What is Restless Leg Syndrome (RLS)?
Restless leg syndrome (RLS) is a unique condition which gives an urge to move the legs.
This condition will cause uncomfortable, sometimes painful sensations throughout the legs. These are typically only relieved with movement, so those affected are often seen moving or stretching their legs.
About seven to 10 percent of the U.S. population is believed to suffer from RLS. Most sufferers are women. It may begin at any point in life, although symptoms tend to become more persistent with aging. (1)
RLS can classify as a sleep disorder because its symptoms become very persistent during the night or while the affected is trying to rest. It is likely to have significant effects on daily life and activities. (2)
It can be characterized as a neurological sensory disorder as the symptoms and sensations are produced in the brain. There are two types of RLS: primary and secondary. (3)
Primary RLS has been labeled as an idiopathic disease, meaning there is no known cause. Although particular genetic makeup has shown to play a role, the exact reasons are still in need of more research.
Secondary RLS is prevalent in people with insufficient iron levels. Those suffering from chronic kidney disease or iron deficiency (anemia) usually present a higher risk. It may also occur during pregnancy, where risks increase throughout the second and last trimesters.
Many of those suffering from RLS may encounter another disorder called periodic limb movement of sleep (PLMS.) This syndrome will affect the legs and sometimes the arms. The limbs will be seen jerking or twitching throughout the night. (4)
RLS can be described as an undeniable urge. People affected might be sitting in a meeting, or watching TV while continually keeping their legs in motion. If they stop, symptoms will recur, and an irritating feeling can take over.
The affected are often very exhausted since the symptoms persist during the night. For many the sensations will disappear around dawn, which gives a chance to catch up on some sleep.
Those affected might encounter:
RLS can cause sensations of crawling or tingling across the legs. They generally describe it as though something is stretching, pulling or scratching. It is typically not a feeling affecting the skin, rather an irritant occurring deeper in the tissue. (5)
Sometimes the person might feel pain or tingling. However, the leg will generally not feel tender upon touch.
When these senses are triggered, it is likely to give an urge to move the leg. Usually it can be perceived as an absolute need, and movement may be the only relief. However, this depends on the severity of the condition.
Some people might experience only mild discomfort which quickly goes away with stretching.
Appart from irresistible urges to move, RLS may also cause spontaneous limb movements. As mentioned above, these may characterize as PLMS.
During the night, the individual might experience quick, uncontrollable movements or jerks in the legs or feet. They may occur every 20 to 40 seconds and can last up to a few moments at a time. (6)
PLMS is very prevalent among people with RLS. An estimated 80 percent will develop this disorder. (7)
In some cases, these uncomfortable sensations may affect the arms. Head and chest might also come under attack, although, this is rarely seen.
When the sensory symptoms begin to affect the arms, it could indicate a more severe RLS. The sensations are often reported similar to those which affect the legs. Crawling, pulling or drawing inside the arm, where relief is only achieved with motion. (8)
Night Time Symptoms
A sure indicator of RLS is when the symptoms get worse during the night. Most people will begin to notice the annoying sensations about 15 to 20 minutes after going to bed. (9)
In severe cases, the affected might only get a few hours of undisturbed sleep during the night. They might have to get up several times to pace around and stretch before being able to return to bed. This can have a serious impact on their mood during the day and is likely to interfere with work or social life.
However in some cases, the affected might be able to sleep through the symptoms. The disorder in its mild form won’t have a significant effect on daily life. (10)
RLS is usually not placed within a stage system. However, before determining a course of treatment, doctors typically try to understand the severity of the symptoms.
The patient may be asked to fill out a questionnaire with a rating system developed by the international RLS (IRLS.) The person is asked to rate the symptoms on a scale from zero to four. (11, 12)
Higher scores will indicate more severe RLS, and will therefore require more intense treatment. Mild symptoms can sometimes be alleviated with minor changes.
