What Tests Can Diagnose Restless Leg Syndrome
There is no definitive test that can diagnose RLS. The diagnosis is made based on your symptoms, however, there are many tests that your healthcare provider may recommend to attempt to find the cause of your RLS. Some possible testing may include lab work, a sleep study, and nerve conduction studies, but the most important test in my vascular office would be an ultrasound of the veins, either in the legs, the pelvis, or both. These vein ultrasounds are called venous Dopplers.
What Is Restless Leg Syndrome
Restless Leg Syndrome is an often uncontrollable urge to twitch and move your legs especially when sitting or lying down. It isnt curable and the cause is unclear, but its a neurological problem that researchers theorize may result from a lack of iron in the brain or a physiological in processing and using iron. Its associated with diabetes, rheumatoid arthritis, pregnancy, kidney failure, Parkinson’s disease, and iron deficiency. Tobacco, caffeine, and obesity tend to make restless leg syndrome worse.
Treatments For Underlying Health Conditions
Many health conditions may cause RLS. Treating these conditions may help to reduce the severity and frequency of RLS symptoms.
A person who experiences RLS should see a doctor to determine whether there is an underlying cause and to receive any necessary treatments.
RLS is a nervous system disorder that causes uncomfortable sensations in the legs. These sensations lead to an overwhelming urge to move the legs.
Some sensations that a person may feel in their legs include:
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Secondary Restless Legs Syndrome
There are a number of factors that appear to be linked to restless legs syndrome. These may include:
Iron deficiency anemia
A lack of iron in the body, leading to iron deficiency anemia, appears to be linked to restless legs syndrome. Iron plays a role in the functioning of dopamine and other neurotransmittersâ function in the brain.
Restless legs syndrome and pregnancy
Pregnant women may develop restless legs syndrome, with symptoms more common in the final trimester. Between 10 percent and 25 percent of pregnant women are thought to experience symptoms.
Nobody is quite sure why pregnancy can trigger restless legs syndrome. There are suggestions it may be connected to:
- Low iron levels
- Circulation problems
- Increase in estrogen
Restless legs syndrome that develops during pregnancy very often goes away within a month after birth.
Conditions often observed alongside restless legs syndrome
There are several conditions that can lead to restless legs syndrome as a complication, or have been linked to it, sometimes without yet fully understanding the mechanisms behind the link, such as:
- End-stage kidney disease, particularly when needing dialysis
- Nerve damage. This includes peripheral neuropathy, which may itself be a complication caused by diabetes
- Spinal cord disease
- Smoking tobacco
Other Conditions To Consider
Polysomnography and related sleep study tests may also be done to help identify problems that can interfere with sleep. You may be evaluated for other conditions with symptoms similar to restless legs syndrome. These conditions include varicose veins, arthritis, or intermittent claudication .
You also may be asked about behaviors, habits, and physical traits that may be related, such as:
- Being overweight and having a high body mass index.
You may also have tests to check for other diseases or health conditionssuch as diabetes, peripheral neuropathy, pregnancy, kidney problems, or iron deficiency anemiathat can cause your symptoms. Tests will vary depending on what your doctor identifies as likely problems.
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Medicines For Aiding Sleep
If restless legs syndrome is badly disrupting your sleep, a short-term course of medicine may be recommended to help you sleep.
Hypnotics are usually only recommended for short-term use .
You may find you still feel sleepy or “hungover” the morning after taking your medicine.
What Is Restless Legs Syndrome
Restless legs syndrome , also called Willis-Ekbom Disease, causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms commonly occur in the late afternoon or evening hours, and are often most severe at night when a person is resting, such as sitting or lying in bed. They also may occur when someone is inactive and sitting for extended periods . Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up. Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops. RLS is classified as a sleep disorder since the symptoms are triggered by resting and attempting to sleep, and as a movement disorder, since people are forced to move their legs in order to relieve symptoms. It is, however, best characterized as a neurological sensory disorder with symptoms that are produced from within the brain itself.
RLS is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance, and personal relationships. Many people with RLS report they are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks. Untreated moderate to severe RLS can lead to about a 20 percent decrease in work productivity and can contribute to depression and anxiety. It also can make traveling difficult.
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Other Lifestyle Tips To Ease Restless Legs
Adopting these lifestyle changes will also help to ease your restless legs symptoms.
