Restless Legs Syndrome: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Uncontrollable urges to move the legs are a defining feature of restless legs syndrome (RLS), which commonly results from an uneasy feeling. You can be seated or lying down when it occurs, and it typically occurs in the evening or late at night. Movement of the legs may temporarily decrease the ache.

Willis-Ekbom disease, often known as restless legs syndrome, can start at any age and typically gets worse as you age. This could have an impact on everyday activities.

Causes of Restless Legs Syndrome 

The reasons for RLS are frequently unknown. Researchers believe that an imbalance in the brain chemical dopamine, which transmits signals that regulate muscular movement, maybe the cause of the condition.

Hereditary

If it appears before the age of 40, hereditary RLS may run in families. Research suggests that specific chromosomal regions may have RLS genes.

Pregnancy

Pregnancy or hormonal changes may temporarily make RLS symptoms worse. Some pregnant women may get their first case of RLS, especially in the third trimester. However, symptoms usually disappear following delivery.

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Symptoms of Restless Legs Syndrome 

The primary symptom is an urge to move one's legs. Simple self-care techniques and lifestyle adjustments may help symptoms disappear. Many RLS patients can benefit from medication. The following are typical RLS comorbidities:

• Sensations that start when you're at rest. The feeling usually starts after you have been lying down or sitting for a while, like in a car, an aeroplane, or a theatre.
• Relief with movement. With movement, such as stretching, jiggling the legs, pacing, or walking, the RLS sensation reduces.
• Symptoms get worse in the evening. Most symptoms happen at night.
• Leg twitching at night. The more prevalent condition known as periodic limb movement of sleep, which causes the legs to twitch and kick while you sleep, possibly all night long, may be linked to RLS.

RLS symptoms are frequently described as prickly, uncomfortable sensations in the legs or feet. Usually, they affect both sides of the body. Less frequently, the symptoms afflict the arms.

The sensations, which typically take place inside the limb instead of on the skin, are defined as:

• Crawling
• Creeping
• Pulling
• Electric
• Throbbing
• Pain

It can be challenging to explain certain sensations. RLS sufferers typically do not characterise the disorder as a muscle cramp or numbness. a desire to move the legs is, however, regularly mentioned.

The degree of symptoms can change over time. Sometimes, symptoms go away for a while before returning.

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Risk Factors Of Restless Legs Syndrome

RLS can start to manifest at any age, even when a toddler. With advancing age, the disorder becomes more prevalent, and women are more likely than males to have it.

RLS frequently has no connection to a significant underlying medical condition. However, other conditions like:

• Peripheral Neuropathy. Chronic conditions like diabetes and alcoholism can occasionally be to blame for this damage to the nerves in the hands and feet.
• Deficiency of iron. Iron deficiency can develop or aggravate RLS even in the absence of anaemia. You can have iron deficiency if you frequently donate blood, have a history of stomach or intestinal bleeding, or have heavy menstrual cycles.
• Kidney failure. Iron deficiency, frequently accompanied by anaemia, may coexist with kidney failure. Iron levels in the blood can drop when the kidneys aren't working properly. RLS may be brought on by or made worse by these and other alterations in body chemistry.
• Spinal cord diseases. RLS has been associated with spinal cord lesions brought on by harm or injury. RLS risk is also increased by previous spinal cord anaesthesia, such as a spinal block.
• Parkinson's disease. RLS risk is higher in those with Parkinson's disease who take particular drugs known as dopaminergic agonists.

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Diagnosis Of Restless Legs Syndrome

Your healthcare professional will ask you to describe your symptoms and collect a medical history. The International Restless Legs Syndrome Study Group set the following criteria for diagnosing RLS:

• You experience an intense, frequently uncontrollable urge to move your legs, which is typically accompanied by unpleasant feelings.
• When you're resting, such as sitting or lying down, your symptoms either begin or get worse.
• Activity, such as stretching or walking, partially or momentarily relieves your symptoms.
• At night, your symptoms get worse.
• The sole cause of symptoms cannot be another medical or behavioural problem.
• Your doctor might perform a neurological and physical examination. To eliminate other potential causes for your symptoms, your doctor may conduct blood tests, particularly those that check for iron deficiency.

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Treatment Of Restless Legs Syndrome

RLS symptoms can occasionally be significantly reduced by treating an underlying illness, such as iron insufficiency. Receiving oral or intravenous iron supplements can help treat an iron deficit. However, only take iron supplements under medical supervision and after your provider has examined your blood's amount of iron.

Treatment for RLS is not accompanied by another condition and it focuses on changing your way of living. Your doctor might suggest drugs if they are ineffective.

Medications

There are a number of prescription drugs that can be used to reduce leg restlessness, the majority of which were developed to treat different disorders. These include

• Medications that elevate dopamine levels in the brain. These drugs have an impact on the brain's dopamine levels, which are a chemical messenger. For the treatment of moderate to severe RLS, the Food and Drug Administration has given the drugs rotigotine and pramipexole their approval.
• Nausea, dizziness, and exhaustion are among the milder short-term side effects of these drugs. In addition, they can result in daytime sleepiness and disorders of impulse control such as compulsive gambling.
• Drugs that alter calcium channels. For some persons with RLS, certain drugs, including pregabalin (Lyrica) and gabapentin (Neurontin, Gralise), function.
• Drugs to induce sleep and relax the muscles. These medications aid in improving your nighttime sleep, but they don't get rid of leg feelings and they could make you drowsy during the day. Usually, only in the event that no other treatment relieves symptoms, are these drugs prescribed.
• Opioids. However, if used in large dosages, narcotic drugs, which are primarily used to treat severe symptoms, may become addictive. Codeine, oxycodone, hydrocodone (Hysingla ER), tramadol, and codeine are a few examples.

Finding the appropriate drug or pharmaceutical combination for you may need multiple trials on your part and that of your healthcare practitioner.

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Complications Of Restless Legs Syndrome

RLS symptoms can range from slightly annoying to incapacitating, even when they don't cause other major diseases. Many RLS sufferers have trouble getting to sleep or staying asleep.

Severe RLS can significantly lower life quality and increase the risk of depression. RLS may prevent naps, while insomnia may cause excessive daytime sleepiness.

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