Restless leg syndrome (RLS) is one of those medical disorders that has been around for a while, but has just recently come into the public eye. Until the latest direct-to-consumer marketing of medications aimed at treating the disorder, many Americans were unaware that the condition even existed.
RLS affects up to fifteen percent of adults in the United States. It seems to be more common as we get older. In individuals over age 65 years, upwards of twenty-five percent may have symptoms suggestive of RLS. It appears to have a genetic component as well, as about 50 to 60 percent of cases have a familial link.
This syndrome is characterized by an uncontrollable urge to move the extremities, mainly the legs. It usually occurs at night or with prolonged rest. The longer the physical and mental inactivity, the more likely it is to occur. Many sufferers describe it as an antsy, electrical, or pins and needles sensation deep within the legs. At times, although more rarely, it will be a pain or a discomfort. Moving the extremity usually relieves the symptoms temporarily.
Another condition called “periodic limb movement disorder” is often associated with RLS. Individuals with this disorder will have involuntary leg twitching or jerking movements of the legs during sleep. This differs from RLS in that the individual is not consciously sensing the urge to move the legs because he/she is asleep. At any rate, normal sleep can be greatly disrupted, leaving the individual feeling un-rested in the morning.
In most cases, the cause of RLS is unknown. However, it can be associated with a few common conditions. These include: low iron levels or anemia; chronic medical conditions such as diabetes or kidney disease; late trimester pregnancy; and certain medications including anti-nausea, anti-seizure, anti-psychotic and stimulant medications. Additionally, the use of alcohol, caffeine, and tobacco may trigger RLS or exacerbate the symptoms.
It is thought that dopamine, one of the chemicals that nerve cells use to communicate with each other, may have an important role in the symptoms of RLS. Hence, some of the prescription medications used to treat the condition will modify dopamine levels in the body.
Since the precise cause of the condition remains elusive, there is no “cure” of RLS. However, there are ways to lessen the symptoms. In some situations, such as with iron deficiency anemia, treatment of underlying conditions can profoundly decrease the sensations. Individuals who are found to be deficient in iron, folic acid, or magnesium may benefit from physician prescribed supplements of these minerals.
Like many other medical conditions, lifestyle modifications are the first step in controlling the symptoms of restless leg syndrome. Studies of individuals with RLS show that a regular sleep pattern every night can help to reduce these sensations. Additionally, regular moderate exercise during the day may help to promote a more restful sleep. However, some have found that intense daily exercise can make symptoms worse.
Decreasing the use of caffeine, tobacco and alcohol may provide some relief. Others have found benefit from hot baths in the evening, leg massage, or using heating pads or ice packs.
For those with moderate to severe symptoms, prescription medications may be needed to control their symptoms. Most of these medicines fall into the class of “nerve modulators,” similar to medications used in Parkinson’s disease, epilepsy, or other nerve disorders.
The content in this column is for informational purposes only. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.