Overview
Restless legs syndrome (RLS) is a condition that causes an uncomfortable urge to move the legs. This usually occurs in the evening hours when lying down or sitting. Moving the legs relieves this feeling temporarily.
Restless legs syndrome, also known as Willis-Ekbom disease, can begin at any age and generally get worse with age, and it can disrupt sleep.
Simple self-care steps and lifestyle changes help relieve symptoms, as do medications have a good role.
Symptoms
The main symptom is the desire to move the legs, and common and accompanying characteristics of RLS include:
• Disturbing sensations that begin during rest. The sensation usually begins after lying down or sitting for a long time, in the car, or in a lecture.
• Comfort with movement. The sensation of restless leg syndrome (RLS) is reduced by movement, such as stretching, rocking the legs, or walking.
• Symptoms worsen in the evening. Symptoms mainly occur at night.
• Leg trembling at night. Restless leg syndrome (RLS) may be associated with another, a more common condition called periodic limb movement during sleep, which causes legs to tremble and kick, possibly persisting throughout the night and during sleep.
People often describe the symptoms of restless leg syndrome (RLS) as cramping and unpleasant sensations in the legs and feet. They usually occur in the lower extremities. Less commonly, it extends into the arms.
The sensations, which generally occur deep within the limb rather than under the skin, are described as creeping, crawling, and pulling with a shaking, itchy pain with a feeling as if an electric current is going through.
Sometimes the feelings are hard to explain. Affected people usually do not describe the condition as muscle cramping or numbness, but rather as a desire to move the legs.
It is common for symptoms to fluctuate in severity. Sometimes, symptoms go away for periods and then come back.
It is necessary to see a doctor, as some people never seek to see a doctor for fear that their complaint will not be taken seriously.
Causes
Often, there is no known cause for RLS. Researchers suspect the condition may be caused by a defect in the brain chemical dopamine, which sends messages to control muscle movement.
Heredity
Sometimes RLS runs in familial strains, especially if the condition manifests before age 40. Researchers have identified sites on chromosomes where RLS genes may be present.
Pregnancy
Pregnancy or hormonal changes may temporarily worsen the signs and symptoms of restless leg syndrome (RLS). Some women develop restless leg syndrome (RLS) for the first time during
pregnancy, especially during the third trimester, and symptoms usually go away after giving birth.
Risk factors
Restless leg syndrome (RLS) can develop at any age, even during childhood. It is more common with age and is more common in women than in men.
Restless leg syndrome (RLS) is usually not associated with a serious underlying medical problem. However, it sometimes accompanies other injuries, such as:
• Peripheral neuropathy, which affects the nerves of the hands and feet, is sometimes due to chronic diseases such as diabetes and alcoholism.
• Iron deficiency. Iron deficiency can cause or exacerbate restless leg syndrome (RLS). Having a history of gastric or intestinal bleeding, or gynecological bleeding, such as heavy menstruation, or excessive frequent blood donation, may lead to iron deficiency.
• Kidney failure. It is often accompanied by anemia, in which the kidneys do not function properly, and iron stores in the blood can be low.
• Diseases of the spinal cord. Existing lesions have been linked with spinal cord disorders.
• Parkinson’s disease. People with Parkinson’s disease who take medications called dopamine agonists are more likely to develop restless leg syndrome (RLS).
Complications
Although restless leg syndrome (RLS) doesn’t lead to other serious conditions, symptoms can range from inconvenience to disabling. Many people with restless leg syndrome find it difficult to fall asleep and interrupted sleep continuity.
Severe restless leg syndrome (RLS) can cause significant impairment in quality of life and can lead to depression. Insomnia may lead to excessive daytime sleepiness.
Diagnosis
The patient will be asked to describe the symptoms. The diagnosis of Restless Legs Syndrome is based on the following criteria established by the International Restless Legs Syndrome Study Group:
• A strong, often irresistible urge to move the legs, usually accompanied by uncomfortable sensations.
• Symptoms start or get worse when you rest, such as sitting or lying down.
• Symptoms are partially or temporarily relieved by activity, such as walking or stretching.
• Symptoms worsen at night.
• Symptoms can’t be explained solely by another medical or behavioral condition
The doctor may perform a physical and neurological examination. Blood tests may be ordered, especially to check for iron deficiency and to rule out other possible causes of symptoms.
In addition, the patient may be referred to a sleep specialist, which may include an overnight stay and study in a sleep clinic if another sleep disorder such as obstructive sleep apnea is suspected.
During sleep.
Treatment and management
Sometimes treating an underlying condition, such as an iron deficiency, greatly relieves symptoms. Correcting an iron deficiency involves receiving oral or intravenous iron supplements. However, under medical supervision after determining the level of iron in the blood.
If the condition is not related to iron deficiency, treatment focuses on lifestyle changes. If these measures are not effective, then medications are prescribed.
Medications
many prescribed medications were developed to treat other diseases, useful in the treatment of restlessness in the legs. These include:
• Medications that stimulate dopamine in the brain. These medications affect levels of the chemical messenger dopamine in the brain. Rotigotine (Neupro) and pramipexole (Mirapex) are approved by the Food and Drug Administration for the treatment of moderate to severe RLS.
Side effects of these medications are usually mild and short-lived. They include nausea, dizziness, and fatigue. However, it can also cause impulse control disorders and daytime sleepiness.
• Medications that affect calcium channels. Some medications, such as gabapentin (Neurontin, Gralise), gabapentin enacarbil (Horizant) and pregabalin (Lyrica), work well for some people with restless leg syndrome (RLS).
• Muscle relaxants and sleep medications. These medications help you sleep better at night, but they don’t eliminate sensations in the leg and may cause drowsiness during the day. These medications are generally only used if no other treatment provides relief.
• Opioids. Narcotic drugs are primarily used to relieve severe symptoms but can be addictive if used in high doses. Some examples include tramadol (Ultram, ConZip), codeine, oxycodone (Oxycontin, Roxicodone, others), and hydrocodone (Hysingla ER).
It may take several trials for the patient and the attending physician to find the right drug or combination of drugs for you.
Caution about medications
Sometimes dopamine medications that have worked for a while to relieve RLS become ineffective, or you notice symptoms returning early in the day or extending to the arms. This is called augmentation. Your provider may substitute another medication to combat the problem.
Most medications prescribed to treat restless leg syndrome are not recommended during pregnancy. Instead, your doctor may recommend self-care techniques to relieve symptoms. However, if the sensations are particularly bothersome during the third trimester of pregnancy, the doctor may approve the use of certain medications.
Some medications may worsen symptoms of restless leg syndrome (RLS). Such as some antidepressants, some antipsychotic drugs, anti-nausea drugs, and some
cold and allergy medications. Then it is recommended to avoid it, if possible.
Lifestyle and home remedies
Making simple lifestyle changes can help relieve symptoms of restless leg syndrome (RLS):
• Baths and massage. Soaking in a warm bath and massaging the legs can relax the muscles.
• Warm or cold packs, or alternately, to reduce the disturbing sensation.
• Good sleeping habits. Fatigue exacerbates symptoms Enjoy a cool, calm, and comfortable sleep environment; such as going to bed and getting up at the same time each day; and sleeping at least seven hours every night.
• Playing sports. Moderate and regular exercise relieves symptoms, but excessive exercise too late in the day may worsen symptoms.
• Avoid caffeine; Sometimes it helps. Including chocolate, coffee, tea, and soft drinks.
• Use of foot rolls and vibrating cushions; Helps relieve symptoms, especially on the back of the legs.
