the symptoms often occur in the calves or both legs simultaneously. The discomfort might begin in one limb and move to another. The majority of restless leg syndrome patients are elderly people and it usually occurs at night. The cause behind this disorder is unknown, but some factors may include iron deficiency, sleep deprivation, diabetes, or peripheral neuropathy. Treatment aims to improve the quality of sleep and reduce these symptoms.
Restless leg syndrome is not fatal, but it can affect the quality of life of a patient. Restless Leg Syndrome is treated by different activities. If the patients are overweight they should try to lose weight in order for Restless Leg Syndrome to be better managed. Exercising regularly and maintaining good posture can help treat the disease. Medications that are prescribed by a physician can also treat Restless Leg Syndrome; some include muscle relaxants, antidepressants, or painkillers. Medications such as Dopamine agonists can help with dopamine deficiency in the brain which contributes to Restless Leg Syndrome.
The most common medications used for treating RLS are:
- Painkillers such as opioids (pethidine) and tramadol (Ultram). These drugs may help reduce pain but not the need to move the legs.
- Tricyclic antidepressants such as amitriptiline (Elavil) and doxepin (Sinequan). These types of drugs work best for RLS if used regularly.
- Antidepressants such as clomipramine (Anafranil) and citalopram (Celexa). These drugs can help with the sleep difficulties caused by RLS.
- Anticholinergic medications such as tegaserod (Zelnorm), diphenhydramine (Benadryl) and oxybutynin chloride (Ditropan). These drugs are effective in treating RLS.
- Antihypertensives such as beta blocker medications such as atenolol (Tenormin), metoprolol (Lopressor), propranolol (Inderal) and timolol (Antilirium). These drugs have been shown to be effective in treating the symptoms of Restless Leg Syndrome.
- Pramipexole (Mirapex), quinpirole (Slidryl), or a dopamine agonists such as pramipexole. These drugs can help with dopamine deficiency in the brain which contributes to RLS.
- Nerve medication such as the selective serotonin reuptake inhibitors such as fluoxetine (Prozac) or paroxetine (Paxil). These drugs are effective in treating RLS.
- Diazepam (Valium) and clonazepam (Klonopin). These drugs may help to control symptoms of Restless Leg Syndrome.
- Antihistamines such as diphenhydramine (Benadryl) or triprolidine (Atarax). These drugs may help to control symptoms of Restless Leg Syndrome.
- Iron and vitamin supplements. These supplements may help to improve the symptoms of Restless Leg Syndrome.
- Amitriptyline (Elavil) or clomipramine (Anafranil). These drugs work best for RLS if used regularly.
- Pregabalin (Lyrica). This drug is effective in treating RLS.
RLS patients should talk with their doctor before taking any over-the-counter medications for Restless Leg Syndrome such as aspirin, acetaminophen, ibuprofen, narcotics, and antacids because these can add to certain side effects associated with RLS. Restless legs syndrome is commonly treated with various medications, but there is still no cure. Treatments include medication and physical therapy.
Manual massage helps and the symptoms ease for a short time, but the feelings return in a few days. A patient may use an electric blanket that helps the sensations and pain to subside, but not the need to move. Some people with RLS buy an air conditioner to help their symptoms. A warm bath or shower can help relieve the discomforting feelings. Ambulation and massage are effective in relieving symptoms.
Non-medication strategies for treating RLS are:
Sensory deprivation techniques may be helpful, such as having the patient wear earplugs or a blindfold while they try to sleep. Because medications may contain caffeine, patients should be instructed to avoid these products which can worsen the symptoms of Restless Leg Syndrome and lead to insomnia. Stimulants and alcohol should be avoided because they can also increase the symptoms of RLS. A natural supplement called Magnesium also helps patients who have this disease although it doesn’t work for everyone. This supplement is safe and it also calms the symptoms of restless Leg Syndrome. Quit smoking because nicotine can lead to many health issues. It is also recommended that patients eat a healthy diet that has a balance of carbohydrates, proteins, and fats.
Restless Leg Syndrome can be diagnosed with a neurological exam. Your doctor will likely perform an examination on your legs and feet for stiffness, muscle tone, temperature, and limb position sense. The cause behind this disorder is unknown, but some factors such as iron deficiency, sleep deprivation, diabetes, or peripheral neuropathy have been linked to this disorder. The sensation of tingling or crawling sensation in the legs and feet can be caused by a number of common blood pressure medications such as beta-blockers, alpha-blockers, and vasodilators; these drugs work as blood pressure medications by relaxing the muscles in blood vessel walls. Restless Leg Syndrome commonly occurs after pregnancy or with iron deficiency anemia.
Finally, around 5-15% of people with RLS have a family member also suffering from this disorder: notably, it is more frequent in men and in children and adolescents. 100% of individuals with Parkinson’s disease have Restless Leg Syndrome. Treatment for this disorder mainly consists of the use of medications. However, some studies suggest that patients respond better to drug therapy when their sleep habits are improved by exercise, good diet, stress reduction, yoga, etc.
Although some researchers are skeptical about the existence of this phenomenon in humans, others observed that the syndrome can be caused by industrial exposure to mercury. A recent study reported the presence of the illness in nearly all populations studied, suggesting that it is widespread and not rare.