Restless legs syndrome
Restless legs syndrome
Restless legs syndrome (RLS) is a condition in which your legs feel extremely uncomfortable while you're sitting or lying down. It makes you feel like getting up and moving around. When you do so, the unpleasant feeling of restless legs syndrome temporarily goes away.
Restless legs syndrome can begin at any age and generally worsens as you get older. Women are more likely than men to develop this condition. Restless legs syndrome can disrupt sleep — leading to daytime drowsiness — and make traveling difficult.
A number of simple self-care steps and lifestyle changes may help you. Medications also help many people with restless legs syndrome.
Commonly described sensations
Sometimes the sensations seem to defy description. Affected people usually don't describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move or handle their legs.
It's common for symptoms to fluctuate in severity, and occasionally symptoms disappear for periods of time.
Commonly reported patterns
When to see a doctor
If you think you may have RLS, call your doctor.
In many cases, no known cause for restless legs syndrome exists. Researchers suspect the condition may be due to an imbalance of the brain chemical dopamine. This chemical sends messages to control muscle movement.
RLS can develop at any age, even during childhood. Many adults who have RLS can recall being told as a child that they had growing pains or can remember parents rubbing their legs to help them fall asleep. The disorder is more common with increasing age.
Although RLS doesn't lead to other serious conditions, symptoms can range from barely bothersome to incapacitating. Many people with RLS find it difficult to get to sleep or stay asleep. Insomnia may lead to excessive daytime drowsiness, but RLS may prevent you from enjoying a daytime nap.
Preparing for your appointment
If you have signs and symptoms of restless legs syndrome, make an appointment with your doctor. After an initial evaluation, he or she may refer you to a doctor who specializes in the diagnosis and treatment of conditions affecting the nervous system (neurologist) or a sleep specialist.
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
Information to gather in advance
Below are some basic questions to ask your doctor about restless legs syndrome. If any additional questions occur to you during your visit, don't hesitate to ask.
What to expect from your doctor
What you can do in the meantime
Cutting back on or eliminating caffeine, alcohol and tobacco may help improve your symptoms. Other self-care steps that may provide relief include taking an over-the-counter pain reliever such as ibuprofen (Advil, Motrin, others) and massaging your legs while soaking in a warm bath.
Tests and diagnosis
Doctors diagnose RLS by listening to your description of your symptoms and by interviewing you about your medical history. In order to be diagnosed with RLS, you must meet four criteria established by the International Restless Legs Syndrome Study Group:
Blood tests or muscle or nerve studies may be ordered to exclude other possible causes for your symptoms.
In addition, your doctor may refer you to a sleep specialist for additional evaluation. This may require that you stay overnight at a sleep clinic, where doctors can study your sleep habits closely and check for leg twitching (periodic limb movements) during sleep — a possible sign of RLS. However, a diagnosis of RLS usually doesn't require a sleep study.
Treatments and drugs
Sometimes, treating an underlying condition, such as iron deficiency or peripheral neuropathy, greatly relieves symptoms of restless legs syndrome. Correcting the iron deficiency may involve taking iron supplements. However, take iron supplements only with medical supervision and after your doctor has checked your blood-iron level.
If you have RLS without any associated condition, treatment focuses on lifestyle changes, and, if those aren't effective, medications.
It may take several trials for you and your doctor to find the right medication and dosage for you. A combination of medications may work best.
Caution about medications
Most of the drugs prescribed to treat RLS aren't recommended for pregnant women. Instead, your doctor may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during your last trimester, your doctor may approve the use of pain relievers.
Some medications may worsen symptoms of RLS. These include most antidepressants and some anti-nausea drugs. Your doctor may recommend that you avoid these medications if possible. However, should you need to take these medications, restless legs can still be controlled by adding drugs that manage the condition.
Lifestyle and home remedies
Making simple lifestyle changes can play an important role in alleviating symptoms of RLS. These steps may help reduce the extra activity in your legs:
Because restless legs syndrome is sometimes due to an underlying nutritional deficiency, taking supplements to correct the deficiency may improve your symptoms. Your doctor can order blood tests to pinpoint nutritional deficiencies and give you a good sense of which supplements may help.
Your doctor can also tell you whether certain dietary supplements may interfere with the way your prescription medications work or may pose health risks for you.
If blood tests show that you are deficient in any of the following nutrients, your doctor may recommend taking dietary supplements as part of your treatment plan:
More research is needed to reliably establish the safety and effectiveness of all of these supplements in the treatment of RLS.
Coping and support
RLS is generally a lifelong condition. Living with RLS involves developing coping strategies that work for you. The Restless Legs Syndrome Foundation recommends these approaches:
Last Updated: 2009-12-23
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