Joseph R. Anticaglia MD
Medical Advisory Board
Stella is a 52 y/o data entry specialist complaining of restless legs for the past 13 years. She first became aware of it while in the theater watching the second act of a play by Neil Simon.
“It was uncomfortable. I couldn’t stop my legs from moving. The more I tried to stop them from moving the worse it got. I had to get up and leave the theater.”
Stella is not alone. “You return home from an exhaustive day at the office, have dinner and try to wind down in front of the TV. Half way through the show, there they go again, that crawling, tingling uncontrollable sensation to move the legs.
Others tell this story: “You’re lying down in bed and your legs start to twitch as if someone stimulated them with a mild electric current. I have to get up and walk around. It messes up your sleep and the next day you’re exhausted.”
Restless Legs Syndrome (RLS) is a common movement disorder associated with abnormal sensations in the legs that causes an irresistible urge to move the legs. It typically occurs in the evening or at night when you’re sitting or lying down. It can start at any age and people usually get temporary relief by walking around. To put it differently:
- People have an unwanted sensation to move the legs.
- Symptoms come on when you’re at rest– sitting or lying down
- Symptoms are typically worse in the evening or at night
- Symptoms are relieved by standing, shaking the legs or waking around
Although the cause of RLS is unknown, scientists suspect that there is an imbalance with the brain’s chemical dopamine and its inability to control muscle movement. Those who develop restless leg syndrome before the age of 45 most likely have a family history of this condition.
People have described the symptoms of RLS as an electric, creeping, pulling, aching in addition to those mentioned above. No test is available that can diagnose RLS. The diagnosis is made by relating your symptoms and medical history to your physician.
RLS may occur alone or may be associated with other conditions which can worsen this situation. Risk factors might include iron deficiency anemia or peripheral neuropathy due to diabetes or alcoholism.
If you have kidney failure, the iron stores in the body can decrease with the symptoms of RLS because of hormonal changes.
Parkinson disease and spinal cord conditions, such as a laminectomy, have been linked to RLS.
People without risk factors often pursue non-drug treatments such as applying hot and cold packs, massaging the legs and moderate physical exercise. They may limit the amount of caffeine and alcohol; but all these efforts have limited value.
On the other hand, treating iron deficiency anemia with iron supplements sometimes greatly benefits patients with RLS.
Although there is no known cure for RLS, current medications offer some benefit for this condition. Most drugs prescribed to treat RLS aren’t recommended during pregnancy and some medications may worsen symptoms of RLS.
It’s best to consult your physician about what drugs might be right for you.
References
Winkelman, J W et al; Restless Leg Syndrome; American Academy of Neurology, Dec 1, 2016
American Academy of Sleep Medicine, Restless Leg Syndrome, Overview and Facts
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.