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What Medicine Is Used For Restless Leg Syndrome

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What Are The Symptoms

How to Treat Restless Leg Syndrome (RLS)

Restless legs syndrome makes you feel like you must move a part of your body, usually your legs. These feelings are often described as tingling, “pins and needles,” prickling, pulling, or crawling.

Moving will usually make you feel better, at least for a short time. This problem usually happens at night when you are trying to relax or go to sleep.

After you fall asleep, your legs or arms may begin to jerk or move. These movements are called periodic limb movements. They can wake you from sleep, which adds to your being overtired. Although periodic limb movement is considered a separate condition, it often happens to people who have restless legs syndrome.

Magnesium May Relax Your Muscles

Like calcium, this mineral is critical for bone and muscle health.

Anecdotally, magnesium may be helpful to relieve restless legs, and it is a natural muscle relaxant, Dr. Vensel-Rundo says. She recommends taking magnesium separately rather than as part of a multivitamin.

Because magnesium can cause side effects, including diarrhea, its best to start at smaller doses of around 200 to 400 mg a day. If you dont have problems with those, you can go up to 1,000 mg daily. Magnesium glycinate seems to have fewer side effects for patients.

Periodic Limb Movement Disorder

PLMD is a similarly related sleep disorder, sometimes called periodic limb movement during sleep . In people with PLMD, the limbs twitch or jerk uncontrollably while sleeping. It is also considered a type of sleeping disorder. The movement may cause the individual to wake up frequently during the night, and this can undermine the quality and length of sleep. It can lead to RLS.

Lifestyle changes and common medications that may help alleviate RLS symptoms include:

  • Warm baths and massages: These can relax the muscles and reduce the intensity of symptoms.
  • Warm or cool packs: Some people prefer warm, some cold, and others say that alternating hot and cold is helpful.
  • Relaxation techniques: Stress can make RLS worse, so exercises such as yoga, meditation, and tai chi may help.
  • Exercise using legs more can help alleviate symptoms. If the patient has a sedentary lifestyle, walking instead of driving, taking up a sport, or exercising the legs in a gym can help.

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What Are Common Signs And Symptoms Of Restless Legs

People with RLS feel the irresistible urge to move, which is accompanied by uncomfortable sensations in their lower limbs that are unlike normal sensations experienced by people without the disorder.; The sensations in their legs are often difficult to define but may be described as aching throbbing, pulling, itching, crawling, or creeping.; These sensations less commonly affect the arms, and rarely the chest or head.; Although the sensations can occur on just one side of the body, they most often affect both sides.; They can also alternate between sides. The sensations range in severity from uncomfortable to irritating to painful.

Because moving the legs relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations.; They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.

A classic feature of RLS is that the symptoms are worse at night with a distinct symptom-free period in the early morning, allowing for more refreshing sleep at that time.; Some people with RLS have difficulty falling asleep and staying asleep.; They may also note a worsening of symptoms if their sleep is further reduced by events or activity.

People with RLS can sometimes experience remissionsspontaneous improvement over a period of weeks or months before symptoms reappearusually during the early stages of the disorder.; In general, however, symptoms become more severe over time.

Other Conditions Associated With Restless Legs Syndrome

Recommended doses for commonly used medications in ...

The following medical conditions are also associated with RLS, although the relationships are not clear. In some cases, these conditions may contribute to RLS. Others may have a common cause, or they may coexist due to other risk factors:

  • Osteoarthritis . About three-quarters of patients with RLS also have osteoarthritis, a common condition affecting older adults.
  • Varicose veins. Varicose veins occur in about 1 in 7 patients with RLS.
  • Obesity.
  • Diabetes. People with type 2 diabetes may have higher rates of secondary RLS. Nerve pain related to their diabetes cannot fully explain the higher rate of RLS.
  • Hypertension .
  • Chronic obstructive pulmonary disease .
  • Chronic alcoholism.
  • Sleep apnea and snoring.
  • Chronic headaches.
  • Brain or spinal injuries.
  • Many muscle and nerve disorders. Of particular interest is hereditary ataxia, a group of genetic diseases that affects the central nervous system and causes loss of motor control. Researchers believe that hereditary ataxia may supply clues to the genetic causes of RLS.
  • Attention-deficit hyperactivity disorder .
  • Psychiatric disorders, such as depression.

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How Do Medications Treat Restless Legs Syndrome

The nerve pathway in the brain that helps control voluntary movements may not work normally in people with restless legs syndrome. This pathway uses certain chemicals that keep your movements normal.

Its believed that people with restless legs syndrome have changes in the normal function of these chemicals. These changes may cause the involuntary movement thats typical of restless legs syndrome.

Certain drugs can help treat the symptoms of restless legs syndrome by acting like the chemicals in this pathway or by helping these chemicals function normally.

The drugs that are used first to treat restless legs syndrome most often include ropinirole, pramipexole, and rotigotine. The drug gabapentin enacarbil is also used, but usually only when the other drugs dont provide relief.

