Restless leg syndrome (RLS) is a disorder in which there are unpleasant sensations in the legs. Along with an uncontrollable urge or need to move the legs to stop the sensations. When people first develop RLS, it almost always starts in the evening and ends up preventing them from sleeping. Which is why it’s considered a sleep disorder. It is estimated that 33% of those with fibromyalgia also have Restless Leg Syndrome.
Restless Leg Syndrome – What It Is
Restless legs syndrome is a disorder of the part of the nervous system that affects the legs. It is characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an overwhelming urge to move them. Moving the legs relieves the discomfort.
Symptoms occur primarily at night when a person is relaxing or at rest. Symptoms can increase in severity during the night. Because it usually interferes with sleep, it also is considered a sleep disorder.
As many as 10 percent of the U.S. population may have RLS. Women are twice more likely to develop RLS than men. It may begin at any age. RLS symptoms can begin during childhood or adolescence. But most often occurs in middle-aged and older adults. The symptoms typically become more frequent and last longer with age.
Restless Leg Syndrome – What Causes RLS
In many cases the cause of Restless leg syndrome is unknown. Evidence suggests that RLS may be due to the way the brain uses dopamine, a brain chemical that helps with muscle movement. Genes may play a role. Nearly half of people with RLS also have a family member with the condition.
Other factors associated with the development or worsening of restless legs syndrome include:
- Chronic Illness – a chronic (long-term) health condition – such as chronic kidney disease, diabetes, Parkinson’s disease, rheumatoid arthritis, an underactive thyroid gland or fibromyalgia
- Iron Deficiency – Low levels of iron in the blood can lead to a drop in dopamine, triggering restless legs syndrome
- Medications – Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing sedating antihistamines may worsen symptoms.
- Pregnancy – Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.
Other triggers include stress, sleep deprivation, lack of exercise and excessive smoking, caffeine or alcohol.
Restless Leg Syndrome – Symptoms
The symptoms of restless legs syndrome can be different from person to person. The symptoms can range from mildly annoying to severely disabling. You may experience the symptoms only once in a while or every night.
These are the signs and symptoms of RLS:
- Uncomfortable sensation in the legs with a clear need or urge to move the legs – These sensations usually occur in the lower leg, but may be felt anywhere from the thigh to the foot. One or both legs may be affected. For some people, the sensations are also felt in the arms. These sensations are often described as:
- pulling or tugging
- itchy, creepy crawly
- burning, stinging, prickly, pins and needles
- aching, throbbing, pain
- Rest triggers the symptoms – Restless leg symptoms start or become worse when you’re sitting, relaxing, or trying to rest.
- Symptoms get worse night – RLS typically flares up at night, especially when you’re lying down. In more severe cases, the symptoms may begin earlier in the day, but they become much more intense at bedtime.
- Symptoms improve when you move your legs – The uncomfortable sensations temporarily get better when you move, stretch, or massage your legs. The relief continues as long as you keep moving.
- Nighttime leg movements – Approximately 85% of people with restless legs syndrome also have periodic limb movement disorder (PLMD), a sleep disorder. Periodic limb movements are repetitive cramping, jerking or twitching of the legs during sleep. These movements can occur about every 20-40 seconds, sometimes all night long, disrupting sleep.
Restless Leg Syndrome – Treatment Options
There is no cure for restless leg syndrome. Various treatments can help lessen the symptoms. Treatment options include lifestyle changes, self-care, and medication. Here are some things to try:
- Review your diet to ensure it is healthy and balanced. Avoid foods that may be causing or worsening the problem, such as alcohol and caffeine.
- Correct vitamin or mineral deficiencies. Iron deficiency is strongly linked to RLS. A deficiency in magnesium causes muscle tightening which can cause the leg spasms common in RLS. A deficiency in vitamin B can cause neurological problems, which is what causes the creepy, crawly sensations.
- Wear compression stockings during the day or try wrapping your legs in ace bandages to see if this helps.
- Develop good sleep habits.
- Stretch and massage. Begin and end your day with stretching exercises or gentle massage. It is important to stretch your hamstrings, calf and thigh muscles.
- Take a bath before bed. Soak in a warm Epsom salt, baking soda or vinegar bath to relax your muscles.
- Apply warm or cool packs. Use of heat or cold, or alternating use of the two, may lessen your limb sensations.
- Try relaxation techniques, such as meditation or yoga. Stress can aggravate RLS. Learn to relax, especially before bedtime.
- Try using a TENS unit. TENS stands for Transcutaneous Electrical Nerve Stimulation. A TENS unit is attached to the skin in order to send electrical signals to certain parts of the body. TENS is believed to help the symptoms of RLS by blocking pain signals.
- Find ways to keep your mind engaged while you are sitting, with activities like needlework, reading or video games.
- Examine prescription drugs, over-the-counter medications or herbal remedies you are taking. Some can trigger RLS symptoms and make them worse.
Medications Used For RLS
Several prescription medications are available to reduce the restlessness in your legs. These include:
- Medications that increase dopamine. There are three FDA approved medications for treatment of moderate to severe Restless Leg Syndrome: Mirapex, Neupro and Requip. These medications reduce motion in your legs by affecting the level of the chemical dopamine in your brain.
- Anticonvulsant medications, such as gabapentin and Lyrica, work for some people with RLS.
- Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in high doses.
- Muscle relaxants, anti-anxiety and sleep medications. These medications help you sleep better at night, but they don’t eliminate the leg sensations, and they may cause daytime drowsiness. Examples are Klonopin, Lunesta, Restoril, Sonata and Ambien.
Prescription medications often have unwanted side effects. A drug that relieves symptoms is one person may worsen them in another. And a drug that worked for a while may lose effectiveness over time.
A non-drug option is Relaxis, a vibrating pad you place under the affected area. It uses specific vibrations to disrupt RLS symptoms. Relaxis is for people with moderate to severe RLS. To obtain the device, a doctor’s prescription is required. You can read more about it here.
The Link between Restless Leg Syndrome & Fibromyalgia
RLS has been linked to fibromyalgia according to this study published in the Journal of Clinical Sleep Medicine. The link is so strong that those with fibromyalgia are 11 times more likely to have RLS than the general population.
The study followed 172 people suffering from fibromyalgia. 93% were female and the average age was fifty. They were compared with a control group of 63 people who had no symptoms of fibromyalgia. The researchers found that 33% of the fibromyalgia group also had RLS as compared to only 3.1 percent of the control group.
Professor Nathaniel F. Watson of the University of Washington in Seattle commented: “Sleep disruption is common in fibromyalgia and often difficult to treat. It is apparent from our study that a substantial portion of sleep disruption in fibromyalgia is due to restless legs syndrome.”