Restless Leg Syndrome: Causes, Symptoms, Diagnosis, Precautions

A benign condition (neurological disorder) of unknown origin characterized by intense disagreeable feelings in the legs at rest, creating an irritating sensation of uneasiness, tiredness, and itching deep within the muscles of the legs. The only thing that provides relief from the discomfort is to move the legs by stretching them or getting up and walking around on them. It usually occurs prior to sleep onset, or when the legs are at rest. This disorder most commonly affects the legs but arms, torso, and phantom limbs could be affected too. This disorder interrupts the sleep cycle and is one of the primary causes of insomnia and can severely reduce the quality of life.

Restless Leg Syndrome Causes

Restless Leg SyndromeThe exact cause for restless leg syndrome, also known as Willis-Ekbom disease is unknown. Though researches suspect an imbalance of the brain chemical dopamine and iron deficiency in the blood to be the primary causes. Restless leg syndrome can be associated with other conditions like diabetes, chronic kidney disease, nerve disease, parkinson’s disease, peripheral neuropathy, pregnancy, hypothyroidism, obesity, smoking, drug abuse, withdrawal from sedatives etc.

Calcium channel blockers, lithium, or neuroleptics, H2-histamine blockers and certain antidepressants could also lead to restless leg syndrome. Restless leg syndrome maybe heredity that is it could be passed down in families. This may be a factor when symptoms start at a younger age, but the abnormal gene has not yet been identified.

Restless Leg Syndrome can develop at any age, even during childhood but is more common in middle-aged and older adults.

This syndrome leads to decreased sleep quality which leads to anxiety or depression, confusion and slower thought process. Stress worsens the symptoms.

Restless Leg Syndrome Symptoms

Typical symptoms as described by patients with restless leg syndrome are:

  1. The bothersome, but usually not painful, sensations deep in the legs which produces an irresistible urge to move.
  2. The symptoms get better with the movements of the toes, feet, or legs (known as restlessness). But the relief is only temporary and the urge starts again as the patient takes a rest.
  3. Creeping, crawling, aching, pulling, searing, tingling, bubbling, cramps, itching, gnawing, burning or crawling are some of the symptoms described by the patients. However, there are many patients who are unable to express these symptoms and often term it as abnormal, unpleasant sensations in their calves, thighs or feet.
  4. Symptoms typically are less bothersome during the day and are felt primarily at night or when resting for a longer period of time such as in a car, airplane or movie theater.
  5. Difficulty in falling or staying asleep.

Restless Leg Syndrome 1

The common characteristics that this syndrome follows are that the sensation typically begins after the person has been lying down or sitting for an extended period of time. The person tries a number of ways to combat the sensation like stretching, jiggling the legs, pacing the floor, exercising or walking.

It may be associated with another condition called periodic limb movement disorder (PLMD).

Restless Leg Syndrome Diagnosis

There are no specific tests for Restless Leg Syndrome but non-specific laboratory tests are used to rule out other causes such as iron, folic acid, magnesium or vitamin deficiencies. A doctor, usually a neurologist or a sleep specialist, looks for the four criteria which must be met for the diagnosis of restless leg syndrome in a person. These criteria have been set by The National Institutes of Health. The criteria are that the patient must experience an irresistible and strong urge to move the limb. The patient is either partially or completely relieved after the activity. The symptoms get worse when the patient is sitting, resting or lying down. The symptoms, in most of the patients start or get worse in the evening or at  night.

Restless Leg Syndrome Treatment

Treating the underlining cause, if any, is the first step in treating this syndrome. Like correcting iron deficiency or peripheral neuropathy provides great relief. If varicose veins are the cause then surgery to repair the circulation may be considered. Successful management of the condition causing the syndrome may help alleviate it completely.

If restless leg syndrome occurs without any associated illness then life style changes and medication helps to bring relief.

Home remedies are aimed at reducing stress and helping the muscles to relax. This can be achieved by moderate but regular stretch muscle exercise including meditation and yoga, soaking in a warm bath and massaging the legs, applying warm or cool packs and cutting back on caffeine, alcohol and tobacco. Taking over the counter pain relievers along with these methods helps in easing the symptoms fast.

Prescription medicines are available in abundance, hence should not be taken, nor should the dose be adjusted without consulting the doctor. The medicines available to treat restless leg syndrome falls into four classes: dopaminergic agents, sleeping aids, anticonvulsants, and pain relievers.

As a single medicine does not work on all patients so several changes in medicines and dosages, in consultation with the doctor is the best approach. It has also been seen that a medicine has stopped working or giving the desired results on the patient after taking it for a period of time. Certain medication like Medications for Parkinson’s disease reduces the amount of motion in the legs by affecting the level of the chemical messenger dopamine in the brain. Certain epilepsy medications may work for some people with restless leg syndrome. Narcotic medications can relieve mild to severe symptoms.

It takes several trials before the right medicine and dosage is fixed. Self-care techniques are still believed to be the best form of treatment. Restless leg syndrome is not a dangerous or life-threatening disease nor is it not a sign of a serious disorder. The right approach helps in coping with this syndrome.

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