An Overview of Restless Legs Syndrome
Restless legs syndrome, also known as restless legs or
RLS, is a condition in which a person has unpleasant feelings or sensations in the legs. These feelings are described as creeping, crawling, tingling, pulling, or painful.
Symptoms of restless legs syndrome usually begin or worsen during periods of rest or inactivity and are partially or totally relieved by movement. RLS symptoms can disturb sleep, and they usually worsen with age.
Restless legs syndrome is generally a lifelong condition for which there is no cure. Current RLS treatments can decrease symptoms and increase periods of restful sleep. In addition, some patients with RLS have remissions, which are periods in which their symptoms decrease or disappear for days, weeks, or months, although symptoms usually reappear. A diagnosis of RLS does not indicate the beginning of any other neurological disease.
Restless Legs Syndrome: How Common Is It?
Restless legs syndrome affects about 2 to 15 percent of Americans. However, it may be more common than we think -- some people with RLS do not seek treatment because they fear they won't be taken seriously, their symptoms are too mild, or they think their condition can't be treated.
Restless legs syndrome affects more women than men. It can start at any age. However, most people with restless legs syndrome are middle-aged or older. People with restless legs syndrome are oftentimes misdiagnosed because it can be easily confused with other conditions. Children who have restless legs syndrome may be misdiagnosed with hyperactivity or growing pains. Adults who have RLS may be misdiagnosed with nervousness,
insomnia (not being able to sleep), stress,
arthritis, muscle cramps, or aging.
Cause of Restless Legs Syndrome
There are two
types of restless legs syndrome: primary and secondary. In primary restless legs syndrome the cause is not known. In secondary restless legs syndrome the cause is another disease or condition or, sometimes, a certain medication. In most cases, the cause of restless legs syndrome is not known. However, in half of all restless legs syndrome cases, there is a family history of the condition.
Restless legs syndrome may be linked to the following factors or conditions:
- Pregnancy, especially in the last three months. However, the symptoms usually go away about four weeks after having the baby.
- Iron deficiency anemia (low iron levels). However, after correcting low iron levels or anemia, symptoms may lessen.
- Chronic diseases such as kidney failure, diabetes, Parkinson's disease, and peripheral neuropathy (loss of feeling or numbness in the hands and feet).
Common Symptoms of Restless Legs Syndrome
Restless legs syndrome symptoms are not the same for every person.
RLS symptoms range from uncomfortable to painful and can vary in frequency. Some people may have periods when RLS does not cause problems, while others may have severe symptoms every day.
- Unpleasant or uncomfortable feelings or sensations in the legs often described as creeping, crawling, tingling, pulling or painful, that often produce an irresistible urge to move the legs. These feelings most often occur deep inside the leg, between the knee and ankle. While rare, they can also occur in the feet, thighs, arms, and hands. Most of these feelings involve both sides of the body, although they can happen on just one side of the body.
- Leg discomfort that occurs and gets worse when lying down or sitting for long periods of time. Long car trips, sitting in the movies, long-distance flights, and having a cast on can trigger restless legs syndrome.
- The need for constant movement of the legs (or other affected body parts) to lessen discomfort. People may pace the floor, move their legs when sitting, and toss and turn in bed.
- Having leg and sometimes arm movements that you can't control when sleeping.
- Trouble falling asleep or staying asleep.
- Sleepiness or tiredness during the day.
Certain medications, such as drugs for nausea,
seizures, and psychosis, as well as some cold and
allergy medicines, may make symptoms worse. Talk with your healthcare provider if you are taking any prescription or over-the-counter medicines.
(Click RLS Symptoms for more information about the symptoms of restless legs syndrome.)
Diagnosing Restless Legs Syndrome
There are no tests available to detect restless legs syndrome. Therefore,
RLS can be hard to diagnose because it is easily confused with other conditions.
In order to make a restless legs syndrome diagnosis, your doctor will:
- Take a complete medical history
- Do a complete physical examination
- Order other tests.
The diagnosis of RLS usually requires the following four conditions to be present:
- An urge to move the legs due to an unpleasant feeling in the legs
- Leg pain that begins or worsens when you are at rest or not moving around frequently
- Leg pain that is partly or completely relieved by continuous movement (such as walking or stretching)
- Leg pain that is worse in the evening and at night, or only occurs in the evening or at night.
Current Treatment for Restless Legs Syndrome
There is no
cure for restless legs syndrome. However, there may be an underlying disease or condition, such as peripheral neuropathy or
diabetes, causing restless legs syndrome. Treating the underlying disease can relieve many of the symptoms of RLS.
Restless Legs Syndrome and Periodic Limb Movements in Sleep
Many people with restless legs syndrome also have a related sleep disorder called periodic limb movements in sleep (PLMS). People with PLMS oftentimes jerk or bend their legs unintentionally during sleep. These movements happen every 10 to 60 seconds throughout the night. PLMS can wake a person from sleep, disturb sleep, and wake bed partners. People who have both restless legs syndrome and PLMS have trouble falling and staying asleep and can have extreme sleepiness during the day.
(Click Periodic Limb Movement Disorder for more information.)
The Prognosis for Restless Legs Syndrome
Restless legs syndrome is a life-long condition for which there is no cure. Restless legs syndrome can range from mild to severe based on:
- How much discomfort you have in your legs and arms
- Whether you feel the need to move around
- How much relief you get from moving around
- How much sleep disturbance you have
- How tired or sleepy you are during the day
- How often you have symptoms
- How severe your symptoms are on most days
- How well you carry out daily activities
- How angry, depressed, sad, anxious, or irritable you feel.
People with restless legs syndrome often have difficulty falling asleep because symptoms are intensified by inactivity and lying down. Therefore, people with restless legs syndrome often don't get enough sleep and may feel tired and sleepy during the day, which can cause difficulty with:
- Concentration
- Learning and remembering new things
- Work
- Carrying out usual daily activities
- Taking part in family and social activities.
Not getting enough sleep can also make you feel depressed or cause mood swings.
Restless Legs Syndrome: Summary of Key Points
Key information about restless legs syndrome includes:
- Restless legs syndrome is a sensory disorder causing an almost irresistible urge to move the legs. The urge to move the legs is usually due to unpleasant feelings in the legs that occur when at rest. Movement eases the feelings but only for a while.
- People with restless legs syndrome may describe the unpleasant feelings in their legs as creeping, crawling, tingling, burning, or painful. The feelings are often hard to describe.
- Many people with restless legs syndrome also have periodic limb movement disorder. This is a condition in which a person's legs twitch or jerk uncontrollably every 10 to 60 seconds and usually happens during sleep.
- Restless legs syndrome can make it difficult to fall asleep and stay asleep. People with restless legs syndrome may feel tired and sleepy during the day.
- There are two types of restless legs syndrome: primary and secondary. In primary restless legs syndrome the cause is not known. Secondary restless legs syndrome is caused by another disease or condition or, sometimes, by taking certain medicines.
- Restless legs syndrome is common in pregnant women. It usually occurs during the last three months of pregnancy and usually improves or disappears within a few weeks after delivery.
- Lifestyle changes can improve and relieve symptoms of restless legs syndrome. Lifestyle changes may be the only treatment needed for mild symptoms of restless legs syndrome.
- Medications can help treat more severe symptoms of restless legs syndrome. No single medicine is helpful in all people with restless legs syndrome, and it may take several changes in medicines and dosages to find the best approach.
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