Restless legs syndrome (RLS): Symptoms, causes, treatments

2021-09-06 06:44 PM

Restless legs syndrome can begin at any age and usually worsens with age. Women are more likely than men to develop this problem.

Restless legs syndrome (RLS)

Define

Restless legs syndrome (RLS) is a condition in which the legs feel very uncomfortable when sitting or lying down. It makes you have to stand up and move around. In doing so, the uncomfortable feeling of restless legs syndrome temporarily disappears.

Restless legs syndrome can begin at any age and usually worsens with age. Women are more likely than men to develop this problem. Restless legs syndrome can disrupt sleep - leading to daytime sleepiness - and make walking difficult.

Some simple self-care steps and lifestyle changes can help. The medication also helps many people with restless legs syndrome.

Symptoms

Describe the feeling

Often describes restless legs syndrome (RLS) with symptoms such as discomfort in the calves, thighs, feet, or arms, often presented as:

Tingling.

Cramp.

Like an animal climbing.

Pull feeling.

Pain.

Muscle twitch.

Stretch.

Uncomfortable.

Itchy.

The feeling of gnawing.

Hurt.

Hot.

Sometimes describing feelings can seem challenging. Affected people usually do not describe problems such as muscle spasticity or numbness. However, the description uniformly desired to move or handle their legs.

It is a common symptom that fluctuates in severity, and sometimes the symptoms go away for a while.

Common symptoms

Common signs and symptoms of restless legs syndrome include:

Start during inactivity. This sensation usually begins after you have been lying down or sitting for a long time, such as in an airplane, car, or movie theater.

Relief by motion. Restless leg syndrome decreases if the sensation is received and moved. Deal with restless legs syndrome in a number of ways - by stretching, stepping, exercising, or walking. Desire to move in response to restless legs syndrome.

Symptoms worsen in the evening. Symptoms are usually less bothersome during the day and are felt mostly at night.

Leg twitching at night. Restless leg syndrome may be associated with a condition called sleep periodic limb movement (PLMS). PLMS makes involuntary shifts and leg extensions during sleep without knowing it's doing it. Hundreds of movements or jerky movements may occur throughout the night. If you have severe restless legs syndrome, kicking movements can also occur while awake. PLMS is common in older adults, even without restless legs syndrome, and does not always disrupt sleep. More than 4 out of 5 people with restless legs syndrome experience PLMD.

Some people with restless legs syndrome never go to the doctor because they worry that the symptoms are too difficult to describe or not taken seriously. Some doctors misdiagnosed symptoms of cramps, stress, insomnia... But restless legs syndrome has received a lot of attention and focus in the public health media in recent years, making make people more aware of this situation.

If you think you may have restless legs syndrome, see your doctor.

Causes

In many cases, the cause of restless legs syndrome is unknown. The researchers suspect the problems may be due to an imbalance of the brain chemical dopamine. This chemical sends messages to control muscle movement.

Inheritance. Restless legs syndrome runs in families in up to half of people with restless legs syndrome, especially if the problem started at a young age. Researchers have identified genetic defects on chromosomes that may be present in people with restless legs syndrome.

Pregnant. Pregnancy or temporary hormonal changes can worsen restless legs syndrome signs and symptoms. Some women experience restless legs syndrome for the first time during pregnancy, especially during the third trimester. However, for most of these women, signs and symptoms usually disappear quickly after giving birth.

Related problem. For the most part, restless legs syndrome is not related to a serious underlying medical problem. However, sometimes accompanied by restless legs syndrome are other problems, such as:

Peripheral nerves. Damage to the nerves in the limbs and sometimes due to chronic diseases such as diabetes and alcoholism.

Iron deficiency. Although restless legs syndrome is not anemic, iron deficiency can cause or worsen restless legs syndrome. If you have a history of stomach or intestinal bleeding, heavy menstrual bleeding, or frequent blood donations, you may have iron deficiency.

Kidney failure. If there is kidney failure, there may also be iron deficiency, often with anemia. When the kidneys are not working properly, the iron in the blood can drop. This, along with other changes in the body, can cause or worsen restless legs syndrome.

Risk factors

Restless legs syndrome can develop at any age, even in childhood. Many adults can remember restless legs syndrome as a child with increasing pain or can remember their parents rubbing their feet to help them fall asleep. This disorder is more common with increasing age.

Complications

Although restless legs syndrome does not lead to other serious conditions, symptoms can range from discomfort. Many people with restless legs syndrome find it difficult to fall asleep or stay asleep. Insomnia can lead to excessive daytime sleepiness, but restless legs syndrome can prevent enjoying daytime naps.

Examination and diagnosis

Doctors diagnose restless legs syndrome by hearing descriptions of symptoms and by interviewing medical history. To be diagnosed with Restless Legs Syndrome, four criteria established by Restless Legs Syndrome International must be met:

There is a strong urge to move the legs, often irresistible, often accompanied by unpleasant sensations. The sensations are often described as a crawling, crawling, cramping, tingling, pulling, tugging, or itching.

Symptoms begin or get worse while resting, such as sitting or lying down.

Symptoms are partially or temporarily relieved by activity, such as walking or stretching.

Symptoms are worse at night.

Blood or muscle testing or neurology may be ordered to rule out other possible causes of symptoms.

Alternatively, your doctor may refer you to a sleep specialist for further evaluation. This may require an overnight stay in the hospital, where sleep habits can be closely studied and leg twitching (periodic limb movement) during sleep can be checked - possible signs of the syndrome. restless leg syndrome. However, a diagnosis of restless legs syndrome usually does not require a sleep study.

Treatments and drugs

Sometimes, treating an underlying problem, such as iron deficiency or peripheral neuropathy, helps relieve the symptoms of restless legs syndrome. Treatment for iron deficiency may include iron supplementation. However, iron supplementation is under medical supervision and after a doctor has checked the level of iron in the blood.

