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Is Restless Leg Syndrome Real? Myths and Facts about RLS

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Is restless leg syndrome real? Read on to discover the myths and truths about this elusive condition.

Recently, some articles and stories have called into question the legitimacy of Restless Leg Syndrome (RLS). According to these stories, RLS is simply a condition fabricated or made to appear worse by the pharmaceutical companies to sell more pills.

However, is this information true? Is RLS a real condition, or is it a fabrication of the medical industry. Read on to learn about the real facts of RLS, as well as many myths surrounding the condition.

What is RLS?

According to a study on RLS conducted by Galway University Hospitals in Ireland in 2006, restless leg syndrome is identified as a sleep disorder and a sensorimotor disorder. The condition is identified as an uncomfortable sensation in the legs (sometimes the arms) that causes a person to move. Often, the symptoms appear after prolonged sessions of rest. Most people feel the most symptoms at night or in the evening. In many cases, RLS causes sleep disturbance.

According to the study, RLS symptoms are deep in the legs and are often described as being in the shin bones. The pain appears between the shin-knee and ankle. Sensations can include feelings of shocking, buzzing, tense, worms under the skin, “crawling out of my skin,” itching, numb, or electric feelings. In some cases, heat is considered an aggravating condition. In others, heat is a calming tool for the sensations.

Most patients can resist the urge to move for a while, but must eventually give in to the movement, much like the compulsion in Obsessive-Compulsive Disorder. While moving, most patients feel complete or partial relief.

The History of RLS

The first recorded instance of RLS was in 1685 in the book “The London practice of physics” by T. Willis. In the book, the disorder was described with the same motor features and sleep disruption issues that RLS sufferers face today. However, it made no mention of the sensory features that most modern patients complain about the most. A 1945 study conducted by the Acta Medica Scand Supply made the first mention of the sensory component of the condition.

In 1995, the International RLS Study Group published the first diagnostic guidelines for the condition. Since then, the National Institute of Health has created a modified guideline for the disorder. Current guidelines include essential criteria for diagnosis, outlined in the next section.

How is RLS diagnosed?

According to the National Institute for Health, there are four criteria that go into diagnosing restless leg syndrome. There are no official tests for the disorder. The diagnostic criteria are as follows:

  • Symptoms which are worse at night and absent or lessened in the morning
  • Sensory symptoms triggered by sleep, rest, or relaxation
  • A strong need to move the limbs, often associated with dysesthesias(a strange feeling in the body) and paresthesias (tingling or burning of the skin for no reason)
  • Symptoms that are relieved by movement and as long as the movement continues.

Doctors typically diagnose the condition based on the description of symptoms, the triggers, what relieves the symptoms, and whether the symptoms occur during the day or just at night. Tests can be performed, but only to rule out other causes. Children with RLS may be misdiagnosed as having “growing pains” or ADD.

The case against restless leg syndrome

For many years, and as recently as 2008, many individuals have questioned the legitimacy of the condition. Part of this skepticism arose from the fact that the first drug approved for RLS was not approved until 2005. A 2006 commentary published in the PLOS Medicine Journal investigated the issue and how the media can make certain conditions turn into fads. The article stated:

PLOS Medicine Journal Report

“The articles also reinforced the need for more diagnosis. About half reported that the syndrome is underdiagnosed by physicians (“.relatively few doctors know about restless legs. This is the most common disorder your doctor has never heard of” [17]) and under-recognized by patients (“.many people can suffer in silence for years before it is recognized” [18]). One-quarter of articles encouraged patient self-diagnosis and suggested people ask their doctor whether restless legs might explain various problems (including insomnia, daytime fatigue, attention deficit disorder in children, and depression). One-fifth of articles referred readers to the “nonprofit” Restless Legs Foundation for further information; none reported that the foundation is heavily subsidized by GlaxoSmithKline. No article acknowledged the possibility of overdiagnosis (the idea that some people will be diagnosed unnecessarily and take medication they do not really need).”