Before a diagnosis of RLS can be made, the patient must show signs of the four key symptoms. These are: urge to move the legs, triggered by inactivity, relief with movement and symptoms which worsen during the night. (13)
One question doctors are likely to stress is how symptoms affect sleep patterns. Doctors might request that you keep a sleep diary of duration, ease of falling and staying asleep, and excessive daytime tiredness. This information might help in the diagnosis.
After an evaluation of the symptoms, doctors will typically do a physical examination. They will also take a medical history as there are some conditions and medications which can trigger RLS.
RLS is not curable. It can sometimes enter a remission phase, where symptoms are not present. However they will eventually return, even after months or years. (14)
There are three goals in the treatment of RLS. The first is to reduce and prevent symptoms. The second is to increase quality and quantity of sleep. And finally, to attend to any possible conditions which could trigger RLS or make it worse. (15)
A mild case of RLS can usually be treated with simple lifestyle changes. There are a few modifications which can help relieve symptoms and may even prevent them.
It is always an excellent start to quit bad habits such as smoking or excessive intake of alcohol. These two substances often contribute to the worsening of RLS symptoms. (16)
Experts may recommend that you begin your preparations for a good night’s sleep during the day. (17)
Staying moderately active throughout morning and afternoon is recommended. A mentally challenging activity such as a puzzle before going to bed could help prevent symptoms during the night.
Adapting good sleeping habits is also suggested. These staying in a comfortable room, preferably without distractions such as tv or phone. Also recommended is waking up and going to bed at regular times and if you can’t fall asleep, avoid staying in bed.
Sometimes symptoms can’t be prevented, so it is essential to know how to relieve them.
Massaging or stretching the leg or pacing back and forth usually reduce the symptoms. Other times ice or heat packs can be applied to the area. A bath may also benefit. (18)
If the above mentioned don’t bring relief, your doctor might recommend that you start medical treatment.
There are a few standard medicines, including a drug also used to treat Parkinson’s disease. It helps the brain control movement better and is likely to prevent symptoms. (19)
You might be prescribed a medicine whose effects may wear off over time. In these cases, doctors can suggest another drug. Some of those affected might require several medications to keep their symptoms under control.
What is restless leg syndrome (RLS)? RLS is a disorder which causes unpleasant sensations in the legs, giving an urge to move them.
What are the signs of restless leg syndrome (RLS)? The four key signs are: an urge to move, triggered by inactivity, decreased symptoms when active and sensations which increase during sleep.
How do you develop restless leg syndrome (RLS)? It depends on which type you have: primary or secondary. The latter is caused by low iron levels whereas primary RLS causes are somewhat unknown. Experts believe specific genes may play a role.
How are you diagnosed for restless leg syndrome (RLS)? Doctors will look for the four key signs, all of which need to be occurring for a diagnosis of RLS. A physical exam generally follows, and further testing such as blood samples and nerve tests. You might be prescribed a short dose of specific medicine. If this relieves symptoms the diagnosis is confirmed. (20)
What is the best treatment of restless leg syndrome? There is not a specific treatment as depends on the individual case. Usually, lifestyle changes and preventative measures will do. If not, there are medicines available which help relieve and reduce symptoms. (21)
Is restless leg syndrome (RLS) considered a disability? No. RLS will not cause physical or mental disabilities, although it can interfere with work.
Is there any cure for restless leg syndrome (RLS)? If the underlying cause can be cured, then RLS symptoms may stop. However, RLS is considered a chronic disorder. (23)
Is restless leg syndrome (RLS) life threatening? RLS is not deemed a life threatening disorder.
Restless leg syndrome (RLS) is a disorder in which unpleasant sensations are sent through the legs. These will give the affected an irresistible urge to move to relieve the symptoms.
Those affected may describe the sensations as pulling, drawing or crawling. It will generally be felt from deeper inside the leg as opposed to on the skin.
RLS is a chronic disease for which there is no cure. It may have severe impacts on a person’s life. However, its symptoms can be reduced with treatment and lifestyle changes.