Restless Legs Syndrome

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move the legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily.

Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally worsens as you age. It can disrupt sleep, which interferes with daily activities.

Simple self-care steps and lifestyle changes may help relieve symptoms. Medications also help many people with RLS.

• Up to 15% of people have RLS, but only around 2% to 3% experience significant symptoms.
• RLS symptoms are not only triggered by rest, they may also worsen with caffeine intake and use of certain medications.
• Healthy sleep habits, dietary changes, exercise, medical devices, and medications are effective treatment strategies for RLS.

Symptoms

The chief symptom is an urge to move the legs. Common accompanying characteristics of RLS include:

• Sensations that begin while resting. The sensation typically begins after you've been lying down or sitting for an extended time, such as in a car, airplane or movie theater.
• Relief with movement. The sensation of RLS lessens with movement, such as stretching, jiggling the legs, pacing or walking.
• Worsening of symptoms in the evening. Symptoms occur mainly at night.
• Nighttime leg twitching. RLS may be associated with another, more common condition called periodic limb movement of sleep, which causes the legs to twitch and kick, possibly throughout the night, while you sleep.

People typically describe RLS symptoms as compelling, unpleasant sensations in the legs or feet. They usually happen on both sides of the body. Less commonly, the sensations affect the arms.

The sensations, which generally occur within the limb rather than on the skin, are described as:

• Crawling
• Creeping
• Pulling
• Throbbing
• Aching
• Itching
• Electric

Sometimes the sensations are difficult to explain. People with RLS usually don't describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move the legs.

It's common for symptoms to fluctuate in severity. Sometimes, symptoms disappear for periods of time, then come back.

Causes

Often, there's no known cause for RLS. Researchers suspect the condition may be caused by an imbalance of the brain chemical dopamine, which sends messages to control muscle movement.

Heredity

Sometimes RLS runs in families, especially if the condition starts before age 40. Researchers have identified sites on the chromosomes where genes for RLS may be present.

Pregnancy

Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms. Some women get RLS for the first time during pregnancy, especially during their last trimester. However, symptoms usually disappear after delivery.

Risk factors

RLS can develop at any age, even during childhood. The condition is more common with increasing age and more common in women than in men.

RLS usually isn't related to a serious underlying medical problem. However, it sometimes accompanies other conditions, such as:

• Peripheral neuropathy. This damage to the nerves in the hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.
• Iron deficiency. Even without anemia, iron deficiency can cause or worsen RLS. If you have a history of bleeding from the stomach or bowels, experience heavy menstrual periods, or repeatedly donate blood, you may have iron deficiency.
• Kidney failure. If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys don't function properly, iron stores in the blood can decrease. This and other changes in body chemistry may cause or worsen RLS.
• Spinal cord conditions. Lesions on the spinal cord as a result of damage or injury have been linked to RLS. Having had anesthesia to the spinal cord, such as a spinal block, also increases the risk of developing RLS.
• Parkinson's disease. People who have Parkinson's disease and take certain medications called dopaminergic agonists have an increased risk of developing RLS.

Complications

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 fall or stay asleep.

Severe RLS can cause marked impairment in life quality and can result in depression. Insomnia may lead to excessive daytime drowsiness, but RLS may interfere with napping.