Restless Legs Syndrome

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KEY POINTS

• Restless legs syndrome (RLS) is aching, twitching, tingling, burning, or prickling feelings in your legs when you lie in bed or are sitting. You may have uncontrollable, and sometimes overwhelming, urges to move your legs.
• If your symptoms are mild, you may not need medical treatment. You may feel better with stretching, massage, or relaxation exercises. Your healthcare provider may prescribe medicine to help you sleep.
• Follow your healthcare provider's advice for relief of your RLS symptoms. It may help if you avoid smoking, caffeine, and alcohol, and get exercise that's right for you.

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What is restless legs syndrome?

Restless legs syndrome (RLS) is aching, twitching, tingling, burning, or prickling feelings in your legs when you lie in bed or are sitting. You may have uncontrollable, and sometimes overwhelming, urges to move your legs. Moving your legs or getting up and standing or walking may make your legs feel better, but not for long. RLS is also called Willis-Ekbom disease.

RLS can cause trouble sleeping (insomnia).

What is the cause?

The exact cause of RLS is not known. It tends to run in families. It is more common after middle age and happens more often in women than in men. Conditions that may be linked to RLS include:

• Nerve damage
• Drinking a lot of alcohol
• Smoking
• Too much caffeine
• Health problems such as Parkinson's disease, rheumatoid arthritis, low blood levels of iron, anemia, or diabetes
• Use of some medicines
• Dialysis
• Pregnancy

The problem may get worse when you have been lying in bed or sitting for a long time.

What are the symptoms?

Symptoms may include:

• Strong urges to move your legs
• Aching, twitching, tingling, burning, or prickling in your legs when you are lying down or sitting
• Relief from the symptoms when you move, especially if you get up and walk

The symptoms start or get worse in the evening or at night.

Leg cramps and occasional, sudden jerking of legs or arms are not symptoms of RLS.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• An EMG (electromyogram), which uses needles passed through your skin to send mild electric signals and check how your nerves and muscles respond

Your healthcare provider may suggest that you get tested for sleep apnea. With a sleep apnea study or at a sleep center, you will have a continuous, all-night recording of your breathing, eye movements, muscle tone and muscle movement, blood oxygen levels, heart rate and rhythm, and brain waves.

How is it treated?

If your symptoms are mild, you may not need medical treatment. Here are some things you can do that may help relieve your symptoms:

• Stretch or massage your leg muscles before going to sleep.
• Practice relaxation methods.
• Ask your provider about wearing elastic compression socks up over your calves. Use a covered hot water bottle or cold moist cloths (whichever works best for you) on painful areas before you go to sleep.
• Take a warm bath before bedtime.

If these steps do not help, your healthcare provider may prescribe medicine to relieve the symptoms and help you sleep better. Medicine is helpful but not a cure. Getting more iron if you don’t have enough iron in your blood sometimes helps ease the symptoms.

How can I take care of myself?

Follow your healthcare provider's advice for relief of your RLS symptoms. You may need to:

• Avoid or cut back on caffeine (coffee, tea, cocoa, cola).
• Avoid or cut back on alcohol.
• Stay fit with the right kind of exercise for you.
• Practice good sleep hygiene and keep a sleep diary.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• Join a support group. Support groups can help by sharing common concerns and solutions to problems with others in the same situation.

Contact your healthcare provider if you have new or worsening symptoms.

You can get more information from:

• Willis-Ekbom Disease Foundation
  https://www.rls.org