| Restless leg syndrome | |||||
 |
print this page |  |
email this page | ||
- What is restless legs syndrome?
- Symptoms of restless legs syndrome
- Causes of restless legs syndrome
- Treatment of restless legs syndrome
- Important restless legs syndrome facts
What is restless legs syndrome?
Restless leg syndrome is a neurological disorder of the legs mainly, but can also affect the arms. It causes discomfort in the legs (or arms) and an urge to move (get up and walk) to relieve the discomfort. Moving around (walking, exercising) seems to only relieve symptoms temporarily in most people.
Since restless legs syndrome affects the legs (and arms) on resting, sleep may be difficult, so people with this disorder often do not get enough sleep and feel sleepy during day, making it difficult to concentrate on work, school or other activities.
Some scienties think that restless legs syndrome may be present in as many as 25% of people with sleep disorders.
People with restless legs syndrome usually report symptoms getting worse later in the day to later at night.
There are two types of restless legs syndrome (RLS):
- Primary RLS - this is the most common type of RLS and once it begins, it is present for life with symptoms usually getting worse over time for most people unless the RLS is a more milder form, which does not usually get worse and may have periods of no symptoms
- Secondary RLS - this is when RLS is caused as a symptom of another disorder, or as a side effect of taking certain medications; once the condition is resolved or th emedication stopped, the RLS seems to improve as well
Symptoms of restless legs syndrome
Symptoms of this disorder can range from mild to severe, depending on the severity of symptoms:
- Discomfort in the legs (or arms) caused by itching, tingling or "crawling" sensations
- Strong urge to move the legs (or arms) to get some relief from the discomforting sensations
- Restlessness, pacing around, tossing and turning in bed and rubbing the legs
- Inability to sleep from the discomfort in the legs (or arms)
- Symptoms normally just occur on sitting or lying down and usually improve with physical activity, unless very severe where nothing seems to help
Many people with restless legs syndrome also have another condition, called periodic limb movement disorder (PLMD), which is a disorder that causes the legs to twitch or jerk uncontrollably about every 10 to 60 seconds, normally during sleep. These movements of the legs (and sometimes the arms) cause repeated awakenings that disturb or reduce sleep.
Causes of restless legs syndrome
The underlying cause of primary restless legs syndrome is not known, although there is ongoing research to determine the cause. Some of the current research areas are:
- Abnormalities in the regulation of neurotransmitters, such as dopamine
- Abnormalities in the central nervous system that controls muscles
Secondary restless legs syndrome is thought to be caused (or worsened) by the following conditions:
- Certain disease conditions - many diseases such as kidney disease (especially if dialysis is required), diabetes, nerve disease, rheumatoid arthritis, varicose veins, myelitis, fibromyalgia, are all linked to secondary RLS
- Certain medications - can cause this condition while taking the medication, symptoms usually resolve after medication is stopped; medications such as - anticonvulsants, antidepressants, beta-blockers, H2 blockers, lithium and neuroleptics may cause secondary RLS
- Certain substances - such as alcohol, smoking cigarettes and caffeine cause cause secondary RSL; avoidance of these substances usually resolves symptoms
- Extreme fatigue - can exacerbate RLS symptoms
- Iron deficiency - studies show that iron deficiency is a cause of secondary RLS which iron supplementation resolves
- Magnesium deficiency - studies show this mineral is involves in causing secondary RLS
- Peripheral neuropathy - damage to the nerves of the legs and arms is thought to be to main cause of secondary RLS
- Pregnancy - many women who are pregnant (up to 40%) often have RLS during the last trimester of pregnancy; the condition normally resolves a few weeks after delivery
- Stress - is known to worsen existing RLS symptoms
- Vitamin B12 deficiency - can cause secondary RLS
Treatment of restless legs syndrome
Diagnosis and testing
Restless legs syndrome is normally diagnosed through:
- History of symptoms - your doctor will ask a series of questions about the symptoms
- Physical examination - to detect the severity of the condition and symptoms
Blood tests can be performed to detect deficiencies of certain nutrients if it suspected that they are the underlying cause of secondary RLS.
Conventional treatment
Treatment consists of various strategies:
- Avoiding the substance or food that causes the symptoms, such as alcohol, caffeine, smoking
- Baths, spas and other water treatments may assist with symptoms
- Increase intake of fruits, vegetables, dairy, nuts and protein to ensure proper nutritional intakes of various vitamins and minerals and to avoid deficiency
- Increase exercise and other physical activities
- Massage of the legs in particular and also the arms, may alleviate symptoms
- Reduce stress by practicing relaxation therapies
- Rest properly - try to get a good night's sleep
In addition to the above strategies, medications are also used for relief of symptoms, which can be used alone or in various combinations, prescribed by a doctor or specialist:
- Alpha2 agonists - these medications stimulate the part of the brain that activate nurons to slow down muscles movements and sensations
- Anticonvulsants - these medications are used for strong muscles spasms, pain and peripheral neuropthy that do not respond to the dopamine agonists
- Dopamine agonists - these medications increase the levels of dopamine in the brain, but cause fewer side effects than Levodopa; are long-acting and treat moderate to severe cases of RLS as well as mild cases that do not respond to Levodopa
- Levodopa - this medication helps with milder forms of RLS, is short-acting and is also used to treat Parkinson's disease; it works to increase levels of the neurotransmitter dopamine in the brain
- Sedatives - benzodiazepine medications assist with sleeping for people who cannot sleep due to the severity of symptoms
- Strong pain-relievers - these are used to treat the pain and discomfort some people experience and are used when pain is severe and if dopamine agonists do not wok
- Supplementation - if secondary RLS is caused by a deficiency in various nutrients, then supplementation is recommended (iron supplementation is most commonly recommended for iron deficiency)
Alternative / complementary treatment
Always ensure that you notify your medical practitioner of any supplements that you want to take - it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take BEFORE you try it.