If restless legs syndrome is present without any associated problems, treatment focuses on lifestyle changes, and if ineffective, medication.

Medicines for treatment

A number of prescription medications, most of which have been developed to treat other conditions, are available to reduce restlessness in the legs. These include:

Drugs for Parkinson's patients. These drugs reduce the amount of leg movement by affecting dopamine levels in the brain. Two drugs, ropinirole (Requip) and pramipexole (Mirapex), are approved by the US Food and Drug Administration to treat moderate to severe restless legs syndrome.

Doctors also often use other medications to treat restless legs syndrome, such as a combination of levodopa and carbidopa (Sinemet). People with restless legs syndrome are no more likely to develop Parkinson's disease than people without restless legs syndrome. Side effects of Parkinson's drugs are usually mild and include nausea, dizziness, and fatigue.

Opioids. Narcotics can relieve severe symptoms, but they can be addictive if taken in too high a dose. Some examples include codeine, oxycodone (Roxicodone), the combination drugs oxycodone and acetaminophen (Percocet, Roxicet), and the combination of hydrocodone and acetaminophen (Lortab, Vicodin).

Muscle relaxants and sleeping pills. Medicines, such as benzodiazepines, help you sleep better at night. But these drugs do not eliminate the feeling of restless legs and can cause daytime sleepiness. Commonly, sedatives used for restless legs syndrome include clonazepam (KLONOPIN), triazolam (Halcion), eszopiclone (Lunesta), ramelteon (Rozerem), temazepam (Restoril), zaleplon (Sonata), and zolpidem (Ambien) ).

Medicines for epilepsy. Certain seizure medications, such as gabapentin (Neurontin), may be helpful for some people with restless legs syndrome.

It may take some experimentation and a doctor to find the right medication and dosage. A combination of drugs may work best.

Drug warnings

One thing to remember with medications to treat restless legs syndrome is that sometimes a medication that worked for a while becomes ineffective. Or notice returning symptoms. For example, if the medication was taken at 08:00, symptoms of restless legs syndrome may begin at 6:00. Your doctor may be able to substitute other medications to combat this problem.

Most medications prescribed to treat restless legs syndrome should not be taken by pregnant women. Instead, your doctor may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during the last 3 months, your doctor may approve the use of pain relievers.

Certain medications can cause symptoms of restless legs syndrome. These include most antidepressants and some anti-nausea medications. Your doctor may recommend avoiding these medications if possible. However, if these medications are required, restless legs can still be controlled by adding managed medications.

Lifestyle and remedies

Making simple lifestyle changes can play an important role in alleviating the symptoms of restless legs syndrome. These steps can help reduce footwork:

Analgesic. For very mild symptoms, take a pain reliever such as ibuprofen (Advil, Motrin, others) at the onset of seizures and reduce sensation.

Try bathing and massage. Soaking in a warm bath and massaging your feet can relax your muscles.

Warm or cool. The use of hot or cold heat, or alternate use, may be found to reduce sensation in the limbs.

Try relaxation techniques like meditation or yoga. Stress can aggravate restless legs syndrome. Learn to relax, especially before going to bed at night.

Establish good sleep. Fatigue tends to worsen the symptoms of restless legs syndrome, so it's important to practice good sleep. Ideally, sleep involves quiet and comfort, a cool environment, going to bed at the same time, getting up at the same time, and getting enough sleep also feels rested.

Do exercise. Moderate regular exercise can reduce symptoms of restless legs syndrome, but exercising too much or working out too late in the day can intensify symptoms.

Avoid caffeine. Sometimes cutting back on caffeine can help jittery feet. Try to avoid caffeine-containing products, including chocolate, and caffeinated beverages like coffee, tea, and soft drinks for a few weeks to consider.

Cut down on alcohol and tobacco. These substances can also aggravate or cause the symptoms of restless legs syndrome.

Keep your spirits up in the evening. Boredom and sleepiness before bed can worsen restless legs syndrome. Stimulating activities such as video games or crossword puzzles can help keep you awake and may reduce symptoms of restless legs syndrome.

Alternative medicine

Because restless legs syndrome is sometimes caused by an underlying nutritional deficiency, supplements to correct the deficiency can improve symptoms. Your doctor may order blood tests to identify nutritional deficiencies and provide a sense of well-being, where supplementation can help.

Your doctor may also tell you that certain dietary supplements or prescription drugs may pose a health risk.

If blood tests show you are lacking in one of the following nutrients, your doctor may recommend dietary supplements as part of your treatment plan:

Folic acid.

Vitamin B.

Magnesium.

More research is needed to establish the reliable safety and effectiveness of all supplements in the treatment of restless legs syndrome.

Coping and supporting

Restless leg syndrome is generally a lifelong problem. Living with restless legs syndrome involves developing coping strategies.

Tell others about the condition. Sharing information about restless legs syndrome helps, family members, friends, and co-workers better understand when they see it.

Do not resist the need. If you try to suppress travel requests, you may see worse symptoms. Get out of bed, find activity.

Keep a sleep diary. Keep an eye out for medications and strategies that may help or hinder treatment for restless legs syndrome, and share this information with your doctor.

Adaptive workspace. May be more comfortable if the foot is raised to a height, which will allow standing while working or reading.

Stretch and massage. Begin and end with stretching or gentle massage.

Seek help. Support groups with family members and people with restless legs syndrome can help. By participating in a group, insights can not only help themselves but can also help others.

Related articles:

- 100 Questions and Answers about restless legs syndrome (PDF)

- Restless legs syndrome-Willis Ekbom disease (PDF)

- Restless legs syndrome: Diagnosis and treatment (PDF)