When Your Legs Just Want To Keep On Walking
Restless legs syndrome is a nerve disorder characterized by throbbing, pulling, creeping or other unpleasant sensations in the legs and an uncontrollable, usually overwhelming, urge to move them.
Symptoms usually start in the evening just as you sit down to relax, and may progressively worsen throughout the night. Both legs are usually affected although one may be worse than the other. In more severe cases, the arms and lower trunk may also be affected. RLS affects more than twice as many women as men.
About Restless Leg Syndrome
Restless leg syndrome usually strikes when youve been inactive for a while, such as sitting at your desk at work, while watching a movie, or when you lie down to go to bed at night. Your symptoms probably become more intense as the evening wears on, making it difficult to drift off or get back to sleep if the sensations in your legs wake you up. The disease leads to intense daytime sleepiness, which can affect your moods, relationships, and performance at work or school.
Restless leg syndrome is technically classified as a sleep disorder because it occurs when you try to rest or sleep. Its also categorized as a movement disorder because you must move your legs for relief. The condition also has strong links to fibromyalgia.
We dont know the specific cause of restless leg syndrome, although there are several known contributing factors such as genetics. For example, if you develop the condition before age 40, chances are, it runs in your family. Some research indicates that the disease could be related to an imbalance in dopamine, a chemical in your brain that helps regulate muscle movement. Other risk factors for the condition include iron deficiency, kidney failure, spinal cord injuries, and neuropathy.
Does Having Rls Increase The Risk Of Developing Pd
Since RLS affects as much as 4-10% of the US adult population, it is clear that the vast majority of those with RLS do not ever develop PD.
Despite this, it still might be the case that RLS increases the risk of subsequently developing PD. There have been many studies trying to figure this out with conflicting results. Some studies show that there is no increased risk and others show that having RLS confers about a two-fold increased risk of developing PD over the general population.
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Causes Of Restless Legs Syndrome
In many cases, the exact cause of restless legs syndrome is unknown.
When no cause can be found, it’s known as “idiopathic” or primary restless legs syndrome.
Research has identified specific genes related to restless legs syndrome, and it can run in families. In these cases, symptoms usually occur before the age of 40.
What Does It Feel Like
People with Restless Legs Syndrome are usually prompted to move because they feel intense sensations in their legs. Below are some ways people have described what the sensations feel like, as reported by the Mayo Clinic:
RLS usually emerges or worsens at night.
Leg twitching or kicking may also result from a condition linked to RLS known as Periodic Limb Movement Disorder. We will cover this in-depth further below.
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When Does Restless Leg Syndrome Happen
Symptoms occur when the person is at rest or inactive, such as:
- Lying down
- In bed
- In a restricted space, like on a plane or at the movies
As a person is more likely to be at rest in the afternoon and evening, those are the parts of day when RLS symptoms are usually at their worst. For some of those affected by RLS, the symptoms may only occur occasionally, while for others they are present every day.
Symptoms tend to improve in the mornings with getting up, and whenever the person starts to move or walk around. Moving around as a remedy can cause problems when the person is trying to go to sleep.
Symptoms can vary in severity, from mild discomfort to being so disruptive and painful they affect day-to-day life. Sleep can be so disturbed that people have difficulty functioning during the day, which can commonly lead to depression and anxiety.
Worried you may have RLS? Start a symptom assessment on the Ada app.
Restless Legs Syndrome: Seeking Help
Studies estimate that one out of 10 people suffer from restless legs, yet its not always easy to find help and support. Many people with RLS never receive proper treatment. Part of the problem is that its hard to explain and sufferers are often dismissed as being nervous. Those who havent experienced the distressing symptoms may not understand how severely they can impact the quality of your life. Even doctors may not take restless legs seriously, recognize the symptoms, or realize that they point to a real medical condition.
The good news is that recent research has increased our understanding of restless legs syndrome, leading to more effective treatments. At the same time, RLS is becoming more widely recognized. If you or your partner suffers from restless legs, theres never been a better time to find relief.
A night in the life of RLS
If you have restless legs syndrome, a typical night might go like this: You lie down in bed, ready to go to sleep, and just as your body begins to relax, the crawling, tingling, or itching in your legs begin. You try to ignore the uncomfortable sensations, hoping they will go away, but eventually the urge to move is too much. You get out of bed to stretch and pace the floor and, for a moment, you find relief. But when you lie down again, the restless sensations in your legs start all over again.
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
While the direct cause of RLS is often unknown, changes in the brains signaling pathways are likely to contribute to the disease. In particular, researchers suspect that impaired transmission of dopamine signals in the brains basal ganglia may play a role. There is a relationship between genetics and RLS. However, currently there is no genetic testing. NINDS-supported research is ongoing to help discover genetic relationships and to better understand what causes the disease.
