Restless Legs Syndrome (RLS)En Español (Spanish Version)
Restless legs syndrome (RLS) is a neurologic disorder characterized by unpleasant sensations in the legs and an irresistible urge to move them. The sensations are typically worse during periods of inactivity and usually strongest at night. The symptoms are improved with activity. For this reason, people with RLS generally have insomnia , which may be severe.
The exact cause of RLS is unknown. RLS may occur for no identifiable reason (primary RLS), or may be caused by other medical conditions or use of certain drugs (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 that interrupt sleep.
These factors increase your chance of developing RLS. Tell your doctor if you have any of these risk factors:
- Family members with RLS
- Pregnant—Some women have RLS during pregnancy; the symptoms usually disappear after giving birth.
- Low iron levels (with or without anemia)—This may happen if you give blood frequently.
- Northern European descent
- Chronic disease (which can lead to secondary RLS):
- Certain medications (eg, tricyclic antidepressants)
- Withdrawing from certain drugs (eg, selective serotonin reuptake inhibitors [SSRIs], lithium, caffeine, dopamine antagonists, sedating antihistamines)
Symptoms may include:
- Feelings of tingling, creeping, pulling, prickling, "pins and needles," or pain in the legs during periods of rest or inactivity—Half of patients complain of restlessness in the arms as well as legs.
- Symptoms typically get worse at night
- A strong urge to relieve these uncomfortable feelings with movement
- Restlessness, including floor pacing, tossing and turning in bed, and rubbing the legs
- Difficulty falling asleep and staying asleep
- Hypersomnia—recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep
Symptoms may begin at any age, but are most common in people older than 60 years old. Symptoms usually increase in the evening and during times of rest, relaxation, or inactivity.
The doctor will ask about your symptoms and medical history, and do a physical and neurologic exam. The diagnosis is based mainly on your symptoms. There is no specific test for RLS, but tests to check for conditions that may trigger RLS include:
- Blood tests to check iron levels
- Monitoring of leg activity during sleep ("sleep study")
- Study of leg muscles, such as electromyography (EMG) and nerve conduction studies
Nerves of the Leg
© 2008 Nucleus Medical Art, Inc.
There is no cure for this condition. Treatments are aimed at relieving or reducing symptoms.
Treatment for Mild Cases of RLS
- Massage your legs.
- Use a heating pad or ice pack.
- Take a hot bath.
- Talk to your doctor about taking supplements that might be helpful, such as folate, iron, magnesium, vitamins B12, C, and E.
- Refrain from using tobacco, alcohol, or caffeine.
- Follow a sleep routine.
- Develop a regular, moderate exercise program.
- Avoid the use of medications that may worsen RLS, such as antidepressants.
Treatment for Conditions That May Trigger RLS
Effective treatment of conditions that may trigger RLS can ease or even eliminate symptoms:
- Kidney failure
Treatment for Severe Cases of RLS
- Dopaminergic agents (ropinirole, pramipexole)—considered the most effective
- Anticonvulsants (gabapentin)
Transcutaneous Electric Nerve Stimulation
During this treatment, electric stimulation is done to the affected area of the leg. This is usually done 15-30 minutes before bedtime to help reduce leg jerking.
National Sleep Foundation
Restless Legs Syndrome Foundation
BC Health Guide
Canadian Sleep Society
Bradley WG, Daroff RB. Neurology in Clinical Practice . Philadelphia, PA: Butterworth Heiemann; 2004.
Current Medical Diagnosis and Treatment . 45th ed. McGraw-Hill; 2006.
National Sleep Foundation website. Available at: http://www.sleepfoundation.org .
Restless legs syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Accessed May 27, 2008.
Restless Legs Syndrome Foundation website. Available at: http://www.rls.org/ .
Shannon, Kathleen. Restless Legs Syndrome In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corp. Medlink website. Available at: http://www.medlink.com. Accessed May 12, 2008.
Worldwide Education and Awareness for Movement Disorders website. Available at: http://www.wemove.org/.
Last reviewed March 2008 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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