Restless Leg Syndrome: Symptoms, Causes, and Treatment

Restless Leg Syndrome is a unique condition that affects a smaller percentage of people compared to many other ailments. As the name implies, a person with Restless Leg Syndrome (RLS) feels an uncontrollable urge to move the leg every now and then. This can happen both when the person is awake or also when he/she is asleep.

RLS can be caused by genetic factors, other ailments, or some medications. RLS cannot be cured and one has to live with it for rest of his/her life. However, its symptoms can be easily managed and kept under control through medication, lifestyle changes, and certain home remedies. But, if left untreated, or ignored, symptoms can worsen over time and greatly affect the person’s quality of sleep. Disturbed sleep in turn causes a whole lot of other complications, so it’s good to be aware of RLS and take medical help on time.

Causes and Risk Factors

It is not known exactly why some people develop RLS. It may be related to how the brain processes dopamine, a neurotransmitter that our brain uses to send messages between nerve cells. In that sense, RLS can be treated as a nervous system disorder. RLS may have also got to do with how our body processes iron.

There are various risk factors for RLS:

• Genetic: People with a family history of RLS are at high risk of developing RLS
• Age: People above 40 are more at risk than younger people
• Gender: Women are at higher risk than men
• Iron deficiency or low levels of iron in the blood
• Uremia which is characterized by reducing or worsening kidney function
• Kidney disease, kidney failure, and dialysis
• Hypothyroidism or low levels of thyroid
• Depression
• Diabetes
• Fibromyalgia
• Rheumatoid arthritis
• Parkinson’s disease
• Peripheral neuropathy
• Pregnancy
• Lifestyle: sleeping late, working night shift
• Sleep disorders such as sleep apnea
• Excessive alcohol or caffeine consumption, and cigarette smoking
• Medications such as antidepressants, and drugs given for allergy or nausea

Symptoms

• Strange sensations in the legs which includes creeping, crawling, tingling, tugging or pulling, itching, burning, similar to electric shock and aching feel.
• The above feelings may be present in arms, neck, and shoulder, and other parts of the body too. They can be present on one or both sides of the body or can start on one side and spread to the other.
• The above symptoms are less during the day and increase through the day, worsening near bedtime. It can also happen during a period of prolonged inactivity as taking a long car ride or flight or sitting in a theatre.
• As described before, an uncontrollable urge to move legs or arms in order to relieve discomfort. The discomfort reduces when the person walks, jiggles legs, massages legs, climbs stairs, etc.
• Sleep disruption: Due to this discomfort, the person may take longer to fall asleep, and may get out of bed a couple of times in the night.
• Daytime sleepiness: Due to the sleep disruption, the person may be sleepy during the day.
• Behavioural and performance issues: Sleep disruption may cause the person to become moody, irritable, hyperactive, and have difficulty in concentrating.

PLMD/PLMS

Periodic Leg Movement Disorder (PLMD) or Periodic Leg Movement in Sleep (PLMS) is a related sleep disorder. In this, the person shakes or twitches the leg uncontrollably or involuntarily during sleep. The person may wake up in the night a couple of times which affects his/her quality of sleep. People with PLMD/PLMS are at a high risk of developing RLS.

Diagnosis

• A review of your family history to identify genetic causes for RLS
• A review of your habits and lifestyle
• Neurological exam to rule out nerve damage or blood vessel issues
• Blood test to rule out iron deficiency
• Polysomnography, or sleep study, to rule out any sleep disorder as cause of RLS

Treatment

Medications: There are many categories of drugs given to treat RLS and the doctor may prescribe one or more of them depending on the patient’s unique situation. These include Dopaminergic drugs, which affect the levels of dopamine in the person’s brain, dopamine agonists, alpha 2 agonists, Benzodiazepines, a type of sedative that helps the person sleep better at night, Opioids or Narcotic pain relievers that can relieve mild to severe symptoms, anticonvulsant or anti-seizure drugs that can help reduce involuntary twitches and jerks, drugs affecting calcium channels and iron supplements.

Lifestyle changes: The person must totally abstain from, or at least cut down on alcohol consumption, caffeine, and tobacco use (cigarette smoking or other means). The person will also be advised to exercise regularly and at moderate intensity (heavy exercise can worsen RLS symptoms). He or she should also try relaxation techniques that help reduce stress such as yoga, meditation, and tai chi.

Sleep Hygiene: The person must practice healthy sleeping habits for a good night’s sleep. This includes various dos and don’ts. A sleep specialist at a reputed hospital can guide the patient on this.

Healthy diet: Since iron deficiency is a risk factor for RLS, it’s good to consume an iron-rich diet that comprises one or more dark green leafy vegetables like spinach and fenugreek, peas and beans, dried fruit, red meat, poultry, seafood, and iron-fortified cereals, pasta, or bread. Since Vitamin C is required to absorb iron from the food into the body, the diet must comprise one or more: vegetables such as tomatoes, broccoli, peppers, and leafy greens; fruits such as oranges, tangerines, grapefruit, melons, kiwis, and strawberries.

Home remedies: Warm baths, leg massages, ice or hot packs on the legs all help relax the muscles and reduce RLS symptoms. A vibrating pad and foot wraps that apply pressure on the feet also relieve RLS symptoms.

See a doctor to get treated

 If you or any of your dear ones are displaying any of the symptoms listed above, do not ignore the same, and do not panic. Consult a reputed hospital. These hospitals have some of the best neurologists and sleep specialists in town, on their rolls. These specialists will diagnose your condition precisely and design a course of treatment for quick recovery and rehabilitation.

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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