- Take walks during your lunch time
- Stretch your legs, arms, and other bendable joints on a regular basis
- Use compression stockings to keep restless legs in place
- Maintain proper blood circulation by moving your legs in the afternoon such as jogging on the spot
- Avoid sitting for prolonged periods of time
- Take frequent breaks throughout the day from your normal occupational stance
- Limit or avoid triggers such as caffeine-induced drinks and food in the afternoon and evening
- Avoid tobacco and alcohol for a few weeks to determine if these are triggers
- Use a pneumatic compression device while you sleep
- Treat poor circulation with light therapy
- Add stationary or outdoor cycling to your weekly exercise routine
- Try aquacise and lap swimming to help lessen pressure on the legs, relax tense muscles, and promote mobility and strength
- Use caution if taking over-the-counter or prescribed cold and sinus medications as they may aggravate the symptoms
Surgery For Varicose Veins
Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency , which means your body cant properly circulate blood. As a result, the blood pools in your legs.
In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery .
Again, more research is needed on this surgery as a treatment for RLS.
If youre interested in any of these less-researched treatments, ask your doctor about them. Of course, you can try hot and cold treatments on your own, but your doctor can tell you more about the other treatments and whether they might be able to help you.
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Drugs That Increase Dopamine
These medications help decrease motion in your legs.
Drugs in this group include:
Side effects may include mild lightheadedness and nausea. These medications can become less effective over time. In some people, they can cause daytime sleepiness impulse control disorders, and worsening of RLS symptoms.
Natural Remedies For Restless Leg Syndrome
Restless leg syndrome , marked by an uncontrollable urge to move the legs, is a neurological disorder that affects as many as 12 million Americans. Symptoms usually strike when patients are lying in bed at night, but restless leg syndrome can also flare up in the daytime .
Restless leg syndrome patients typically report a feeling of burning, tingling, aching, itching, or tugging deep beneath the skin of their lower legs . Although symptom intensity and duration vary from person to person, moving the legs tends to ease the discomfort for most patients.
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Symptoms Of Restless Arm Syndrome
Restless arm syndrome is a spectrum disease, meaning that the symptoms can vary greatly from person to person in both severity and frequency. Symptoms range from mild to unbearable and from occasionally to daily. Symptoms may include:
- Involuntary Arm Movements: People tend to experience sudden, jerky, uncontrollable movements in the arms, and in some case other body parts as well, most commonly the legs
- Odd Sensations: People with restless arm syndrome often report feeling strange sensations in their arms such as tingling, burning, numbness, tickly, buzzing or itching sensation or like a creepy crawly crawling over you. The strange sensations associated with restless limbs can also give you a strong urge to want to move
- Daily Pattern: Symptoms of restless limbs tend to be worse in the evenings and overnight or when resting or relaxing. As a result, sleep is often affected. Some people get symptoms throughout the day, but they tend to be least in the mornings
Lifestyle And Home Remedies
Making simple lifestyle changes can help alleviate symptoms of RLS:
- Try baths and massages. Soaking in a warm bath and massaging your legs can relax your muscles.
- Apply warm or cool packs. Use of heat or cold, or alternating use of the two, may lessen your limb sensations.
- Establish good sleep hygiene. Fatigue tends to worsen symptoms of RLS, so it’s important that you practice good sleep hygiene. Ideally, have a cool, quiet, comfortable sleeping environment go to bed and rise at the same time daily and get at least seven hours of sleep nightly.
- Exercise. Getting moderate, regular exercise may relieve symptoms of RLS, but overdoing it or working out too late in the day may intensify symptoms.
- Avoid caffeine. Sometimes cutting back on caffeine may help restless legs. Try to avoid caffeine-containing products, including chocolate, coffee, tea and soft drinks, for a few weeks to see if this helps.
- Consider using a foot wrap. A foot wrap specially designed for people with RLS puts pressure under your foot and may help relieve your symptoms.
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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.
