Symptoms Of Restless Leg Syndrome
The most pronounced symptom of RLS is the worsening of the discomfort at night and being less in the morning. The symptoms of RLS range from mild to severe. RLS is usually characterized by
- Uncomfortable sensation or movement in the legs which is different from those without the disorder. This may range from being a mere discomfort to irritating to painful.
- An uncontrollable urge to move the legs
- Symptoms which become worse at night
- Insomnia caused by the discomfort
- Reappearing symptoms after weeks of improvement.
These symptoms tend to rapidly become severe if the person having this disease has a related disease but this is not so for those who have just the RLS. If those without a related disease first experienced the symptoms when they were younger, it may take many years before the symptoms become worse.
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.
What Causes Restless Legs Syndrome
In the majority of cases, there’s no obvious cause of restless legs syndrome.
This is known as idiopathic or primary restless legs syndrome, and it can run in families.
Some neurologists believe the symptoms of restless legs syndrome may have something to do with how the body handles a chemical called dopamine.
Dopamine is involved in controlling muscle movement and may be responsible for the involuntary leg movements associated with restless legs syndrome.
In some cases, restless legs syndrome is caused by an underlying health condition, such as iron deficiency anaemia or kidney failure. This is known as secondary restless legs syndrome.
There’s also a link between restless legs syndrome and pregnancy. About 1 in 5 pregnant women will experience symptoms in the last 3 months of their pregnancy, although it’s not clear exactly why this is.
In such cases, restless legs syndrome usually disappears after the woman has given birth.
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Environmental And Dietary Factors
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.
- Caffeine. Coffee drinking is specifically associated with PLMD.
Drugs that may worsen or provoke RLS include:
- Calcium channel blockers
- Spinal anesthesia
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.
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Get More Iron In Your Diet
Using your diet to safely correct any iron deficiency can help alleviate RLS symptoms. The catch, Dr. Berkowski says, is knowing what your iron levels are. Iron supplements are certainly one way to get those levels up but youll need to be sure to consult with your doctor about that. If your iron levels are already normal or even too high, more iron wont help you give you those benefits, he adds.
If you are iron deficient, though, there are plenty of healthy ways to get iron through your diet. Eating red meat can really boost iron levels, Dr. Berkowski says, and if youre vegetarian, eating tofu, legumes, lentils and spinach is a way to get that iron.
Other foods that are rich in iron include eggs, fish and nuts, like cashews and almonds.
What Is The Treatment For Restless Leg Syndrome
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.\
Medications used to treat restless leg syndrome include:
- natural supplements ,
- carbidopa-levodopa ,
- opioids ,
- carbamazepine ,
- clonazepam ,
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Restless Legs Syndrome Treatment Over The Counter
The medication given to patients with RLS depends on the patient and the severity of the disease. Most times, the patients are advised to use
These supplements will be helpful whose cause of RLS is the low level of iron in the brain. This medication may not work for others especially if theirs is not caused by iron deficiency.
Non-steriodal anti-inflammatory drugs like ibuprofen are helpful in the treatment of RLS. These drugs can easily be gotten over the counter.
These are sedatives which are given to those with sleep disorders as a result of the disease. Benzodiapines like restoril, klonopin, or clonazepam are commonly used. The use of this drug at night can cause sleepiness during the day time, reduce energy which in turn reduces productivity. This drug should not be used except it is the only option. This is because it can cause apnea during sleep.
These drugs help increase the dopamine effect by increasing the level of dopamine, which is a neurotransmitter. These drugs are taken at night and it has been found to help reduce the unpleasant sensation in the leg experienced by those with RLS. It is mostly taken by those with Parkinson?s disease. Some of these dopaminergic agents are carbidopa and levodopa.
This drugs though well tolerated can cause nausea, dizziness and other short term side effect.
These drugs have some side effects like dizziness, sleepiness and fatigue.
What Are The Symptoms Of Rls
The common symptom of RLS is that you have a strong, overwhelming urge to move the affected part of your body, usually your leg. Symptoms can range from a mild feeling of restlessness in your legs on some evenings, to a more severe problem that occurs every evening and night which regularly disturbs sleep. Many people fall somewhere in between these extremes.
