Restless Leg Syndrome: Causes, Symptoms, and Treatment

Restless leg syndrome (RLS) is a neurological disorder that causes uncomfortable sensations in the legs and an irresistible urge to move them, often disrupting sleep and causing daytime sleepiness or leg problems.

Understanding RLS is essential to managing the condition, alleviating uncomfortable symptoms, and improving sleep quality.

In this article, you can learn about restless leg syndrome, its symptoms, potential underlying causes, and available treatment options.

What is restless leg syndrome?

Restless legs syndrome is both a neurological disorder and a sleep disorder. It causes uncomfortable sensations in the legs, leading to uncontrollable and involuntary leg movements.

These episodes often occur during nighttime, disrupting sleep and making it hard to fall asleep. RLS can lead to decreased sleep quality, tiredness during the day, general anxiety, stress, and other problems.

Movement usually eases the symptoms for a while, but they might return or become more intense when you rest your legs. Restless legs syndrome is a chronic condition with no known cure, so treatment focuses on easing the symptoms and their effects on your everyday life.

The condition is also known as Willis-Ekborm disease.

Restless leg syndrome symptoms

The hallmark symptom of RLS is discomfort in the legs. It might be a crawling, pulling, throbbing, itching, or aching sensation. Cramps in the legs might also occur. These symptoms are usually felt inside the legs, not on the skin, and they are often triggered when resting the limbs.

Due to these sensations, one will feel the urge to move the legs, which usually eases the symptoms to some degree. This leads to leg twitching, involuntary movement of the legs, and a general feeling of restlessness.

Restless leg symptoms are more apparent in the late afternoon or the evening, especially when one goes to bed. As a result, one might experience difficulty falling asleep, twitchy legs, leg sweating, and waking up in the middle of the night. The decreased quality of sleep leads to further problems associated with RLS.

General fatigue, daytime sleepiness, mood changes, depression, and anxiety are all common symptoms among RLS patients.

Restless leg syndrome can play a role in the onset of other sleep disorders, such as hypersomnia. It may also develop as a secondary condition related to neuropathy, sleep apnea, and other medical conditions.

Another disorder that causes similar symptoms is periodic limb movement of sleep (PLMS), which leads to involuntary jerking of the limbs during sleep. RLS and PLMS are easy to differentiate, as PLMS doesn’t cause symptoms during the day, while RLS does.

Restless leg syndrome causes

What causes restless leg syndrome is not entirely clear yet.

Genetics might be at play in some cases since RLS can be inherited. Experts suspect that the condition might result from dysfunction in the basal ganglia, the part of the brain responsible for movement. The basal ganglia need dopamine to fulfill its function, and low dopamine levels might lead to the onset of RLS. Iron deficiency in the brain can also be linked to restless leg syndrome, even when iron levels appear normal in the bloodstream.

Restless legs syndrome might also appear as a result of some other conditions. In this case, doctors refer to it as secondary RLS. Diabetes, kidney diseases, anemia, Parkinson’s disease, and neuropathy could all lead to secondary RLS.

Some medications like antihistamines, antidepressants, and antinausea medications might also lead to the development of RLS or make the symptoms of an existing condition worse.

Restless leg syndrome and pregnancy might also be linked since the condition is more common among pregnant women. RLS occurring during pregnancy often goes into remission after giving birth, but sometimes the symptoms remain.

RLS can affect people of any age, including children, but it’s more common in people over 50.

Diagnosing restless leg syndrome

There are no exact tests for restless legs syndrome, so doctors will try to rule out other possible conditions to diagnose it.

First, they will perform a physical exam, ask about your medical history, and if RLS was present in your family.

Differential diagnosis focuses on ruling out other conditions which might present similar symptoms. Doctors usually perform neurological exams, blood tests, and sleep studies.

The following criteria must be met to make the diagnosis for RLS:

• Uncomfortable sensations in the legs, even during daytime
• The urge to move the legs
• Symptoms get worse during rest, and movement relieves them
• Symptoms are more apparent in the evening or night
• No other underlying condition is responsible for the symptoms

Sometimes, restless leg syndrome can result from some other underlying condition. In these cases, doctors usually make the diagnosis of secondary RLS.

Diagnosing RLS in children is more complicated because it might be difficult for them to describe their symptoms. Another factor is that RLS shares similar symptoms with ADHD and growing pains, all common conditions among children.

Restless leg syndrome treatments

Restless leg syndrome is a chronic condition that has no known cure yet. However, it’s possible to manage symptoms, and in some cases, RLS can go into remission without symptoms.

When one has secondary RLS caused by some other condition, doctors will treat the underlying condition, which usually lessens RLS symptoms as well.

Lifestyle changes for restless leg syndrome

If restless legs syndrome only presents milder symptoms, doctors usually recommend some lifestyle changes first.

• Avoid stimulants like alcohol, nicotine, and caffeine, especially before bedtime.
• Keep a strict sleep schedule.
• Sleep in a dark and silent environment. Use blackout curtains, white noise, or earplugs if needed.
• Dedicate time for relaxation before bedtime.
• Try herbal teas or sleep patches.
• Try massages, hot baths, or stretching during episodes of discomfort to ease the symptoms.

Medications for restless leg syndrome

In some severe cases, the above methods might not prove enough, so doctors may prescribe medications to ease your symptoms.

• Dopamine agonists, such as ropinirole, pramipexole, and rotigotine, can help increase dopamine levels in the brain and ease the symptoms of RLS.
• Painkillers can lessen the discomfort and leg pain associated with RLS.
• Hyptonics like zopiclone or zolpidem can promote more restful sleep, but these sleeping pills are usually only recommended for short-term use.
• Anti-seizure medicines, such as gabapentin enacarbil or pregabalin, can ease sensory discomfort in the legs.

Benzodiazepines, like clonazepam or lorazepam, can remedy anxiety, insomnia symptoms, and muscle problems.