Restless legs syndrome: Overview
Restless legs syndrome is a common nervous system problem. People with this syndrome feel a creeping, achy, or unpleasant feeling in the legs and an overpowering urge to move them. It often occurs in the evening and at night and can lead to sleep problems and tiredness.
Your doctor may suggest doing a study of your sleep patterns to figure out what is happening when you try to sleep. Many people get relief from symptoms when they get regular exercise, eat well, and avoid caffeine, alcohol, and tobacco.
Restless legs syndrome (RLS)
Restless legs syndrome, or RLS, is a disorder that makes you want to move your legs or other parts of your body when you lie down to sleep. People also describe the feeling as "pins and needles," prickling, pulling, or crawling. The tingling usually makes you want to move, and that can make it hard to sleep.
Experts don't know what causes RLS. But it can be triggered by pregnancy, iron deficiency, and certain medicines.
What are the symptoms of restless legs syndrome (RLS)?
The main symptom of RLS is uncomfortable or painful sensations that happen after you lie down to sleep. The sensations are described as aching, creeping, crawling, or prickling. Often, the uncomfortable feelings make you want to move, instead of sleep. Sometimes, RLS also causes jerking movements.
How is restless legs syndrome (RLS) treated?
Treatment for RLS is based on the type of symptoms you have and how bad they are. Getting regular exercise and enough sleep may be enough for mild symptoms. But if your symptoms get in the way of how well you can function, you may need medicines.
First treatments
Changing your daily routine is sometimes enough. It may help if you do things like stretch, walk, exercise regularly, get a massage, or take a hot or cold bath. Losing weight and avoiding smoking, alcohol, and caffeine can also help.
If your symptoms are caused by another medical problem like diabetes or iron deficiency anemia, you will be treated for that problem first. For example, you'll take iron supplements if you aren't getting enough iron.
If RLS starts during pregnancy, your doctor may just recommend exercise and stretching.
For children, regular exercise and sleep routines are usually tried first. If those don't work, the doctor may prescribe medicine.
Medicines
If your symptoms don't improve, you may try medicines. These include:
- Dopamine agonists, such as ropinirole (for example, Requip).
- Anticonvulsants, such as gabapentin (for example, Neurontin) or gabapentin enacarbil (for example, Horizant).
In some cases, your doctor may recommend an opioid pain medicine.
If your doctor recommends medicine, be sure to talk about the possible benefits and risks. Let your doctor know about all of the other medicines you take. Medicines for other conditions sometimes help cause RLS. For example, antidepressants may improve symptoms. Or they may make them worse.
Ongoing treatment
Over time, a dopamine medicine may not work as well.
You may also notice that your symptoms start earlier in the day. Or they may be more intense. Or they may spread to another part of your body.
If you're taking a dopamine medicine and your symptoms change, tell your doctor. Don't stop taking your medicine without talking to your doctor first. You can work with your doctor to find the best treatment for you.
If you make lifestyle changes, and you still have symptoms, you may need a doctor to reevaluate your symptoms. Many other health problems have similar symptoms. These include several vitamin and mineral deficiencies.
Your doctor may recommend different medicines. Or your doctor may recommend a combination of medicines. Follow up with your doctor if your symptoms don't improve.
Other treatment
Your doctor may have you try other treatments. These include:
- A pneumatic compression device. This machine pumps air in and out of sleeves to make them tight and loose around your legs while you are resting.
- Vibrating pads (Relaxis). The pads send vibrations to your legs. They may improve sleep for some people with RLS.
How is restless legs syndrome (RLS) diagnosed?
If you think you have RLS, your doctor will review your symptoms and will look for any other causes of your symptoms. You may get tested for other conditions. And your doctor may recommend a sleep study.
Improving symptoms of restless legs syndrome at home
There are ways to improve your symptoms of restless legs syndrome at home. Here are some things to consider.
- Try regular, moderate exercise.
Avoid long periods between activity and avoid sudden bursts of intense activity. Talk to your doctor before you start an exercise program.
- Try heat or cold.
Your symptoms may be relieved by bathing in hot or cold water. Or try a heating pad set on low, hot water bottle, or ice bag. Keep a cloth between the heating pad, hot water bottle, or ice bag and your skin.
- Keep good sleeping habits.
Fatigue can make your symptoms worse. So it is important to keep good sleep habits. Keep your bedroom cool, quiet, and comfortable. Use it only for sleeping, not for watching TV. Try to go to bed and get up at the same time every day.
- Try stretching and massage.
You may be able to control your symptoms by gently stretching and massaging your limbs before bed or as discomfort begins.
- Avoid caffeine, tobacco, and alcohol.
These may make your symptoms worse.
- Limit certain medicines.
Some prescription and over-the-counter (OTC) medicines (such as cold and sinus medicines) can make symptoms of RLS worse. If you think your symptoms get worse after you take a certain medicine, talk to your doctor.
- Avoid being confined for long periods.
Try to plan for times when you will need to remain seated for long stretches. For example, if you are traveling by car, plan to make some stops so you can get out and walk around.
- Avoid excessive exercise.
Although moderate exercise may help relieve symptoms, unusually intense workouts may make them worse. Try to figure out at what level exercise helps and at what point it triggers restless legs syndrome.
See your doctor if your symptoms do not improve, if they become worse, or if they significantly interfere with your sleep and daily functioning.
What is restless legs syndrome (RLS)?
Restless legs syndrome is a disorder related to sensation and movement. People with RLS have an unpleasant feeling or sensation in parts of their bodies when they lie down to sleep. Most people also have a very strong urge to move. And moving sometimes makes them feel better. But all this movement makes it hard or impossible to get enough sleep.
RLS usually affects the legs. But it can cause unpleasant feelings in the arms, torso, or even a phantom limb. A phantom limb is the part of a limb that has been amputated.
When you don't get enough sleep, you may start to have problems getting things done during the day because you're so tired. You may also be sleepy or have trouble concentrating. So it's important to see your doctor and get help to manage your symptoms.
What causes restless legs syndrome (RLS)?
Usually there isn't a clear reason for restless legs. The problem often runs in families. Sometimes there's a clear cause, like not getting enough iron. If that's the case, treating the cause may solve the problem.
Women sometimes get restless legs while they are pregnant.
Other problems that are sometimes linked to RLS include kidney failure, rheumatoid arthritis, diabetes, nerve damage, anemia, and Parkinson's disease. But most people who seek treatment don't have any of these other problems.
Restless legs syndrome: When to call
Watch closely for changes in your health, and be sure to contact your doctor if:
- You are still not getting enough sleep.
- Your symptoms become more severe or happen more often.
What can make symptoms of restless legs syndrome worse?
Some things can make symptoms of restless legs syndrome worse. They include:
- Caffeine, tobacco, and alcohol.
- Certain prescription and over-the-counter (OTC) medicines.
- Being confined for long periods.
- Excessive exercise.
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