Restless Leg Syndrome

Restless Leg Syndrome

What is Restless Leg Syndrome?

Restless Leg Syndrome is a neurological condition that causes an irresistible need to move the legs. The movement is caused by uncomfortable or strange feelings which are often described as itching, crawling, or pulling deep in both legs. The feelings typically occur while the affected person is lying or sitting down and are worse at night. Movement, such as rubbing, stretching, pacing, or kicking makes the discomfort temporarily go away. The unpleasant feelings and the resulting need to move the legs frequently make it tough for an affected person to stay asleep or fall asleep. The signs and symptoms of Restless Leg Syndrome range from mild to severe. People with mild cases might have symptoms a few times a month, while those with more severe cases may experience symptoms nightly. In severe cases, the uncomfortable feelings might also affect the arms or other parts of the body.

Several people with Restless Leg Syndrome also experience uncontrollable and repetitive leg movements that happen while relaxed, drowsy, or sleeping. When these movements happen while a person is awake, it is a periodic limb movement of wakefulness (PLMW). When they happen during sleep, they are called periodic limb movements of sleep (PLMS). However, it is unclear whether PLMW and PLMS are types of Restless Leg Syndrome or it represents similar, but separate conditions.

Restless Leg Syndrome and PLMS could affect the quality and extent of sleep. Consequently, affected persons may have trouble concentrating during the day, and some may develop depression, mood swings, or other health complications. Researchers have labeled early-onset and late-onset forms of Restless Leg Syndrome.

  • The early-onset form starts before age 45, and occasionally as early as childhood. The signs and symptoms of the early-onset form usually worsen slowly with time.
  • The late-onset form starts after age 45. Its signs and symptoms tend to worsen more quickly.

The Two Main Types of Restless Leg Syndrome

Primary or Idiopathic Restless Leg Syndrome

This is the most common type and has the following characteristics:

  • It can start as early as childhood.
  • It usually begins before the age of 40.
  • It may have a genetic cause.
  • Once this condition starts, it tends to be life-long.

Symptoms may be irregular, or slowly worsen and become more prevalent over time. In mild cases, the person might have no symptoms for a long time.

Secondary Restless Leg Syndrome

A secondary disorder is caused by another condition or disease. Secondary Restless Leg Syndrome usually starts after the age of 45 years. The condition does not tend to be hereditary. This type of Restless Leg Syndrome is particularly different:

  • Symptoms may be more severe and do not usually worsen over time.
  • The onset is sudden.

Diseases and symptoms that may trigger Secondary Restless Leg Syndrome include:

  • Neuropathy
  • Diabetes
  • Kidney failure
  • Iron deficiency
  • Rheumatoid arthritis
  • Parkinson’s disease
  • Pregnancy

Exactly how Restless Leg Syndrome occurs is not well understood, but it may be associated with how the body processes dopamine that plays a role in controlling muscle movements. Several medications, such as antidepressants and selective serotonin reuptake inhibitors (SSRIs) may trigger Restless Leg Syndrome. These medications affect the activity of dopamine. It is also related to pregnancy. Around 20% of women experience Restless Leg Syndrome during the last trimester of pregnancy, even though the reasons are uncertain.

Possible Causes of Restless Leg Syndrome

Restless Leg Syndrome likely results from a combination of environmental and genetic factors, but many of which are unknown.

Studies suggest that this condition is linked to a lack of iron in particular areas of the brain. Iron is involved in some critical functions in brain cells, including the production of a chemical messenger called dopamine. Amid its numerous functions, dopamine activates signals within the nervous system that aid the brain control physical movement. Researchers believe that malfunction of the signal system of dopamine may cause abnormal movements in people with Restless Leg Syndrome. On the other hand, it is unclear how lack of iron is linked to abnormal dopamine signaling or how these changes in the brain cause the particular signs and symptoms of the condition.

Differences in several genes have been studied as risk factors for Restless Leg Syndrome. Most of these genes are supposed to be involved in the development of nerve cells called neurons before birth. However, it is uncertain whether any of the genes play roles in dopamine signaling or brain iron levels. Differences in known genes seem to have an account for only a small percentage of the risk of developing Restless Leg Syndrome. Variations in other genes, which have not been recognized, possibly also contribute to this complex disorder. Researchers are suspicious that the early-onset form of Restless Leg Syndrome is more likely than the late-onset form to have a genetic basis.

Non-genetic factors are also believed to play a role in Restless Leg Syndrome. For instance, some other illnesses increase the risk of developing the condition. These include:

  • Diabetes mellitus
  • A life-threatening failure of kidney function called end-stage renal disease
  • Parkinson disease
  • Multiple sclerosis
  • Rheumatoid arthritis

People with low iron levels and women who are pregnant or lack red blood cells are also more likely to develop pregnant women. In these cases, the disorder usually goes away or improves when iron levels increase or after the woman gives birth.

