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Restless Legs Syndrome

Restless Legs Syndrome is a neurological disorder that causes a strong urge to move the legs. People who have RLS describe feelings of crawling, itching, tingling, burning, aching and even electric shocks in one or both legs when they are resting or inactive.

The feelings often occur in the calves but can occur at any place in the legs or feet and sometimes in the arms. Moving the legs relieves the urge and the uncomfortable feelings.

RLS affects 5% to 15% of Americans. RLS can affect both genders but women are more likely than men to have it. Many people who have RLS are diagnosed in middle age and the number of cases rises with age. People who develop RLS early in life tend to have a family history of the disorder. People who have certain diseases, medical conditions, or who take certain medicines, are also more likely to develop RLS.  Most people with Restless Legs Syndrome also have periodic limb movement disorder, but the reverse is not true.

Causes of Restless Legs Syndrome

Research suggests that the main cause of RLS is a lack of iron, or faulty use of iron, in the brain, according to the National Institutes of Health. The brain uses iron to make the chemical dopamine, which works in the parts of the brain that control movement.

  • Various medical conditions, including kidney failure, Parkinson's disease, diabetes, rheumatoid arthritis, pregnancy, and iron deficiency, can affect how much iron is in the brain, how it's used and increase the risk of RLS. 
  • People whose family members have RLS also are more likely to develop the disorder. 
  • Nerve damage in the legs or feet and sometimes in the arms or hands may cause or worsen RLS. Several conditions can cause this type of nerve damage, including diabetes. 
  • Medicines and substances can trigger RLS including: anti-nausea medications, antidepressants, antipsychotic drugs, cold and allergy medicines that contain antihistamines and calcium channel blocking drugs used to treat heart problems and high blood pressure. 
  • Certain substances, such as alcohol and tobacco, also can trigger or worsen RLS symptoms.

Signs and Symptoms of Restless Legs Syndrome

All four of the following signs must be present for a sufferer to be diagnosed with RLS:

  • A strong urge to move your legs to relieve unpleasant feelings of: crawling, itching, tingling, burning, aching and even electric shocks. When the disorder is severe, there may also be an urge to move the arms.
  • Symptoms are worse during periods of inactivity, for example when sitting still or lying down and resting.
  • Movement, especially walking, brings relief. 
  • Symptoms that start or worsen during the evening or at night.

RLS symptoms often worsen as time passes. However, some people's symptoms disappear for weeks to months at a time. If a medical condition or medicine caused the RLS, the disorder may go away if the condition or the medicine is no longer present. The most obvious example is pregnancy-related RLS.

Risks

RLS can make it difficult to fall asleep and to stay asleep. Lack of sleep can make it hard to concentrate and can cause depression, mood swings and other health problems such as diabetes and high blood pressure.

What to Do

RLS has no cure, although if a condition or medicine is triggering the disorder, it may disappear or improve if the trigger is relieved or stopped.  RLS can be treated, however, with the goal of preventing or relieving symptoms; increasing the amount and quality of sleep and treating or correcting any underlying condition that may trigger or worsen RLS

Mild cases of RLS often are treated with lifestyle changes and sometimes with periodic use of medicines. More severe RLS usually is treated with daily medicines.

If you suspect that you or a loved one suffers from RLS, see your physician. An RLS diagnosis is based on the patient’s symptoms, medical and family histories, a physical exam, and test results. Your doctor may recommend blood tests to measure iron levels and possibly muscle or nerve tests to identify any condition that can worsen RLS or that has symptoms similar to RLS.