- You may also get an uncomfortable or tingling sensation such as ‘pins and needles’, prickling, pulling or crawling.
- These feelings begin about 15 minutes after you lie down to sleep or to relax or when you have not moved for long periods, such as when travelling in a car or airplane.
- Moving will usually make you feel better, at least for a short time.
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Treatment Of Restless Legs Syndrome
Treatment for RLS includes medicines and lifestyle changes. Medicines used to treat Parkinsons disease can help reduce tremors and twitching in the legs. If your iron levels are low, your doctor may prescribe an iron supplement.
In some cases, an anticonvulsant medicine can be helpful. Historically, sleep aids, muscle relaxants , and pain medicines have been prescribed by doctors to relieve symptoms. Use of these medicines is becoming more and more limited for RLS because of their known side effects and potential drawbacks. Opioids, if not taken exactly as instructed by your doctor, can be addictive.
For many cases of RLS, a combination of medicines is usually needed to best treat the condition. Your doctor may prescribe several trials of medicine before finding one that works best for your case of RLS.
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
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Stretching And Movement Tips
Keeping your body physically active is a great way to lessen RLS symptoms. When you are immobile for too long , this is when those creepy sensations can start up. Try these stretching and movement tips:
- Go walking for lunch. Take your sandwich and head to the park down the street.
- Jog in place to give your circulation a boost.
- If you sit down a lot for work, get up and walk around for five minutes every hour.
- Right when you get out of bed in the morning and right before you hit the sack at night, take some time to stretch your legs.
- If on a road trip, stop every hour or so for a stretch.
- If flying in a plane, request an aisle seat. When it is safe to do so, walk up and down the aisles a couple times every so often.
Enjoy A Soak In The Tub
Try taking a warm bath or shower, one of the more useful home remedies to help reduce restless leg syndrome. Warmth relaxes muscles and helps prevent spasms and twitching. Adding Epsom salts can reduce aches and pains. A warm bath can also help you wind down and set the stage for a restful night.
Relaxing Bath Additions
There are several essential oils, bath crystals, and other ingredients to add to bath water to make it a more relaxing experience. Lavender essential oil is known for its ability to ease you into slumber. Rose, chamomile, and eucalyptus can be similarly soothing. Baking soda and bentonite clay are other bath additives you might find beneficial. Experiment to find the bath add-ins that reduce your RLS complaints and help you get a relaxing night’s rest.
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Restless Legs Syndrome And Periodic Limb Movement Disorder
Most people who have RLS also have a condition called periodic limb movement disorder . PLMD involves repetitive flexing or twitching of the limbs while asleep at night. It is different from RLS in that these movements are not accompanied by uncomfortable sensations and because they occur during sleep, patients are often not aware of them. However, PLMD-associated movements can cause a person to wake up and therefore can compound sleep issues in patients who also have RLS.
Although most people with RLS have PLMD, many with PLMD do not have RLS.
Risk Factors For Periodic Limb Movement Disorder
About 6% of the general population has PLMD. However, the prevalence in older adults is much higher, reaching almost 60%. Studies suggest that PLMD may be especially common in older women. As with RLS, there are many conditions that are associated with PLMD. They include sleep apnea, spinal cord injuries, stroke, narcolepsy, and diseases that destroy nerves or the brain over time. Certain drugs, including some antidepressants and anti-seizure medications, may also contribute to PLMD. About a third of people with PLMD also have RLS.
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How Long Will Restless Legs Syndrome Last
Symptoms of primary or idiopathic RLS typically worsen over time, but, for some people, weeks or months may pass without any symptoms. If the RLS stems from a condition, illness, pregnancy, or medication, it may go away as soon as the trigger has gone.
RLS can pose problems for women during pregnancy.
Women who already have RLS can find that symptoms get worse during pregnancy. However, becoming pregnant can lead to RLS in its own right. Symptoms tend to get worse as the pregnancy progresses and are especially likely in the third trimester.