Restless Leg Syndrome can also be triggered by medications, including certain drugs used to treat:

  • Nausea
  • Heart problems
  • Colds and allergies
  • High blood pressure
  • Depression
  • Other mental health disorders

In addition, the use of alcohol, caffeine, and nicotine can also trigger Restless Leg Syndrome or make the signs and symptoms worse. In these cases, the condition usually improves or goes away once a person stops using these substances or medications.

Symptoms of Restless Leg Syndrome

Restless Leg Syndrome’s main symptom is an urge to move the legs. Common associated features of the condition include:

  • A sensation that starts after rest: It usually begins after you’ve been sitting or lying down for an extended time, such as in a movie theatre, car, or airplane.
  • Worsening of symptoms in the evening: Symptoms happen mostly at night.
  • Relief with movement: The sensation of Restless Leg Syndrome reduces with movement, such as jiggling your legs, stretching, or walking.
  • Nighttime leg twitching: This condition may be along with periodic limb movement of sleep that causes your legs to kick and twitch, perhaps during the night while you sleep.

People usually describe Restless Leg Syndrome symptoms as unpleasant sensations in their feet or legs. These commonly occur on both sides of the body. Less commonly, the sensations affect the arms.

The sensations, which commonly happen within the limb rather than on the skin, are described as:

  • Creeping
  • Crawling
  • Pulling
  • Aching
  • Throbbing
  • Electric
  • Itching

At times, the sensations are hard to explain. People with Restless Leg Syndrome usually don’t define the condition as numbness or muscle cramp. However, it constantly defines as the urge to move the legs. It is common for symptoms to vary in severity. At times, symptoms go away for days and then come back.

Risk Factors of Restless Leg Syndrome

Various things could put you in a higher risk category for Restless Leg Syndrome. However, it is uncertain if any of these factors cause the condition. Some of them are:

  • Family history: You are more likely to have Restless Leg Syndrome if others in your family have it.
  • Gender: Women are two times as likely as men to get Restless Leg Syndrome.
  • Age: Even though you can get Restless Leg Syndrome at any age, it is more common and likely to be more severe after middle age.
  • Chronic diseases: Disorders such as diabetes, peripheral neuropathy, and kidney failure, may lead to Restless Leg Syndrome. Frequent treating the condition relieves symptoms of Restless Leg Syndrome.
  • Pregnancy: Several women develop Restless Leg Syndrome during pregnancy, mostly in the last trimester. This commonly resolves within weeks of delivery.
  • Medications: Antipsychotic, anti-nausea, antihistamine, and antidepressant medications may trigger or worsen symptoms of Restless Leg Syndrome.
  • Ethnicity: Anyone can get Restless Leg Syndrome, but it is more common in people of Northern European descent.

Having Restless Leg Syndrome may affect your overall well-being and quality of life. If you have this condition and chronic sleep deficiency, you may be at a higher risk of:

  • Diabetes
  • Heart disease
  • Depression
  • Kidney disease
  • Stroke
  • Early death

How to Manage Restless Leg Syndrome?

Lifestyle and Home Remedies

Experts believe that low levels of iron in the brain might be accountable for the disease. An imbalance of dopamine is also believed to contribute. About 60% of people with Restless Leg Syndrome have a family member with a condition that indicates a strong genetic component. Additionally, in recent years, experts have discovered better ways to manage and relieve symptoms of Restless Leg Syndrome. It includes self-help remedies and simple lifestyle changes you can practice at home to quiet your Restless Leg Syndrome and enjoy a peaceful, refreshing sleep.

Making simple lifestyle changes can help alleviate symptoms of Restless Leg Syndrome:

  • Try massages and baths: Massaging your legs and soaking in a warm bath can relax your muscles.  
  • Apply cool or warm packs: Use of cold or heat, or alternating use of the two, may reduce your limb sensations.  
  • Establish good sleep hygiene: Fatigue might worsen the symptoms of Restless Leg Syndrome. Therefore, you must practice good sleep hygiene. Preferably, you can have a cool, quiet, and comfortable sleeping environment and get at least seven hours of sleep every night.
  • Exercise: Getting regular exercise helps relieve symptoms, but overdoing it may intensify symptoms.
  • Consider using a foot wrap: A foot wrap particularly designed for people with Restless Leg Syndrome puts pressure under your foot and may help relieve your symptoms.
  • Avoid caffeine: Occasionally, cutting back on caffeine helps with restless legs. Try to avoid caffeine-containing products for a few weeks to see if this helps.

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