Restless Legs Syndrome (RLS)

What is RLS?

Restless legs syndrome, or RLS, is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described as burning, creeping or tugging, or like insects crawling inside the legs.

You usually have these sensations in the calf, but they may be felt anywhere from the thigh to the ankle. One or both of your legs may be affected. Some people may have the sensations in the arms. With RLS, you have an irresistible urge to move the affected limb when the sensations occur. Moving often briefly relieves the limb discomfort.

Sleep problems are common with RLS because of the difficulty it causes in getting to sleep. Severe daytime fatigue can also be a big problem.

What causes RLS?

The cause of RLS is still unknown. Some cases are believed to be inherited. Some cases have been linked with nerve damage in the legs due to diabetes, kidney problems, or alcoholism.

As many as one in 10 people in the U.S. may have RLS. Incidence may be slightly higher in women than in others. Although the syndrome may begin at any age, even as early as infancy, most patients who are severely affected are middle aged or older. In addition, the severity of the disorder appears to increase with age. Older patients experience symptoms more frequently and for longer periods of time.

What are the symptoms of RLS?

Sensations occur when you lie down or sit for a prolonged time. This causes:

  • The need to move the legs for temporary relief of symptoms by:

    • Stretching or bending

    • Rubbing the legs

    • Tossing or turning in bed

    • Getting up and pacing

  • Worsening symptoms when lying down, especially when trying to fall asleep at night, or during other forms of inactivity, including just sitting

  • A tendency to feel the most discomfort late in the day and at night

How is RLS diagnosed?

Your doctor can diagnose RLS based on your signs and symptoms, a complete medical history, and a physical exam. In addition, tests, such as lab tests or a sleep study, may be done. Currently, there is not a definitive test to diagnose restless legs syndrome.

The diagnosis is especially difficult with children because the physician relies heavily on the patient's explanations of symptoms, and given the nature of the symptoms of RLS, can be difficult for a child to describe. The syndrome can sometimes be misdiagnosed as "growing pains" or attention deficit disorder.

How is RLS treated?

Your doctor will consider your age, overall health and other factors when advising treatment for you.

Treatment options for restless legs syndrome may include:

  • Trying good sleep habits

  • Stopping activities that worsen symptoms

  • Avoiding caffeine, alcohol, and tobacco, which may worsen symptoms

  • Regular, moderate exercise

  • Maintaining a well-balanced diet

  • Treating underlying chronic conditions

Medications, including:

  • Dopaminergic agents (drugs that increase dopamine) which are largely used to treat Parkinson's disease

  • Benzodiazepines such as clonazepam and diazepam

  • Opioids such as codeine, propoxyphene, or oxycodone

  • Anticonvulsants such as gabapentin and pregabalin

Consult your doctor for more information regarding the treatment of restless legs syndrome.

Key Points

  • Restless legs syndrome is a sleep disorder that causes unpleasant sensations in the legs. The cause of RLS is still unknown.

  • With RLS, you have an irresistible urge to move the affected limb when the sensations occur.

  • Your doctor can diagnose RLS based on your signs and symptoms, a complete medical history, and a physical exam, but there is no definitive test to diagnose RLS.

  • Medications and lifestyle changes can help relieve RSL symptoms.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.

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