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Restless leg syndrome (RLS) affects millions of people. In this article, we introduce the causes, symptoms, and treatments of RLS.
Restless leg syndrome is an unusual neurological issue characterized by legs that feel as though they need to get up and move.
Restless leg syndrome is not a deadly disease, and it doesn't indicate any other brain problems. Nevertheless, it can be very disruptive to your quality of life, and some studies have linked RLS to other issues, like heart disease.
Restless leg syndrome is often difficult to understand, because the feeling itself may be somewhat subjective.
The idea behind RLS is that the legs make the individual feel as though they need to get up and move. The symptoms of RLS are not always in the legs either. Some experience it in the arms, and possibly the trunk. It's one of the reasons that many are calling for RLS to be renamed Willis-Ekbom disease after the two researchers that first discovered it – to avoid some of the incorrect notions about RLS.
The restless "feeling" itself may be different for different people. Some describe it as:
The feeling starts to become disruptive and noticeable, leading the individual to feel that they absolutely must get up and move. Once they do, however, the feeling subsides, and they can go back to their seated or resting position.
Restless leg is a disorder that may be experienced in a variety of ways across an entire spectrum. Some people only experience a minor tickling or need to move. Others experience a feeling so strong that it's overwhelming.
Restless leg would not necessarily be a problem if not for when the experience occurs. During the day in the workplace, restless leg may not be much of an issue – the individual simply gets up from their desk, walks around, and sits back down (this may still be very disruptive in some workplaces).
However, on a long flight or when trying to sleep, RLS can be a tremendous problem. Getting up and walking may not be possible, and the feeling can cause significant discomfort.
Furthermore, some people experience RLS while asleep, causing them to wake and not get enough rest. In addition, one of the characteristics of RLS is "leg jerking." This is when the leg kicks out, thus waking the person up from their sleep (and possibly kicking anyone next to them).
Restless leg symptoms also tend to get worse when relaxed.
It's these restless leg symptoms and others that make the disorder troubling, and something few people wish to live with.
For those living with restless leg syndrome, it's comforting to know that the disorder is not dangerous or life threatening.
Some studies have linked those living with restless leg with an increased risk of heart disease. Restless leg itself does not necessarily cause heart disease, however. The study measured the leg twitches of those with restless leg syndrome and found that those with more twitches tended to have thicker heart walls, which in turn was more dangerous to their health.
Still, this research was fairly preliminary, and it's strongly believed that RLS as a disorder was unlikely to have contributed to the heart health problems. If there is a link, it is most likely due to sleep disturbances in those with heart issues, or perhaps those with heart problems tend to have more disruptive RLS symptoms.
However, restless leg can have secondary dangers, because a lack of sleep can cause stress, poor decision making, and fatigue problems. RLS is its own disorder, but several types of health problems (such as diabetes and nutrient deficiencies) tend to be more common in those with RLS. The reason for this isn't entirely clear, but it's likely that the stress from a lack of sleep makes one at greater risk for these health conditions.
Restless leg itself may also be stressful, and that stress can contribute to its own problems.
As a disorder, restless leg appears to be fairly safe, but there is reason to want to cure restless leg symptoms.
While restless leg is a neurological disorder, its causes are a bit less clear.
It's largely believed to be a genetic issue. More than half of all RLS cases are passed down from a relative with RLS, indicating a strong genetic link. Scientists have yet to locate the gene with certainty, but heredity is very likely to be the leading cause of RLS.
Iron deficiency is also believed to contribute to RLS. Low levels of iron are common in RLS patients, and many believe that those with "enough" iron may still not be getting enough to the areas of the brain that need it.
Studies have shown that the issues related to both genetics and iron (and to a lesser extent dopamine, which also may be involved in RLS) may also be triggered or exacerbated by other underlying health conditions. Some of these include:
Those with a vein disease were also found to more commonly have RLS. Some medicines can also contribute to RLS, or trigger it temporarily.
It's because of these wide range of potential causes that some in the medical community believe that some (although not all) cases of RLS are simply symptoms of other issues. They worry that RLS is being diagnosed in some patients that have a different condition causing the RLS.
Nevertheless, current research points to the idea that treatment should still be effective. Also, due to the frequency with which RLS has no physical cause, diagnosing RLS should be no cause for alarm.
RLS is a subjective experience. Many people feel they have to move their legs without having RLS, simply because of excess energy, positioning, etc. As a neurological disorder, there are also no tests for restless leg to correctly identify who is experiencing it and who is not.
Generally, restless leg is diagnosed through the process of elimination and through shared experiences.
Often a doctor will try to rule out any underlying issues, and may check for vitamin levels (to ensure there is proper amount of iron and other nutrients in the blood).
Doctors will also ask about the main characteristics of RLS:
Depending on the type of RLS treatment, a doctor may even start a safer treatment without confirming the diagnosis. In some cases, however, the doctor may want to rule out all other disorders before diagnosing RLS.
There are a variety of ways to treat RLS.
If any underlying symptom is present, then treating the underlying symptom will come first. In the case of some issues like pregnancy or RLS caused by medications, generally the doctor will recommend waiting it out, because studies have shown that the experience often goes away after giving birth or finishing the medications.
Iron supplementation is also a very common treatment.
As mentioned earlier, those with RLS tend to be deficient in iron, and many believe that those with the "right" amount of iron in their blood may be in need of greater levels of iron then the general population.
Doctors may also prescribe medications for those living with RLS.
Dopamine agonists are common, although most doctors will explore other options before using these drugs. Most symptoms of RLS occur at the same time as dopamine release, indicating that it is likely that some aspect of RLS is related to dopamine levels in the brain. Dopamine can have some risky side effects, which is why they are not the first choice of most doctors.
Anticonvulsants may also be prescribed, with a few (like Gabapentin Enacarbil) designed specifically for those living with RLS. These are generally recommended when the restless leg is considered painful, since that pain can be very stressful.
Also, many sleep aids may be prescribed as well. This is to prevent the most troubling symptom of RLS – the waking in the middle of the night.
Vitamins C and E may also be prescribed, and some people use medical marijuana as well, although marijuana is still largely illegal and not generally recommended.
Some cases of RLS are relieved on their own, although this is less common.
Restless leg syndrome can be a highly unpleasant disorder.
While it's not life threatening, it's stressful enough that curing it remains a top priority. Restless leg prevents sleep, can be disruptive in both the workplace and at home, and causes enough stress that those with RLS may be at risk for stress-related long term health issues.
Luckily, treating RLS is possible, and with treatment and lifestyle changes, anyone living with restless leg syndrome should be able to control the issue in time.
Lavigne, GJ; Montplaisir, JY (1994). "Restless legs syndrome and sleep bruxism: prevalence and association among Canadians". Sleep 17 (8): 739–43.
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