In short, the author of the article questioned the sudden prevalence of the issue and wondered if media attention was causing more people to self-diagnose for this condition than actually suffer from the disease.

While it is possible that some of the individuals who claim to have RLS may be misinformed (or a hypochondriac), there are still millions of people who actually suffer from the real disorder, which can actually be much more dangerous than a simple inability to rest at night."


The case for restless leg syndrome

There is too much medical history for RLS to conclude that the condition is completely made up by the pharmaceutical industry. This condition is real and has real consequences. In fact, a 2012 study conducted by Harvard University followed 18,425 men reporting restless leg syndrome for over 8 years. During that time, 2,765 of the men died. According to the statistics from the study, having RLS increased the men’s mortality rate by 39 percent. That is a huge increase, which shows that RLS should be taken seriously and not swept under the rug or ignored.

Is RLS serious?

RLS can be a serious condition. While the full repercussions of the disorder are unknown, there are serious side effects. The Harvard study above listed a possibility of an increased mortality rate of nearly 40 percent for individuals with RLS. Other side effects of the condition include depression, reduced quality of life, chronic tiredness, and an inability to engage with others due to lack of sleep. These issues can lead to a mental state that is unhealthy, as well as lead to other problems that are caused by lack of sleep, such as decreased mental activity and increases irritability.

RLS Myths everyone should know

There are certain myths that surround the condition of restless legs syndrome. It is important to refute these myths to help those who truly suffer from the condition. Trivializing a disease is never a good idea, and will only lead to additional pain and suffering. 

Myth 1: RLS is trivial

According to the Galway University study, most individuals (and even some doctors) consider RLS as a trivial condition. There are several reasons for this. One reason is the name. Restless leg syndrome sounds like a made-up name. Most people have experienced some feeling of “antsy” behavior that many consider a natural part of life. The high reports of RLS in studies about the disorder also cause some medical professionals to question the legitimacy of the issue.

Although some people with RLS have mild symptoms, many people have symptoms severe enough to warrant attention. As the Harvard study showed, there is a clear link between RLS and a higher mortality rate. Even if RLS does not kill the person with the condition, it does interrupt sleep and the quality of life that person can have on a day-to-day basis, which is something that should not be ignored.

Myth 2: RLS is “in your mind”

When RLS sufferers report their symptoms to friends and even some medical professionals, they are met with scorn and told their symptoms are psychogenic. The strange symptoms of this condition often lead medical professionals to conclude that the disorder is not medically related, but rather related to the mind.

In many cases, RLS is associated with anxiety and depression. A 2005 study from the Institute of Psychiatry in Munich showed that individuals with panic disorders, depression, and anxiety disorders had a higher chance of suffering from RLS symptoms.

Myth 3: RLS is only a leg condition

Many health professionals believe that RLS is a vascular disorder of the legs (dating back to a study from 1945). However, looking at the legs only is ignoring the pathogenesis of RLS. A 1996 study conducted by the Baylor College of Medicine in Texas indicated that RLS is a presenting feature of neuropathy, like alcohol abuse, diabetes mellitus, Charcot-Marie-Tooth syndrome type 2, and radiculopathy. This indicates that RLS is related to a central nervous system abnormality.

Myth 4: RLS cannot be treated

RLS is a condition that has many treatment options today that range from iron supplements, to vitamin increase, to dopaminergic treatments. Today, RLS is a fully treatable condition. For all but an estimated 3 percent of cases, diet, exercise, and supplements alone will be enough to eliminate or greatly reduce RLS symptoms.

The Reality of RLS

RLS is a real condition and it is not “all in your head.” Millions of Americans suffer from this condition on some level or another. However, with diet, exercise, and supplements, you should be able to reverse most of the symptoms that you feel on a day-to-day basis and become a healthier, happier, more rested you.

Sources


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936366/

http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm#241553237

http://thechart.blogs.cnn.com/2011/01/11/get-some-sleep-is-restless-legs-syndrome-real/

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