*Nothing in this article constitutes medical advice. Seek the guidance of a physician if you have any questions.*
Restless legs syndrome (RLS), also known less commonly as Willis-Ekbom disease, is a condition that affects roughly 7-10% of the United States’ population. Generally speaking, RLS affects adults over the age of 40. The condition is somewhat more common in men than in women. Broadly, RLS causes annoying and/or painful sensations in the legs that can make it difficult for individuals to fall or stay asleep. This, in turn, may cause or worsen daytime sleepiness or exhaustion. Let’s take a closer look at what restless leg syndrome is and how it is treated.
What Is Restless Leg Syndrome?
According to the Mayo Clinic, restless leg syndrome presents as a “condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation.” In simpler terms, individuals with RLS experience an intense urge to move their legs due to a feeling of “tightness” or “stiffness” in their legs.
There are several different symptoms associated with RLS that differentiate it from other types of leg pain. Let’s take a look at the most common of these.
- Description of pain: Patients often have a hard time describing exactly what the sensation feels like, but some of the most common terms are creeping, crawling, throbbing, aching, itching, and electric.
- Uncomfortable sensation after rest: Typically, patients with RLS will begin to feel symptoms after prolonged rest. Usually, this resting period is several hours. Common triggers include sitting down to watch a movie, sitting for the duration of a flight, or laying down for an extended period of time.
- Relief from movement: Unlike other types of leg pain, the uncomfortable sensations caused by RLS are usually relieved by movement. Patients often find relief from walking, jogging, or jiggling their legs.
- Peak at night: Typically, the pain begins to set in during the evening. While sensations in the morning are possible, they are relatively uncommon.
- Leg twitching: Individuals with RLS may also experience symptoms of a related disorder, periodic limb movement disorder (PLMD). This causes individuals to twitch and possibly kick their legs at night.
Not unlike other sleep disorders, the exact cause of RLS is often unknown. Presently, this is an active area of research. Several theories have been proposed as to the origin of RLS.
- Dopamine: Abnormal levels of the neurotransmitter dopamine can cause muscle spasms, according to Johns Hopkins University. In fact, physicians at Johns Hopkins have observed “marked improvement in RLS symptoms seen with drugs that stimulate the dopamine system.
- Hereditary: Several studies have provided strong evidence for the genetic basis of RLS. While the precise nature of inheritance is still unknown, RLS is likely somewhat inheritable.
- Pregnancy: For women who already have RLS, symptoms may worsen.
If any of these symptoms sound familiar to you or a loved one, it may make sense to contact your physician to discuss your condition with them. First, your practitioner is likely to ask about your relevant medical history, including any conditions affecting your nervous system, kidneys, and blood.
According to the International Restless Legs Syndrome Study Group, a diagnosis of RLS should be based upon the following five criteria.
- You have a strong, somewhat irresistible urge to move your legs. This is also usually accompanied by uncomfortable sensations.
- Your symptoms start or get worse when you’re resting, such as sitting or lying down.
- Your symptoms are partially or temporarily relieved by activity, such as walking or stretching.
- Your symptoms are worse at night.
- Symptoms can’t be explained solely by another medical or behavioral condition.
If you and your physician believe that these describe you or your loved ones, they will likely discuss what this means for your personal health as well as discuss next steps. For some individuals, your physician may order a sleep study to better understand your sleep habits and any underlying conditions.
Generally speaking, RLS is not related to a more serious underlying condition. But, evidence suggests that RLS may present as a symptom along with several other disorders.
- Iron deficiency: Individuals with low blood iron, known as anemia, may experience much higher rates of RLS. Specifically, levels of iron in the brain seem to particularly important. For some individuals, supplementation with oral iron is sufficient to drastically reduce the frequency of RLS symptoms.
- Kidney failure: This risk factor is closely related to anemia. Individuals with kidneys operating at less than 100% are at a much higher risk of developing low iron levels. As stated above, low iron levels may increase the risk of developing RLS.
- Peripheral neuropathy: This disorder is resultant from damage to nerves outside of the central nervous system (brain and spinal cord). This damage can produce symptoms similar to RLS, except they can occur almost anywhere on the body. Individuals with peripheral neuropathy
- Spinal cord conditions: Almost any injury to the spinal cord will increase the likelihood of an individual developing RLS. This could be due to lesions, fractures, or any other type of damage to the spinal cord.
After a diagnosis of RLS, your physician will likely discuss possible treatment options. Most of these will likely be medications that fall into one of several different categories.
- Dopamine medications: Certain medications such as Ropinirole, Rotigotine, and Pramipexole all modulate the levels of dopamine in the brain. This can help alleviate the pain associated with RLS.
- Opioids: For extremely severe cases of RLS, your physician may prescribe certain opioid medications. This is typically a short-term solution as these drugs are highly addictive.
- Muscle relaxers and sleep medications: These drugs will not prevent or treat symptoms of RLS specifically, but they can help you fall asleep even when the sensations are actively occurring.