What Is The Prognosis For People With Restless Legs Syndrome

RLS is generally a lifelong condition for which there is no cure.; However, current therapies can control the disorder, minimize symptoms, and increase periods of restful sleep.; Symptoms may gradually worsen with age, although the decline may be somewhat faster for individuals who also suffer from an associated medical condition.; A diagnosis of RLS does not indicate the onset of another neurological disease, such as Parkinsons disease.; In addition, some individuals have remissionsperiods in which symptoms decrease or disappear for days, weeks, months, or yearsalthough symptoms often eventually reappear.; If RLS symptoms are mild, do not produce significant daytime discomfort, or do not affect an individuals ability to fall asleep, the condition does not have to be treated.;;

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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.

Environmental And Dietary Factors

Restless Leg Syndrome: Triggers, Home Remedies and Treatment | Andy Berkowski, MD

The following environmental and dietary factors can trigger or worsen RLS:

  • Iron deficiency. People who are deficient in iron are at risk for RLS, even if they do not have anemia.
  • Folic acid or magnesium deficiencies.
  • Smoking.
  • Caffeine. Coffee drinking is specifically associated with PLMD.
  • Stress.

Drugs that may worsen or provoke RLS include:

  • Antidepressants
  • Calcium channel blockers
  • Metoclopramide
  • Antihistamines
  • Spinal anesthesia

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Is Restless Legs Syndrome Affecting Your Sleep

You may know it as the urge to move or jerk your legs when youre sitting or lying still, especially at night. Restless legs syndrome occurs when brain cells send false signals of pain, discomfort, tingling and itchiness to nerve endings in the legs . Moving your legs turns off these signals, but the creepy-crawly sensations return as soon as youre still again.

The syndrome is thought to result from an overproduction of the brain chemical dopamine during the day, which leads to an underproduction at night. Heres what to do if your itchy, jerking legs keep you awake at night.

How Is Rls Diagnosed

There is no specific exam or lab test a doctor can do to determine if you have RLS. Your description of what happens to your body when you try to relax is usually sufficient. Tell your doctor if you have:

  • An overwhelming urge to move your limbs, accompanied by an uncomfortable or tingling sensation
  • Funny sensations in your legs triggered by rest, relaxation, or sleep, and relieved with movement
  • Symptoms that are worse at night and better in the morning.

Since RLS can occur because of another condition, your doctor may still run a few tests. RLS is more common in people:

  • With iron deficiency
  • Who are pregnant, especially in the third trimester
  • With either low or high thyroid levels
  • With rheumatoid arthritis, chronic kidney disease, or diabetes
  • Taking certain medicines, such as antinausea pills , antipsychotics, antidepressants, and some antihistamines.

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Symptoms And Signs Of Plmd And Rls

Periodic limb movement disorder is characterized by repetitive twitching or kicking of the lower or upper extremities during sleep. Patients usually complain of interrupted nocturnal sleep or excessive daytime sleepiness. They are typically unaware of the movements and brief arousals that follow and have no abnormal sensations in the extremities.

Restless legs syndrome is a sensorimotor disorder characterized by an irresistible urge to move the legs, arms, or, less commonly, other body parts, usually accompanied by paresthesias and sometimes pain in the upper or lower extremities; symptoms are more prominent when patients are inactive or recline and peak in severity around bedtime. To relieve symptoms, patients move the affected extremity by stretching, kicking, or walking. As a result, they have difficulty falling asleep, repeated nocturnal awakenings, or both. Symptoms may be worsened by stress. Episodes may occur occasionally, causing few problems, or several times a week.

Repetitive Transcranial Magnetic Stimulation

Treatment of Restless Legs Syndrome (RLS) in Older Adults #79

A noninvasive procedure thats typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising (4, 41,

Repetitive transcranial magnetic stimulation sends magnetic impulses to certain areas of the brain.

Its not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS .

In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended .

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Periodic Limb Movement Disorder And Restless Legs Syndrome

, MD, University of Pennsylvania, Division of Sleep Medicine

PLMD and RLS are more common during middle and older age; > 80% of patients with RLS also have PLMD.

The mechanism is unclear but may involve abnormalities in dopamine neurotransmission in the central nervous system . PLMD and RLS can occur

  • In isolation

  • With use of stimulants, certain antidepressants, or dopamine antagonists

  • During pregnancy

  • In patients with chronic renal or hepatic failure, iron deficiency, anemia, diabetes mellitus, a neurologic disorder , or other disorders

In primary RLS, heredity may be involved; more than one third of patients with primary RLS have a family history of it. Risk factors may include a sedentary lifestyle, smoking, and obesity.

Periodic leg movement disorder is common among people with narcolepsy and rapid eye movement sleep behavior disorder.

Restless Leg Syndrome And Cardiac Risk

Restless leg syndrome has been associated with an increased risk of cardiovascular disease.