The NINDS also supports research on why the use of dopamine agents to treat RLS, Parkinsons disease, and other movement disorders can lead to impulse control disorders, with aims to develop new or improved treatments that avoid this adverse effect.
More information about research on RLS supported by NINDS or other components of the NIH is available through the NIH RePORTER , a searchable database of current and previously funded research, as well as research results such as publications.
Relieving Restless Legs In The Moment
Sometimes, despite your best self-help efforts, the symptoms of restless legs flare up. The following tips will help you find quick relief:
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How To Tell The Difference Between Rls And Neuropathy
RLS symptoms are often described as creepy crawly or jumpy leg sensations, but they can also be described as painful at times. To see if you have RLS, your health care provider will look for the following specific features:
- You have an urge to move your legs to stop discomfort or unusual feelings.
- Your symptoms worsen during rest or inactivity, such as lying or sitting.
- Your symptoms tend to go away with movement, such as walking or stretching.
- The urge to move or unpleasant sensations occur in the evening or nighttime.
- The disorder is not explained by another current sleep disorder, medical or neurological disorder, medication use or substance abuse disorder.
Neuropathy symptoms are often described as burning, shooting, electrical or pins-and-needles in the arms, legs, feet and hands.
While both can cause leg discomfort, there are some hallmark differences between the two.
Whereas RLS tends to occur at night, neuropathy doesnt only occur at night, but typically occurs during the day and night, Dr. Lee-Iannotti said. Rest doesnt make neuropathy worse, but movement doesnt make it better either. In fact, patients often say that movement makes the pain worse.
As well, RLS tends to run in families, but there may or may not be a familial link with neuropathydepending on whether it is inherited or acquired.
Establishing A Treatment Plan For Restless Legs Syndrome
When treating RLS, doctors must consider the severity of the condition and the extent to which it affects your quality of life. Due to the potential for side effects, doctors may prefer to avoid prescribing medication for mild symptoms that dont interfere with day-to-day life.
Since RLS can occur on its own or as a result of another medical condition, treatment for RLS symptoms may need to be approached differently depending on the root cause. Before proceeding with RLS treatment, experts recommend looking for other conditions that could be causing or aggravating RLS symptoms. Common culprits include:
- Sleep deprivation
- Renal insufficiency
- Medication such as antihistamines and certain antidepressants
For many people, addressing these factors may lead to a drastic reduction in RLS symptoms. However, if symptoms are still bothersome, or if they interfere with sleep, doctors may advise additional remedies.
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Attention Deficit Hyperactivity Disorder
There is significant overlap between some of the symptoms and treatments for RLS and attention deficit hyperactive disorder . Up to a quarter of children diagnosed with attention-deficit hyperactivity disorder may also have RLS, sleep apnea, or PLMD. These conditions may actually contribute to inattentiveness and hyperactivity. The disorders have much in common, including poor sleep habits, twitching, and the need to get up suddenly and walk about frequently. Some evidence suggests that the link between the diseases may be a deficiency in the brain chemical dopamine.
Leg Pain And Plantar Fasciitis
If you have plantar fasciitis and youre dealing with leg pain that isnt accompanied by movement, youre not alone.
Gait abnormalities or tight and inflexible muscles in the calves, ankles, and thighs, can all contribute to leg pain that accompanies heel pain. For the most part, improving the alignment of the feet and legs, as well as massage and stretching to help muscles become stronger and more flexible can significantly improve both your heel pain and your leg pain.
Remember: Your feet and heels dont work in isolation. All of the muscles, tendons, and ligaments in the feet and legs work together to help you take every step. When the arch and heel are struggling, the legs often suffer and vice versa!
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Ropinirole Stimulates Dopamine Receptors
Ropinirole is a dopamine agonist and was the first medication approved for moderate-to-severe RLS by the FDA in 2005. Ropinirole fools dopamine receptors into thinking that there is extra dopamine available, and consequently helps relieve symptoms of RLS.
Ropinirole is also used to treat people who suffer from Parkinson’s disease but don’t worry, scientists have found no link whatsoever between RLS and an increased risk of developing Parkinson’s disease. Ropinirole should not be stopped suddenly. As with any new medicine, discuss the risks and benefits with your doctor.
What Causes Restless Body Syndrome
The two most common causes of RLS are: 1) iron-deficiency anemia and 2) peripheral neuropathy, which is damage to the nerves of the legs cause by an underlying condition.
There may be other causes including parkinsons disease and Varicose Veins.
Although there is no known one cure for RLS, iron supplementation can help. In fact, one study found that in patients whose serum ferritin was < 75 µg/l, oral iron therapy on average improved RLS symptom after 3 months. Iron supplements may be taken as capsules, tablets, chewable tablets, and liquids. The most common tablet size is 325 mg .
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Check Your Medicine Cabinet
There are many common medicationsboth prescription and over-the-counterthat can trigger the symptoms of RLS or make them worse. Medications to watch out for include:
- Cold and allergy medications containing antihistamines .
