Restless Legs Syndrome
DefinitionRestless legs syndrome (RLS) is a neurologic disorder. It is characterized by:
- Unpleasant sensations in the legs
- An irresistible urge to move the legs
CausesThe cause of primary RLS is unknown. RLS may have some genetic component. In some cases, it may be caused by other conditions or certain medications. This is called secondary RLS.Many people with RLS also have periodic limb movement disorder (PLMD). This is a related motor disorder characterized by:
- Involuntary, repetitive, jerking movements
- Interrupted sleep because of periodic leg movements
Risk FactorsFactors that may increase your chance of getting RLS include:
- Family history
- Certain medications, such as antidepressants, antipsychotics, caffeine, theophylline, dopamine antagonists, and sedating antihistamines
- Peripheral neuropathy
- Chronic kidney failure
- Anemia or iron deficiency
- Chronic obstructive pulmonary disease (COPD)
SymptomsSymptoms may include:
- Feelings of tingling, creeping, pulling, prickling, pins and needles, or pain in the legs during periods of rest or inactivity—may also occur in the arms
- Symptoms typically get worse at night
- A strong urge to relieve uncomfortable sensations with movement
- Restlessness, including floor pacing, tossing and turning in bed, and rubbing the legs
- Difficulty falling asleep and staying asleep
DiagnosisThe doctor will ask about your symptoms and medical history. A physical and neurologic exam will be done. The diagnosis is based mainly on your symptoms. There is no specific test for RLS.Tests to check for conditions that may trigger RLS include:
- Blood tests
- Monitoring of leg activity during sleep
- Study of leg muscles, such as electromyography (EMG) and nerve conduction studies
|Nerves of the Leg|
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TreatmentThere is no cure for RLS. Treatments are aimed at relieving or reducing symptoms.
Treatment for Mild Cases of RLSSelf-care
- Massage your legs.
- Use a heating pad or ice pack.
- Take a hot bath.
- Avoid using tobacco, alcohol, or caffeine.
- Follow a sleep routine.
- Begin a safe exercise program with the advice of your doctor.
- Avoid the use of medications that may worsen RLS.
Treatment for Conditions That May Trigger RLSEffective treatment of conditions that may trigger RLS can ease or resolve your symptoms:
Treatment for More Severe Cases of RLSMedicationDopamine agonists are the only drugs that are FDA approved to treat restless leg syndrome. They are often considered the most effective type of medication for this condition.Other medications may be used to help control symptoms of restless leg syndrome. Some medication options include clonidine, anticonvulsants, and opioids. Your doctor will select the medication based on your symptoms and medical history.
PreventionThere are no current guidelines to prevent RLS because the cause is unknown.
National Sleep Foundation
Willis-Ekbom Disease Foundation
Canadian Sleep Society
Cui Y, Wang Y, Liu Z. Acupuncture for restless legs syndrome. Cochrane Database Syst Rev. 2008;CD006457.
Explore restless legs syndrome. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/rls/. Updated November 1, 2010. Accessed June 27, 2013.
Restless legs syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 7, 2013. Accessed June 27, 2013.
Restless legs syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/restless%5Flegs/detail%5Frestless%5Flegs.htm. Updated June 13, 2013. Accessed June 27, 2013.
Salas RE, Gamaldo CE, Allen RP. Update in restless legs syndrome. Curr Opin Neurol. 2010;23(4):401-6.
What is Willis-Ekbom disease (WED)/RLS? Willis-Ekbom Disease Foundation website. Available at: http://www.rls.org/about-wed-rls. Accessed June 27, 2013.
11/26/2012 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Aurora R, Kristo D, Bista S, et al. The Treatment of Restless Legs Syndrome and Periodic Limb MovementDisorder in Adults—An Update for 2012: Practice Parameters with an Evidence-Based Systematic Review and Meta-Analyses. Sleep. 2012;35(8):1039-1062.
- Reviewer: Rimas Lukas, MD
- Review Date: 05/2014
- Update Date: 06/02/2014