Restless Legs Syndrome (RLS)

Restless legs syndrome (RLS) is a neurological disorder marked by symptoms of unpleasant sensations and an uncontrollable desire to move the legs.

Epidemiology

It is estimated that up to 10% of individuals may experience symptoms of restless legs syndrome, with 2-3% of adults reporting moderate to severe symptoms. However, it is difficult to determine the exact prevalence, as many individuals with mild symptoms do not seek medical advice.

It can affect individuals of any age, including the elderly and young children, and the symptoms typically worsen with age. Both genders can suffer from the syndrome, but is it significantly more common in women.

Symptoms

The characteristic symptoms of restless legs syndrome include throbbing, pulling, crawling, itching, tingling, aching or creeping sensations in the legs, accompanied by an irrepressible urge to move them. The uncomfortable sensations tend to be relieved by movement of the legs.

Symptoms usually present at nighttime when the affected individual is at rest and trying to relax. They can vary significantly in severity but often initiate as a mildly uncomfortable sensation but can become more severe as the night continues, sometimes to be described as painful.

As a result of the need to move the legs to relieve the associated sensation, many patients with RLS have difficulty falling or remaining asleep at night. Consequently, patients are more likely to become sleep deprived and experience excessive daytime sleepiness, which can affect their performance at work or in studies.

Cause

There is no clear identifiable cause for most individuals with restless legs syndrome. It can have a familial link in some cases, but many individuals with the condition do not have a family history of the syndrome.

It has been suggested that the symptoms may be caused by changes in the action of dopamine in the body. This neurotransmitter plays an essential role in controlled muscle movement and abnormalities may be responsible for causing the sensations noted in RLS.

There can also sometimes be an underlying cause of the condition, resulting in secondary RLS. Associated conditions may include iron deficiency anemia or kidney failure. Additionally, pregnant women are more likely to be affected by the syndrome, although this is usually temporary.

Management

The management of restless legs syndrome depends on the severity of the condition and many people with mild cases will not require any medical treatment but simple lifestyle changes can suffice. These may include:

• Maintaining regular sleep schedule
• Avoiding consumption of alcohol, caffeine or nicotine before bed
• Keeping physically active during the day

When a patient experiences an episode or RLS, there are several techniques they can use to relieve the symptoms. This could involve massaging or applying a hot or cold compress to the affected area. Light exercise to relax, such as walking, stretching, yoga or tai chi, may also be beneficial.

If there is an underlying medical condition, such as iron deficiency anemia or kidney failure, that is likely to be worsening symptoms, this should be addressed before treatments specifically for RLS are used.

For patients with more severe symptoms associated with idiopathic RLS, medications may be needed to regulate the dopamine level in the body or aid sleep at night.

Related Conditions

The vast majority of people with restless legs syndrome also experience symptoms of periodic limb movement disorder (PLMS). PLMS is a more common disorder characterized by involuntary movements of the legs during sleep at intervals throughout the night, which can disrupt sleep.

References

• http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm
• https://www.nhlbi.nih.gov/health/health-topics/topics/rls
• http://www.nhs.uk/conditions/Restless-leg-syndrome/Pages/Introduction.aspx
• http://emedicine.medscape.com/article/1188327-overview
• http://patient.info/health/restless-legs-syndrome-leaflet

Further Reading

• All Restless Legs Syndrome Content
• Growing Pains and Restless Leg Syndrome

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.