Ras And Other Phenotypic Variants Of Rls
Restless arms due to an extension to the upper limbs are commonly observed in severe RLS patients, especially in case of augmentation syndrome.9 Arm involvement is reported in 2157% of cases.1 Usually restlessness in the upper extremities appears later in the course of typical patients who had RLS only in the legs. In this situation, restlessness remains most invalidating in the lower limbs with a milder discomfort in the arms as compared to the legs. However, symptoms severity can be predominant on the upper limbs in exceptional cases of RLS extension to the arms.48,54 Rare cases of restlessness limited to the shoulders have been described.55 This literature review focuses on RAS limited to the upper limbs with a possible extension to the lower limbs in some patients. It remains unknown whether a continuum exists from RLS limited to the lower limbs, RLS extending to the upper limbs, RAS extending to the lower limbs, and RAS limited to the upper limbs. Specific underlying mechanisms of the spread of RLS to restlessness in the upper limbs and of RAS have not yet been identified. It remains hypothetic whether in RAS cervical spinal segments might be involved rather than lumbar segments.
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Ruling Out Potential Causes
Your first step in addressing RLS should be to figure out if something is causing it. While RLS can be related to things that are largely out of your control, such as genetics or pregnancy, other possible factors can be addressed.
These factors could be daily habits, medications youre taking, health conditions you have, or other triggers.
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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Ras Management Strategies And Impact Are Comparable To Those Of Rls
Similarly to RLS, RAS patients benefitted from dopaminergic treatment, complementation of iron deficiency, treatment of coexisting obstructive sleep apnea and good sleep hygiene. Alpha 2 delta ligands and opioids might also be efficient in RAS.8
Impact of RAS on sleep and daytime functioning was important and present in most patients. As for RLS, some RAS patients developed depression and suicidal thoughts when symptoms were severe.15 A substantial negative impact of RLS on quality of life and health has been described in RLS, but had not been evaluated in RAS patients.1
Overall, the clinical picture of RAS seems not differ from that of RLS, except for the localization of the symptoms on the upper limbs. However, RAS patients had less family history as compared to idiopathic RLS and genetic risk factors of RAS are unknown. Large sample studies including long-term follow-up of RAS patients are needed.
Home Remedies For Restless Legs Syndrome
Home remedies offer a simple way to improve RLS symptoms. Though more research is needed to confirm how effective these methods are, many people with mild to moderate RLS symptoms find relief from a combination of the following:
- Moving the legs: Moving the affected body part usually leads to relief from uncomfortable sensations, though symptoms may return when movement ceases.
- Implementing healthy sleep hygiene habits: RLS can cause sleep loss , but its also exacerbated by sleep problems. Try to keep a regular sleep schedule and ask your doctor for personalized sleep hygiene tips.
- Avoiding tobacco and eating a healthy diet: The Restless Legs Syndrome Foundation recommends reducing alcohol, caffeine, sugar, and salt and following a healthy diet rich in vitamins and minerals. In addition to relieving RLS symptoms, a healthy diet can help improve sleep quality.
- Exercising: Moderate exercise and stretching may help reduce RLS symptoms. That said, people with RLS should be careful with high-intensity activity, which may cause muscle cramps and stiffness that can exacerbate symptoms.
- Receiving massages or self-massaging: Some people find relief from RLS symptoms after massaging affected areas.
- Using heat or cold: RLS-related discomfort can often be tamed by applying a hot or cold compress or taking a warm bath before bed. Response to temperature may vary from person to person.
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Make Exercise A Habit
Moderate exercise during the day pays off with better sleep at night. Walk, jog, lift weights, or find any exercise you enjoy. One study found that exercise led to less leg movement and longer and deeper sleep for people with RLS. Be careful not to overdo it. Intense exercise or working out just before bedtime could make your symptoms worse.
How Is Restless Legs Syndrome Diagnosed
Since there is no specific test for RLS, the condition is diagnosed by a doctors evaluation. The five basic criteria for clinically diagnosing the disorder are:
- A strong and often overwhelming need or urge to move the legs that is often associated with abnormal, unpleasant, or uncomfortable sensations.
- The urge to move the legs starts or get worse during rest or inactivity.
- The urge to move the legs is at least temporarily and partially or totally relieved by movements.
- The urge to move the legs starts or is aggravated in the evening or night.
- The above four features are not due to any other medical or behavioral condition.
Diagnosing RLS in children may be especially difficult, since it may be hard for children to describe what they are experiencing, when and how often the symptoms occur, and how long symptoms last. Pediatric RLS can sometimes be misdiagnosed as “growing pains” or attention deficit disorder.
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.