Researchers believe that if there is a cause-and-effect relationship, it may have to do with;hypertension. It turns out that many people with restless leg syndrome also have a movement disorder called periodic limb movements of sleep , in which repeated episodes of stereotypical leg movements occur while sleeping. Most people with PLMS are unaware they have such a condition . Research shows that patients with PLMS can have significant elevations in their blood pressure during episodes of leg movement while sleeping.

The degree of nocturnal hypertension that has been demonstrated is believed to be sufficient to significantly increase an individual’s risk of developing cardiovascular diseaseand may help to explain the association between restless leg syndrome and cardiovascular disease.

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Restless Legs Syndrome Medication

Medication is currently considered the gold standard for people with moderate to severe RLS. To reduce the risk of unpleasant side effects, always work with a doctor to find the medication thats right for you.

People with RLS resulting from another condition, or those with another consideration such as pregnant women, children, people with anxiety or depression, or individuals with kidney disease, may need to exercise extra caution when taking medication.

RLS can be treated with several different families of medications, the most common being dopamine agonists and anti-seizure drugs.

How Do I Know If I Have Restless Leg Syndrome

What is Restless Leg Syndrome? (Symptoms, Causes, and Treatments)

The diagnosis of restless leg syndrome is established on four criteria established by The National Institutes of Health.

  • A strong urge to move your legs. This urge often, but not always, occurs with unpleasant feelings in your legs. When the disorder is severe, you also may have the urge to move your arms.
  • A strong urge to move the legs along with other RLS symptoms that begin or worsen when inactive, or in the evening and at night.
  • Treatment of restless leg syndrome is first directed toward any underlying illness, if known. For example:

    • Blood testing to reveal underlying iron deficiency anemia may reveal the underlying cause.
    • If varicose veins are thought to be the cause, then surgery to repair the circulation may be considered.
    • Reduction or elimination of caffeine, nicotine, and alcohol from a person’s diet can be very helpful.
    • Stopping smoking can significantly diminish or prevent symptoms.
    • Getting better sleep and exercise can help some persons affected by restless legs.
    • Pregnant women who do not sleep well at night and other people with sleep disorders may develop RLS.

    There is no cure for restless leg syndrome; however, the condition usually responds well to home remedies and medications. The outlook is excellent for people with restless leg syndrome as long as it does not weaken or damage the function of the legs.

  • Acupuncture
  • Natural treatments such as quinine water at bedtime
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    Transcutaneous Electrical Nerve Stimulation

    With transcutaneous electrical nerve stimulation , a device sends small electrical currents to parts of your body to help relieve pain.

    Theres not a lot of research on the use of TENS to treat RLS, but it could work.

    The idea is that like the Relaxis vibrating pad, it uses counterstimulation. One study showed that regular use of TENS along with a vibration treatment completely relieved one mans RLS symptoms (

    However, more research is needed to confirm acupuncture as a reliable treatment for RLS.

    Treatment If The Condition Gets Worse

    Over time, treatment of RLS with a dopamine medicine may not work as well as it did at first. This is called augmentation.

    You might notice that your symptoms:

    • Begin earlier in the day.
    • Become more intense.
    • Spread to another part of your body.

    If you are taking a dopamine medicine for RLS and your symptoms change, tell your doctor. Do not stop taking your medicine without talking to your doctor first. You can work with your doctor to decide what treatment is the best one for you.

    If you continue to have symptoms even though you are receiving treatment with drugs and are exercising regularly, eating right, and not smoking, drinking alcohol, or using caffeine, your symptoms may need to be reevaluated. Many other conditions can cause the sensations found in restless legs syndrome, including several vitamin and mineral deficiencies.

    Your doctor may recommend different drugs or a combination of drugs. Follow up with your doctor if your symptoms do not improve.

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    Primary Or Idiopathic Rls

    Idiopathic means that the cause is unknown.

    It is the most common type and has the following characteristics:

    • It usually begins before the age of 40.
    • It can start as early as childhood.
    • It may have a genetic cause.
    • Once primary RLS starts, it tends to be lifelong.

    Symptoms may be sporadic, or gradually worsen and become more prevalent over time.

    In mild cases, the person may have no symptoms for a long time.

    Medical Devices For Restless Legs Syndrome

    Pharmacological treatment of restless legs syndrome ...

    New attention is being given to the possibility of using medical devices to improve RLS symptoms. Similar to the way that moving the legs gives temporary relief, these medical devices aim to reduce discomfort of RLS symptoms by providing external stimulation.

    So far, the Food and Drug Administration has approved two medical devices as RLS treatments: a compression foot wrap and a vibrating pad. Both are available by prescription and designed for people with moderate to severe RLS.

    The foot wrap works by applying targeted pressure to the affected area, usually the lower leg or foot. By contrast, the vibrating pad uses counter-stimulation to mask RLS symptoms and improve sleep quality. Both devices are considered fairly safe, though they may not be suitable for people with certain underlying health conditions.

    Some physicians also recommend using a pneumatic compression device to ease RLS symptoms. Its thought that compression of the veins helps boost circulation and reduce the uncomfortable sensations caused by RLS.

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