Restless legs syndrome (RLS): Symptoms and more (original) (raw)

Restless legs syndrome (RLS) is a sleep disorder that causes a feeling of heaviness and discomfort in the legs, usually after going to bed. Stretching or moving the legs usually helps. It may also affect the arms.

RLS may happen because of mental or physical problems, or it may be an adverse effect of some medications. It is also known as Willis-Ekbom disease.

RLS may be mild or severe, depending on the frequency and severity of the symptoms, how well the symptoms can be relieved by moving around, and how much disturbance they cause.

The vast majority of cases of RLS resolve on their own over time or once simple lifestyle changes have been made. A doctor may also recommend medications.

Read on to learn about the types of RLS, symptoms, how doctors diagnose the condition, treatment options, and more.

There are two main types of RLS: primary RLS and secondary RLS.

Exactly how RLS happens is not clear, but it may be related to how the body processes dopamine, a neurotransmitter that plays a role in controlling muscle movements.

It is also linked to pregnancy.

Primary or idiopathic RLS

Idiopathic means that the cause is unknown. However, it may have a genetic cause, with a familial link in anywhere from 25% to 75% of cases.

Primary RLS usually begins before the age of 40 years.

Secondary RLS

Secondary RLS happens as a result of another condition. Examples of conditions that may cause secondary RLS include:

• diabetes
• iron deficiency
• kidney failure
• Parkinson’s disease
• peripheral neuropathy
• venous insufficiency
• pregnancy
• fibromyalgia
• celiac disease

Some medications can also lead to secondary RLS, particularly those that affect the activity of dopamine. Examples of medications that can cause or worsen secondary RLS include:

• selective serotonin reuptake inhibitors (SSRIs)
• serotonin-norepinephrine reuptake inhibitors (SNRIs)
• tricyclic antidepressants
• beta-blockers

RLS may also occur alongside periodic limb movement disorder (PLMD). PLMD is a similar sleep disorder that causes the limbs to twitch or jerk uncontrollably while sleeping.

RLS causes a strong urge to move the legs. People have described these feelings as:

• aching
• burning
• crawling
• creeping
• itching
• tugging
• tingling
• similar to electric shocks

The only way to relieve the discomfort is to move the legs. The sensations tend to occur when the individual is resting or inactive, not only during the night. Symptoms often worsen in the evening and at night.

How long does restless legs syndrome last?

Secondary RLS may resolve after addressing the underlying cause. If RLS occurs due to pregnancy, it should resolve a few weeks after delivery.

In other cases, there is no known cure for RLS. However, a person might experience periods of remission, when they experience no or few symptoms for a number of weeks or months.

A pregnant person may develop RLS. It occurs in around 20% to 33% of pregnancies.

The cause of the increased incidence of RLS during pregnancy is unclear, but a possible cause is low levels of minerals or vitamins, such as iron and folate.

This condition has not been widely researched during pregnancy. Some of the drug treatments for RLS, such as rotigotine and gabapentin, have not been assessed for safe use in people who are pregnant.

If a person receives treatment for RLS and then becomes pregnant, it is important to speak with a doctor to ensure the current treatment plan is safe during pregnancy.

There is no specific test for RLS. Instead, a doctor will ask questions about the symptoms. They will also look for certain criteria, including:

• an overwhelming urge to move the legs
• symptoms that happen or worsen during rest or inactivity
• symptoms that worsen in the evening or during the night
• symptoms that are relieved when moving the legs

Before speaking with a doctor, it may be helpful to keep a record of when symptoms occur.

If the doctor suspects something other than RLS, they may order tests to rule out other possible causes.

Treatment for RLS may involve addressing an underlying cause. This can help resolve symptoms in some cases.

If symptoms do not resolve, doctors may recommend a combination of home remedies and medical treatments.

Home remedies

Home remedies for RLS can include:

• maintaining a regular sleep schedule
• getting enough regular physical activity or exercise
• taking a warm bath
• massaging the legs
• applying a cool pack or heat pack
• avoiding alcohol, caffeine, and nicotine
• use foot wraps specially designed for RLS

Medical treatments

If symptoms do not improve, a doctor might recommend medical treatments. These can include:

• anti-seizure medication such as pregabalin and gabapentin enacarbil
• iron supplements
• benzodiazepines to manage muscle spasms and insomnia
• dopaminergic agents such as carbidopa and levodopa, usually for short-term use
• opioids in severe cases
• tonic motor activation (TOMAC), a prescription device that the individual wears on the lower legs to mimic the sensation of movement

Restless legs syndrome (RLS) causes the legs to feel heavy. Symptoms usually resolve with moving or stretching the legs.

Primary RLS has no known cause, but home remedies and medical treatments may help alleviate symptoms. It is also possible to enter a period of remission. where symptoms go away for weeks or months.

Secondary RLS happens due to an underlying cause, such as diabetes, iron deficiency, kidney disease, and more. Secondary RLS can also occur during pregnancy.

Contact a doctor if there are concerns about RLS. They can assess the symptoms to help confirm the diagnosis, and they may order tests to rule out other possible causes.

After diagnosis, they can help create a suitable treatment plan to manage symptoms and address any identifiable cause.