Uncomfortable sensations in the legs that start at rest, improve with movement, and worsen at night. Symptoms may also affect the arms. restless legs syndrome (RLS) often runs in families. It can be made worse during pregnancy or hormonal changes.
Your healthcare provider can diagnose this disorder based on your symptoms and health history. They may check your blood and urine, and look for conditions like diabetes or iron deficiency that can make the symptoms worse.
Symptoms
Uncomfortable sensations in the legs (and sometimes arms) that cause an irresistible urge to move. These feelings typically start after you’ve been sitting or lying down for long periods of time, such as during a long car ride or movie theater show. They usually get worse in the evening and may disturb your sleep at night.
The discomfort feels different for everyone, but often it’s like a prickling or tingling sensation. The sensations may also feel like itchy or burning skin. They usually occur in one or both legs, but they can also happen in the feet, arms and torso. The sensations aren’t painful, but they are very bothersome. They can interfere with daytime activities and make it hard to concentrate or focus.
There’s no known cause for restless legs syndrome, but it seems to be linked to how the brain chemical dopamine works. It’s thought that RLS might be partly genetic, and some people pass it on to their children. Symptoms can begin at any age, but they tend to get worse with age. Having other medical conditions that can affect your blood vessels, nerves and muscles, such as varicose veins, diabetes, peripheral neuropathy or rheumatoid arthritis, may increase your risk of having RLS.
For some people, the symptoms improve with exercise or by avoiding things that trigger them, such as caffeine. A vibrating pad can also help some people. Medications that are used to treat depression, anxiety or epilepsy can reduce the severity of the symptoms in some people. These drugs are called alpha-2-delta ligands and include gabapentin (Neurontin), pregabalin (Lyrica) and clonidine (Catapres).
Your healthcare provider will ask about your past health, symptoms and family history. They will do a physical exam and look for any signs of other illnesses or problems. There’s no test to diagnose RLS, but your provider might suggest a sleep study (polysomnogram) to rule out other possible causes of the symptoms. Taking certain medicines can ease the symptoms of restless legs syndrome, and some simple self-care steps can help too. Your healthcare provider can recommend other treatments if the medicines don’t work for you.
Diagnosis
Restless legs syndrome (RLS) is a disorder that causes an irresistible urge to move your legs. This feeling is uncomfortable, and it usually happens in the evening or at night. It makes it hard to fall asleep or stay asleep. It may also cause daytime drowsiness. It can happen in one or both legs. But it mostly affects the lower legs and feet, and less often the arms. The sensations are not like a muscle cramp, but more like a creeping, crawling, or tingling. These feelings are different for everyone. They can be very uncomfortable, but they are not painful. The feelings usually only last for a few minutes and get better as soon as you move.
Doctors can diagnose RLS by listening to your description of the symptoms and performing a simple test. They can help you rule out other conditions that might cause them, such as leg cramps, positional discomfort, or arthritis. They will also check if you are taking any medicines that could make the symptoms worse.
There is no known cause of RLS, but scientists believe it has to do with how the brain part that controls movement functions. This part of the brain uses the chemical dopamine to send messages that control how you move. When the dopamine levels are too low, it can lead to the RLS symptoms. RLS can also run in families. Some people develop it in childhood, while others first experience it as adults. It is also more common in women than men.
Symptoms of RLS can vary in severity, but they typically start after you’ve been sitting or lying down for a long time. They get worse during the evening or night and tend to go away with movement, such as walking, stretching, or massaging your legs. Symptoms may also get worse during pregnancy or during other times when you are changing hormone levels, such as after childbirth or menopause.
RLS can be a lifelong condition, but there are ways to improve your quality of life. Medicines and self-care can help relieve the symptoms. Simple steps, such as soaking your legs in a warm bath, doing exercises or massages, and avoiding caffeine, alcohol, and cigarettes, can also improve your symptoms.
Treatment
If you have RLS, your symptoms will usually get worse when you’re resting at night and they will interfere with sleep. They can also be caused by other conditions, such as leg cramps or peripheral neuropathy. Some people with RLS have remissions, periods of time when their symptoms decrease or disappear for weeks or months.
You can treat the discomfort in your legs with lifestyle changes and medicines. Your doctor can diagnose RLS based on your symptoms, health history and physical exam. They may refer you to a specialist, such as a neurologist who treats movement disorders or a sleep medicine expert.
Treatments for RLS focus on easing your discomfort and helping you fall asleep at night. Medications called dopamine agonists are usually the first choice. These are similar to the medications used in Parkinson’s disease and can improve your symptoms. They work by replacing a natural chemical in your brain. You can also get relief from your symptoms by exercising regularly and getting enough sleep, especially at night.
In some cases, your doctor may refer you to a sleep specialist for a more in-depth look at your sleep habits and to rule out other conditions that cause similar symptoms, such as obstructive sleep apnea. You may need to stay at a sleep clinic overnight to have a test called an apnea study.
Nonmedication treatments for RLS include leg massages, hot or cold compresses, avoiding caffeine and alcohol, and using vibrating pads to soothe the muscles in your legs. You can also try practicing relaxation techniques, such as deep breathing or meditation, to help you sleep better at night.
You may also benefit from taking a vitamin supplement that contains iron. This can help prevent an iron deficiency, which often causes RLS. You should only take iron supplements under your doctor’s supervision and after having your blood iron level checked.
Most experts agree that it’s important to make regular exercise a part of your daily routine. Studies show that patients with RLS who exercise at least 30-60 minutes a day on most days have less severe symptoms than those who don’t exercise.
Prevention
The cause of restless legs syndrome isn’t known, but it may be related to an imbalance of the brain chemical dopamine. It is thought that this may affect the part of the brain that controls movement. The sensations usually occur in the evening and at night, when sitting or lying down. They are worsened by sleep deprivation or fatigue. They can interfere with daily activities, such as driving and working. RLS can also cause excessive daytime sleepiness and difficulty paying attention or concentrating. The symptoms of restless legs syndrome are different for each person, and they can be mild or severe.
Most people with restless legs syndrome have no other medical conditions, but the condition can increase with age. It can also run in families. It is more common in women than men, but both sexes can have it at any age. The symptoms can also become more frequent and severe during pregnancy, and it is often worse in the last trimester.
In some cases, there’s no identifiable cause of restless legs syndrome, but it can be linked to anemia, pregnancy and some medicines. It can be made worse by caffeine, alcohol and tobacco. It can be caused by nerve damage and vascular disease, including peripheral vascular disease (PVD), which is when arteries and veins narrow or close.
It’s not possible to prevent RLS, but there are steps you can take to reduce the symptoms. These include using a hot or cold compress on the legs, massaging them and applying heat or ice. Practicing good sleeping habits, such as a cool, dark and comfortable bedroom, setting a regular bedtime and avoiding large meals, alcohol and naps, can help. A regular exercise regimen can help too.
If you have any of the symptoms of restless legs syndrome, see your doctor for treatment options. There are medications and lifestyle changes that can help, and you might need to try a few things before you find the right one for you. Some people get symptom relief with vitamins and supplements, such as magnesium, but you should check with your doctor before taking any of these.