Photo by Andrea Piacquadio.

You’re relaxing at the end of the day in your favorite easy chair when suddenly you are overcome by the urge to move your legs, or maybe also your arms, or even your whole body. You might find these urges unpleasant or even painful, but they might be milder. They might feel electric, itchy, throbbing, creeping, or crawling. If you get up and move around, the urges may lessen, but they might come back as you attempt to fall asleep, or even interrupt your sleep, with ill effects spilling over into the next day and eventually your whole life. This common condition affects 7-10% of the US population, women more often than men; kids can have it, but it usually appears in late middle age, and there is no known cure.

Symptoms

First described by English physician Sir Thomas Willis in 1672, the symptoms of Restless Legs Syndrome (RLS) were only sporadically recognized and were thought of as a bizarre inexplicable condition until the 20th century. It wasn’t until 1944 that Swedish Neurologist Karl Ekbom conducted a thorough investigation of the condition, giving it its current name. Then in 1995, the International Restless Legs Syndrome Study Group defined the four minimal criteria for arriving at an RLS diagnosis:

1. An urge to move the legs, accompanied or caused by an unpleasant sensation. Sometimes the arms are involved, and sometimes the sensation is not unpleasant.
2. The urges occur while the person is inactive or resting.
3. The urges are partly or fully relieved by movement.
4. The urges are worse at night compared to daytime, or they only occur at night.

Many people who suffer from these symptoms never seek medical advice, partly because of embarrassment over something so seemingly trivial. But others, who find their sleep cycles severely disturbed are better served by seeking treatment.

Possible causes

Sleep impairment is usually the most serious issue associated with RLS.

The cause of RLS is unknown, but one theory is that it is caused by an imbalance in the brain’s chemical dopamine, which is responsible for the control of muscle movement.

Hereditary factors may play a role, especially in those who experience symptoms under the age of 40. Possible genetic links have been identified by researchers.

Pregnant women are more likely to experience RLS, pointing to a hormonal connection.

RLS is not usually directly related to any serious underlying conditions. However, it may accompany certain more serious issues such as peripheral neuropathy, iron deficiency which is sometimes brought on by kidney failure, lesions on the spinal cord or having had a spinal block or anesthesia to the spinal cord, and Parkinson’s Disease. Without any of these other conditions, sleep impairment is usually the most serious issue associated with RLS.

If you suspect you have RLS, see your provider and they will check you for the four defining symptoms and ascertain how severe of an impact they are having on your health. Your iron levels may be checked, and if anything in your health history dictates, other testing may be done to rule out more serious causes.

Remedies and treatment

Relaxation techniques often help, as does increased exercise, lessening caffeine consumption, and quitting cigarette smoking.

Natural remedies are often recommended before any pharmaceuticals are prescribed. Relaxation techniques often help, as does increased exercise, lessening caffeine consumption, and quitting cigarette smoking. Magnesium supplementation has shown promise and has no negative side effects. Up to 80% of Americans may be magnesium deficient. Natural substances such as vitamin B6 and melatonin that help improve the quality of sleep may also be part of the RLS remedy.

Acupuncture and massage therapy are well-supported by anecdotal accounts, and it is hoped that more formal research will be done to reinforce those results.

Treatment might involve iron supplementation, but if no iron deficiency is detected, two classes of drugs are generally tried. Medications that increase dopamine in the brain, such as Rotigotine or Pramipexole, may be used, but be sure to discuss their side effects with your provider.

The well-tolerated Gabapentin is often prescribed and can relieve RLS symptoms, although the science is unclear as to how.

Rarely, sleep aids or even opioids can be prescribed, but are not favored due to their addictive properties and their likelihood of causing debilitating daytime symptoms.

Don’t be shy about being seen by your provider for this common and often progressive condition. You may be surprised by how easy it is to decrease your RLS symptoms, and the likely improved sleep that you experience may do wonders for your quality of life throughout the day. The next time you sink into that easy chair, it may be much more relaxing.

Ann Constantino, submitted on behalf of the SoHum Health’s Outreach department.