The cause of the increased incidence of RLS during pregnancy is unknown, but the following factors are believed to be involved:
- low levels of minerals or vitamins, such as iron and folate
- sleep deprivation as a result of changes in the body and discomfort
- changes in the hormones
- increased sensitivity of the senses
This condition has not been widely researched during pregnancy. However, some of the drug treatments used outside of pregnancy, such as rotigotine and gabapentin, have not been assessed for safe use in women who are pregnant.
Behavioral treatments, such as mild exercise and a healthy sleeping pattern, are often recommended as a first-line treatment for women during pregnancy.
If iron levels are low and thought to be the cause of RLS, oral iron supplements are safe to prescribe during pregnancy. In severe cases, higher concentrations may be administered intravenously through a drip.
There are two main types of RLS:
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.
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Deep Breathing Can Help
Stress and Restless Leg Syndrome
As with many medical conditions, stress aggravates restless leg syndrome and makes things worse. Stress is associated with higher levels of cortisol and other inflammatory markers, all of which aggravate RLS. Successful restless legs syndrome treatment incorporates stress reduction techniques. Thankfully, there are many ways to combat stress, all of which may help your RLS.
Less Stress Success
Everyone should incorporate stress reduction practices into their daily routine. If you have a condition that is worsened by stress, it’s even more important to make an effort to reduce stress levels. Deep, diaphragmatic breathing can very quickly activate the parasympathetic nervous system, the branch of the nervous system that is responsible for the “rest and digest” functions of the body. Mindfulness meditation is easy to learn and promotes reduced stress and lower levels of inflammation. Listening to soothing music is a nice way to unwind and distress at the end of a long day.
I Cant Sleep Is This Restless Legs Syndrome
Its the middle of the night, youre exhausted, but your legs wont stop moving. Weve all felt something like this after a long day of hiking or after forgetting to apply sunscreen to your legs. But for some, this is a nightly routine leading to exhaustion and mental fatigue. If you are frequently feeling the uncontrollable urge to move your legs while you rest, you may be experiencing restless legs syndrome .
To help answer questions about this often mysterious condition, we spoke with Joyce Lee-Iannotti, MD, a neurologist and sleep specialist at Banner Health in Phoenix, Arizona.
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What Does Restless Legs Syndrome Feel Like
Restless legs syndrome feels a little different for every person, said Dr. Lee-Iannotti. But most describe a tingling or the sensation of ants crawling on their legs. For some it can feel like pins and needles. In some cases, the feeling may progress beyond simple sensations to be painful.
Dr. Lee-Iannotti commented that as much as 10% of the U.S. could be suffering from RLS, however the condition is sometimes misdiagnosed. Even more often, patients never bring the issues to their doctors attention. RLS tends to develop slowly, over decades. However, if left untreated the symptoms can become severe. In advanced cases, nights become extremely stressful and symptoms can persist throughout the day, spreading from the legs to other extremities.
What Is The Outlook
The outlook for RLS varies. In some people, the problem gradually becomes worse. It may also lead to other problems, such as a less good quality of life, insomnia, anxiety or depression. In others, however, it stays much the same without becoming worse or better. In some people symptoms improve of their own accord, or there are long periods of time with no symptoms. If RLS is due to another condition then it will often improve once the cause has been treated.
RLS is not life-threatening – it does not cause death, but it can affect quality of life. In some people it can cause a lot of distress. There is no cure for RLS, but usually medicines can help symptoms if they are interfering with your quality of life.
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Goodfellow Gem: Dopamine Agonists May Be Effective For Restless Legs
Restless legs syndrome is defined as an urge to move legs often accompanied by uncomfortable and unpleasant sensations in the legs. Check ferritin and reverse iron deficiency first. Tools for Practice1 reported on a systematic review on pramipexole. Dopamine agonists can be considered as first-line treatment for restless legs syndrome but be aware of adverse effects such as augmentation , loss of impulse control, and drowsiness. Initiate treatment with pramipexole starting dose 0.25 mg, maximal dose 0.75 mg. The NNT is about 5. Ropinirole is another option, with a starting dose of 0.125 mg, maximal dose 4 mg orally once daily 2 hours before bedtime. These medications are also used in treating Parkinsons Disease, and both are funded in New Zealand.
Reference: A good sleep would be dop doc! Pramipexole in restless legs syndrome Tools for Practice #275, 2020