Restless Legs Syndrome, also known as Willis-Ekbom disease, is a neurological disorder that creates a powerful, often irresistible urge to move the legs. This condition is characterized by uncomfortable or strange sensations deep within the limbs. These feelings represent a medical condition that can significantly disrupt rest and sleep. RLS is a sensorimotor disorder, meaning it involves both sensations and an overwhelming need to move.
Defining Symptoms and Diagnosis
A diagnosis of Restless Legs Syndrome is clinical, meaning it relies on a patient’s description of their symptoms. Healthcare providers use a specific set of four criteria to identify the condition. The first is a strong urge to move the legs, which is almost always accompanied by uncomfortable sensations. People describe these feelings as a crawling, creeping, pulling, or itching sensation within their feet, calves, or thighs.
A second diagnostic point is that symptoms are triggered or worsen during periods of rest or inactivity. The sensations and the urge to move manifest when a person is sitting for extended periods, such as on a long flight, or when lying down to relax. This aspect of the condition directly interferes with the body’s ability to rest.
The third criterion is that movement provides partial and temporary relief from the unpleasant sensations. Walking or stretching the affected limbs can lessen the discomfort, but the relief lasts only as long as the activity continues. Once the movement stops and the person attempts to rest again, the symptoms return.
Finally, the symptoms of RLS follow a circadian rhythm, worsening in the evening and at night. This nighttime escalation is a primary reason it is also classified as a sleep disorder. A physician confirms the diagnosis based on these four points after conducting a medical history and physical exam to rule out other conditions.
Potential Causes and Risk Factors
The origins of Restless Legs Syndrome are categorized as primary and secondary. Primary RLS, called idiopathic, has no known underlying cause and has a genetic component, meaning it can run in families. This form may be linked to how the brain utilizes dopamine, a neurotransmitter involved in controlling muscle movement. Dopamine levels decrease in the evening, which may explain why RLS symptoms are more severe at night.
Secondary RLS develops from an underlying medical condition or the use of certain medications. A significant and treatable factor is iron deficiency. Even if blood tests show normal overall iron levels, the brain may have insufficient iron for dopamine production. A physician can check for this by testing ferritin levels, which reflects the body’s iron stores.
Certain chronic health conditions are also associated with the development of RLS, such as end-stage kidney disease, diabetes, and peripheral neuropathy. Pregnancy is another common trigger, with about one in five women experiencing symptoms, particularly in the final trimester; these symptoms resolve after giving birth.
Specific lifestyle factors and medications can trigger or aggravate RLS symptoms. The use of caffeine, alcohol, and nicotine can worsen the condition. Additionally, some medications are known triggers, including certain antidepressants, antipsychotics, and some over-the-counter antihistamines.
At-Home and Medical Relief Options
For milder cases of RLS, a variety of at-home strategies can provide relief. Establishing a consistent sleep schedule and practicing good sleep hygiene helps create a stable routine. Reducing or eliminating caffeine, alcohol, and nicotine, especially before sleep, can also prevent the aggravation of symptoms.
Other helpful measures include gentle, regular exercise like walking or cycling, but intense workouts close to bedtime should be avoided. Many people find relief by soaking their legs in a warm bath or applying hot or cold packs to the muscles. Gentle stretching or leg massages at the beginning and end of the day may also help relax the muscles.
When lifestyle modifications are not sufficient, medical interventions become necessary. A doctor will first test for and treat any underlying conditions, with a primary focus on iron deficiency. If blood tests reveal low iron stores, a healthcare provider may recommend oral iron supplements, which can sometimes resolve symptoms.
If symptoms persist, a doctor may discuss prescription medications. Several classes of drugs can be effective, including dopamine agonists like ropinirole or pramipexole, which increase dopamine in the brain. Another class of medication, which includes gabapentin, is also used to relieve the painful sensations of RLS.