Restless legs syndrome (RLS) is a movement disorder that affects millions of U.S. adults — up to 10 percent of the population — according to the National Institute of Neurological Disorders and Stroke. Also, approximately 30 million children suffer from moderate to severe RLS. The disorder occurs more frequently in women than men.
Symptoms & Causes
The characteristic sign of RLS is an intense urge to move the legs. The impulse can be so strong that an individual is unable to resist.
There are several other symptoms of RLS including a creepy-crawly feeling, and a sensation of pulling. Also, some individuals experience cramping, aching and burning feelings. Symptoms can range from uncomfortable to painful.
Typically, the sensations appear when an individual is trying to relax, or sitting for long periods. Moving diminishes the sensations, but in the evening and during sleep, symptoms worsen.
According to the Restless Legs Syndrome Foundation, many people who have RLS also have a disorder called periodic limb movements of sleep. Signs of this disorder are quick movements of the legs every half-minute during the night.
The exact cause of RLS is often unknown. It seems to run in families and it may involve areas of the brain that control normal muscle movement.
The disorder can also be a secondary condition to another disease. Individuals with diseases like diabetes and women who are pregnant may develop RLS. Also, individuals taking certain antidepressants, antipsychotics and even cold medicines with antihistamines may also experience RLS.
Diagnosis & Tests
Many people are wary of speaking to a physician about their symptoms because of the stigma associated with the disorder. This is a major hurdle to diagnosing RLS.
Also, many RLS symptoms may be incorrectly attributed to other disorders. This is a particular problem in children as they may not be able to accurately describe their symptoms. Children may be misdiagnosed with attention deficit disorder or even “growing pains”, according to the National Institute of Neurological Diseases and Stroke.
Giving a physician exact descriptions of symptoms and how they are relieved are important in making a correct diagnosis of RLS. In addition to a physical exam and complete medical history — including a list of drugs the individual is currently taking — a physician will also perform a neurological exam.
Lab tests may be done to make sure that other diseases aren't the cause of symptoms.
Another test, called a polysomnography, may be performed. A polysomnography measures heartbeat, brain waves and movement, and can rule out conditions like sleep apnea that may cause similar symptoms to RLS.
Treatments & Medications
If blood tests indicate that an individual is low in certain vitamins, a physician may recommend dietary supplements. In some cases, this can reduce symptoms.
Still, in most cases the first line of therapy for RLS is to make lifestyle adjustments. Activities that relax muscles and relieve stress can improve symptoms. For example, warm baths, massages and yoga are helpful.
The Mayo Clinic suggests that alternating between warm and cool compresses may reduce the leg sensations associated with RLS.
Regular exercise and making dietary adjustments such as drinking less alcohol and caffeine may improve symptoms. Also, quitting smoking can prevent further aggravation of symptoms.
If lifestyle changes are unsuccessful, medication may be necessary. There are no drugs specifically indicated to treat RLS; however, some medications that affect the nervous system may reduce symptoms.
Opioids, or narcotics, can reduce pain sensation in the legs. Types of opioids include codeine and oxycodone. These treatments, however, can be very addictive.
Drugs used to treat epilepsy and Parkinson's disease may benefit individuals with RLS. Parkinson's drugs like ropinirole can decrease leg motions by reducing the levels of dopamine in the brain.
Benzodiazepines may also be prescribed to treat RLS. These drugs include muscle relaxants and sedatives. Benzodiazepines can cause daytime drowsiness, and may not effectively reduce sensations in the legs.
Often, individuals may have to try several medications before an effective treatment is found.