- Dietary changes- these may reduce symptoms and improve sleep and quality life
- Avoid alcohol - drinking alcohol seems to make symptoms worse and is a cause of secondary RLS; limit alcohol intake
- Avoid caffeine - as it can make symptoms worse
- Eat folate-rich foods - studies show a deficiency of this vitamin may be implicated in development of RLS; ensure folate levels are adequate by eating lots of leafy green vegetables
- Eat more magnesium rich foods - studies show that magnesium deficiency may play a role in development of RLS, so eating foods rich in this mineral may prevent the condition from occuring
- Ensure iron levels are adequate - iron deficiency is a known cause of secondary RLS, so ensuring iron levels are adequate by eating iron-rich foods is vital
- Herbs - these may reduce symptoms and improve sleep and quality life
- Ginkgo biloba - studies show this herb has beneficial effects on peripheral circulation which may improve symptoms
- Lifestyle changes- these may reduce symptoms and improve sleep and quality life
- Exercise more - at least 30 minutes of low impact exercise is recommended each day; walking, swimming and dancing are excellent ways to reduce symptoms
- Have a bath or foot spa - these seem to reduce symptoms in many people
- Relax - stress and anxiety both aggravate symptoms, so relaxation therapies should be used to reduce symptoms
- Rest - over-exertion can exacerbate the symptoms, so resting is recommended
- Stretch - exercises which stretch the legs (and arms) help to reduce symptoms in many people
- Use hot and cold packs - these seem to work on reducing symptoms in many people
- Minerals - some studies show that a deficiency of certain minerals could be the underlying reason for this conditions and supplementation may either resolve the condition or greatly reduce symptoms
- Calcium - this mineral is necessary for proper muscles contraction and ensuring the muscles work properly, so may assist with reduction of symptoms
- Iron - studies have shown that iron deficiency can be a cause of this condition
- Magnesium - this mineral is essential to enable the muscles to relax and calm down and studies show it may assist in reducing symptoms associated with this condition, especially as a deficiency in magensium can cause secondary RLS
- Potassium - this mineral is necessary for proper muscles contraction and ensuring the muscles work properly, so may assist with reduction of symptoms
- Nutrients - certain nutrients may assist with reducing symptoms
- Essential fatty acids - this
- GABA - this amino acid relaxes the body and is required in the synthesis of dopamine; the body makes GABA to be used as an important neurotransmitter
- Tryptophan - studies show there is a link between levels of tryptophan and incidence of RLS, most likely because tryptophan and vitamin B3 (niacin) are closely related and vitamin B3 (niacin) is especially required to relieve RLS symptoms
- Vitamins - certain vitamins can be beneficial in reducing symptoms
- Folic acid - studies show supplementation with folic acid alleviates symptoms
- Vitamin B1 - this vitamins assists the nervous tissue to perform correctly and reduces incidence of symptoms
- Vitamin B5 - this vitamins assists the nervous tissue to perform correctly and reduces incidence of symptoms
- Vitamin B12 - this vitamins assists the nervous tissue to perform correctly and reduces incidence of symptoms and a deficiency in this vitamin is known to cause secondary RLS
- Vitamin C - helps to strengthen the capillary walls and may help with thos people that have peripheral neuropathy
- Vitamin E - studies show that vitamin E may help to reduce symptoms
Important restless legs syndrome facts
- Onset of symptoms are reported mainly in children and young adults aged between 10 and 20 years
- Studies show this condition is more common than either epilepsy or diabetes in children and young adults between the ages of 10-20 years
- People who have a more severe form of the condition are usually middle-aged or older
- People who have RLS are often sleep-deprived from the symptoms keeping them awake at night
- Other conditions can mimic restless legs syndrome, so a medical diagnosis is required to diaignose the condition
- Restless legs syndrome become worse when sitting or lying down
Last reviewed: 14 January 2007 || Last updated: 21 September 2007
Related Articles
references
- Agarwal R. Nonhematological Benefits of Iron. Am J Nephrol. 2007 Sep 5;27(6):565-571
- Karatas M. Restless legs syndrome and periodic limb movements during sleep: diagnosis and treatment. Neurologist. 2007 Sep;13(5):294-301
- Lee KA, Zaffke ME, Baratte-Beebe K. Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med. 2001 May;10(4):335-41
- Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Mollica G, Granieri E. Pregnancy as a risk factor for restless legs syndrome. Sleep Med. 2004 May;5(3):305-8
- Osiecki H. The Physicans Handbook of Clininical Nutrition, 6th Edition. Bioconcepts Publishing QLD, 2001
- Patrick LR. Restless legs syndrome: pathophysiology and the role of iron and folate. Altern Med Rev. 2007 Jun;12(2):101-12
- Picchietti D, Allen RP, Walters AS, Davidson JE, Myers A, Ferini-Strambi L. Restless legs syndrome: prevalence and impact in children and adolescents--the Peds REST study. Pediatrics. 2007 Aug;120(2):253-66
- Williams DC. Periodic limb movements of sleep and the restless legs syndrome. Va Med Q. 1996 Fall;123(4):260-5
To learn more, go to the following web sites:
- Restless Leg Syndrome Australia
- National Institute of Neurological Disorders & Stroke (USA)
- Restless Leg Syndrome Foundation (USA)
NOTE: Mega doses of any type of vitamin, mineral, amino acid or herbal supplement cannot cure illnesses and in fact can be very dangerous and produce toxic side effects and interfere with medicine you are taking. Always ensure you consult your doctor before taking any type of complementary supplements.
Disclaimer: This guide is not intended to be used for diagnostic or prescriptive purposes. For any treatment or diagnosis of illness, please see your doctor.
