What is Restless Leg Syndrome?

Restless leg syndrome or RLS is a nervous system disorder that affects almost ten percent of Americans.  This condition is characterized by sensations like itching, aching or pins and needles that can only be relieved by moving the legs. Medical experts classify RLS as a sleep disorder because symptoms usually worsen at night and can disrupt sleep.

Symptoms may vary from mild to quite severe, but treatments are available. If you are suffering from mild to moderate symptoms, it may not be apparent to your doctor that you are suffering from restless leg syndrome. Depending on the nature of your condition, your physician may prescribe medications or lifestyle changes to manage symptoms.

An Introduction to Restless Leg Syndrome

Restless leg syndrome, also known as Willis-Ekbom disease, is usually accompanied by one or more of the following sensations:

  • Itching
  • Tingling
  • Crawling
  • Pulling
  • Pins and needles

These sensations may be relieved by moving the legs, or, in rare cases, the arms. This compelling urge to move occurs most often while relaxed or sleeping. For people with mild symptoms, these may not occur every night and may be confused with restlessness or anxiety.

In most cases, symptoms afflict both sides of the body, but some people may experience them on only one side. Although RLS sensations are normally found in the legs, some people may feel them in other parts of the body like the head or arms. Restless leg syndrome may become a chronic condition that becomes more severe with age.

Causes of RLS

In many cases of restless leg syndrome, it is unknown what is causing the condition. It has been confirmed that about 40 percent of RLS patients have family members also with this condition. There is a strong genetic component to this disease; if you have a family history of restless leg syndrome, you are likely to show symptoms prior to age 40.

There is evidence that restless leg syndrome may be related to Parkinson’s disease, or at least use similar neurological mechanisms like the dopamine pathways in the brain. This explains why so many people with Parkinson’s also have restless leg syndrome and why many medications used to treat Parkinson’s disease also relieve RLS symptoms.

Although RLS may be an independent health condition, in some cases, it may be a secondary condition related to diabetes, kidney failure, or neuropathy.  Other conditions that have been linked to restless leg syndrome include

  • Varicose veins
  • Certain cancers
  • Fibromyalgia
  • Anemia
  • Thyroid gland abnormalities
  • Pregnancy
  • Cigarette smoking
  • Lyme disease
  • Spinal nerve injuries
  • Rheumatoid arthritis
  • Alcohol or caffeine use
  • Magnesium or vitamin B-12 deficiency
  • Medications including anticonvulsants, antidepressants, beta-blockers, or antipsychotics

There is no single test for restless leg syndrome, but your physician may perform certain tests to rule out other conditions. This includes a thorough physical examination and medical history. Your physician will probably take blood to determine your hemoglobin, blood cell and thyroid hormone levels.  A nerve conduction test may also be performed to see if there is any neuropathy. A polysomnography or sleep test may be administered to observe sleep disturbances.

Treatment Options for Restless Leg Syndrome

There are a wide variety of therapeutic options for managing restless leg syndrome that range from home remedies to medications. Your physician will recommend treatments based on your prognosis and the severity of symptoms.

  • Dietary changes—you may find that very minor changes in what you consume can help relieve RLS symptoms. Your physician may ask you to quit smoking, drinking or consuming caffeine as all of these substances may worsen restless leg syndrome.  You may also need to adjust your diet so that you are getting all of the vitamins and minerals necessary to stave off RLS.
  • Review medications—your physician should review all of the medications you are taking.  If some of these are linked to RLS, she may substitute less problematic alternatives.
  • Treat related conditions—if your RLS is due to another underlying condition, it is critical that the underlying condition is properly managed. If you suffer from diabetes, anemia or a thyroid condition, you must manage them or your RLS symptoms will continue.
  • Good sleep hygiene—although your sleep habits may not be the cause of your restless leg syndrome, they may be contributing to poor sleep. Make sure that you go to sleep and wake up at the same time every day. Remove distractions like TVs and phones from your bedroom and stay away from caffeine later in the day.
  • Exercise regularly—getting in a few miles on a regular basis helps many RLS sufferers with mild or moderate symptoms. Physical exercise can improve restless leg syndrome by relaxing tense muscles and providing more restful sleep.
  • Yoga and stretching—one 2013 study of ten RLS sufferers found that yoga provided significant symptom relief by reducing stress levels and inducing better sleep. Another study showed that stretching exercises also improved restless leg syndrome symptoms, although researchers could not point to a reason why this occurred.
  • Massage therapy—although the benefits are not proven for everyone, massage therapy can provide symptom relief for at least some restless leg syndrome patients. One case study of a 35-year-old RLS patient found that two 45-minute massage therapy sessions for three weeks greatly reduced symptoms for at least two weeks following the regimen.
  • RLS medications—there are a host of drugs that have been used to successfully treat restless leg syndrome.
    • Dopaminergics—drugs like Mirapex, Requip, and Neupro increase the levels of dopamine in the brain and provide some symptom relief. Drug resistance will eventually occur, so only minimal dosages are prescribed.
    • Gabapentin—it is not well understood why this antiseizure drug improves RLS symptoms, but studies show that gabapentin does produce substantial improvement.
    • Benzodiazepines—normally used to treat anxiety, benzodiazepines are used with restless leg syndrome sufferers to help improve the quality of sleep.
    • Opioids—low doses of opioid medications have been used to treat RLS symptoms including unrestful sleep. Due to the risk of dependency, opioids are usually a last resort.
  • Interventional procedures—Dr. Jason Krutsch, co-founder of Colorado Pain Care, has developed a novel treatment for RLS that has proven effective in more than 90% of patients. This unique treatment, covered by most insurance plans, is only offered at Colorado Pain care.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.