- Anti-nausea medications .
- Calcium channel blockers .
- Antidepressants .
- Antipsychotics .
Get checked for iron and vitamin deficiencies
A number of vitamin and mineral deficiencies are linked to restless legs syndrome.
Iron. Iron deficiency is a well-known cause of RLS, so ask your doctor to test you for anemia. However, supplementing with iron can also improve RLS symptoms in those who arent anemic.
Magnesium. Magnesium can improve sleep and some studies have shown it to be beneficial for restless legs. Try experimenting with a magnesium supplement at bedtime to see if your symptoms improve.
Vitamin D. Recent studies show that RLS symptoms are more frequent and more severe in people with vitamin D deficiency. Your doctor can easily test your vitamin D levels or you can simply make it a point to get out more in the sun.
Folate . Folate deficiency has been linked to RLS, which may explain why restless legs are so common in pregnant women . When folic acid is low, B12 is often low as well, so you may want to try supplementing with a B-complex vitamin.
Sleep Hygiene For Restless Legs Syndrome
Sleep hygiene is important, as tiredness makes symptoms worse.
- Sleeping in a cool, quiet bedroom.
- Going to bed at the same time every night, and getting up at the same time every morning.
- Reduce the amount of light you are exposed to for an hour before bed.
- Avoid stimulating drinks, such as caffeine or sugar.
- Avoiding or reducing alcohol consumption and tobacco.
Exercise and physical activity can help RLS, but it can also aggravate it. Most patients find moderate exercise helpful, but too much can make symptoms worse. Working out late in the evening may also be unhelpful.
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What Is Normal Protective Pain
Normally pain is good. It informs you about potential or actual damage to your bodys tissues. Nociceptor nerve cells in the tissues of your body, react to strong stimuli such as pressure, heat, cold or chemicals.
These nociceptors send a message to the spinal cord, which then forward another message up to the brain. Your brain then processes these messages and produces a coordinated response to escape whatever is causing the tissue damage.
Tips For Coping With Restless Legs Syndrome
Learning to recognize and avoid your personal triggers can help you manage RLS over time.
Effective techniques for minimizing RLS symptoms vary from person to person. Many people find relief from keeping active throughout the day and using acupuncture, massage, stretching, or relaxation techniques at night. During the day, you may be able to ward off RLS symptoms by keeping your mind busy even when you are sitting still with activities like reading or chatting to a friend.
Though RLS is not life-threatening, the frustration of not being able to sleep well can take a toll on mental health. Cognitive behavioral therapy, support groups, or reaching out to family and friends may provide additional emotional resources for coping with RLS.
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Plantar Fasciitis And Restless Leg Syndrome
Restless leg syndrome is a condition that affects anywhere between 4 and 30 percent of the US population. The condition causes discomfort or a pins-and-needles sensation and the urge to move the lower legs during periods of inactivity, such as sitting or while lying in bed. Often, the condition gets worse at night and interferes with falling asleep.
Plantar fasciitis, on the other hand, is a condition that impacts the arch of the foot, or more specifically the plantar fascia, a ligament that connects your heels to your toes and helps absorb impact and distribute weight evenly while you walk or move. When this band of tissue becomes strained, inflamed, or overused, plantar fasciitis develops.
Its worth noting that individuals with restless leg syndrome often experience other foot problems as well, including bunionsand plantar fasciitis.
While the cause of restless leg syndrome is unknown, there is growing support for the theory that RLS is caused by problematic movement patterns, and stress and strain to myofascial trigger points, or muscle knots, in the skeletal muscles of the feet and legs. Some experts believe that the gait changes that often occur alongside plantar fasciitis can trigger restless leg syndrome.
Tip : Get Daily Exercise
Daily activity, including aerobic exercise and lower-body resistance training, can significantly reduce the symptoms of restless legs syndrome in most people. Choose activities you enjoy, especially those that emphasize using the legs. Try to exercise for at least 30 minutes on most days, although not too close to bed time.
The exercise doesnt need to be intense. Simple daily activities such as walking can often deliver all the benefits youre looking for. In fact, highly vigorous exerciselike training for a marathoncan sometimes backfire and make RLS symptoms worse.
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Treatment Of Restless Legs Syndrome In Children
The US Food and Drug Administration has not approved any medication for treating restless legs syndrome in children. The long-term effects of treating children with medication approved for adults are unknown.
Benzodiazepines, such as clonazepam, are not recommended for children because they can increase the risk of collapse of the upper airway. Up to 20 percent of children taking levodopa and carbidopa develop a side effect of feeling nauseous.
Good sleep habits are recommended for treating restless legs syndrome in children, as is avoiding caffeine and antihistamines. Vitamin and mineral supplements may help, when taken in consultation with a doctor.