What is Restless Leg Syndrome
Restless leg syndrome (RLS) is a neurological condition, characterized by several unpleasant sensations (creeping, crawling, etc.) in the legs, associated with an urge to move legs, particularly experienced at night. Although there can be an involvement of a single site, most people will experience symmetrical symptoms where both sides of the body get affected on similar distribution patterns.
These unusual sensations are quite similar to cramps and occur with soreness and can mostly be felt in calves, while feet, thighs, arms and hands can also get affected rarely. Some people may even experience sensations similar to shooting darts of electricity or squirming insects inside legs, and the severity of these can range from some discomfort to extremely painful.
Lying down and relaxing will often aggravate the restless movements which will keep people awake or give rise to multiple sleep disturbances with various negative consequences such as poor performance in work, exhaustion, daytime fatigue, depression, etc.
With a slight female predominance, RLS can occur at any age although elderly people are more at risk due to various underlying health conditions.
What Causes Restless Leg Syndrome
Even though the exact etiology of Restless leg syndrome is not known, several factors are thought to be playing important roles in bringing out these signs and symptoms.
Idiopathic RLS (primary RLS): This is the commonest cause of restless leg syndrome, which is clinically diagnosed by excluding other causes.
Genetics: With a research-based familial predisposition, most genes linked with RLS are known to affect people, below the age of 40.
Dopamine: This is a neurotransmitter which acts as a messenger between the brain and peripheral nervous system, on muscle coordination and regulation of movements. Decreased levels of Dopamine (due to lack of production or increased destruction on nerve damages) can result in muscle spasms and involuntary movements. However, latest research studies have found out that Dopamine levels, naturally drop down, towards the end of the day, which is thought to be the reason for RLS symptoms to precipitate particularly at night.
Medical Conditions: Also known as secondary RLS, this type generally takes place as a result of an underlying health condition.
Iron Deficiency Anemia: Low levels of iron in the body can ultimately reduce the production of Dopamine, which will lead to previously mentioned precipitation of symptoms related to RLS.
Chronic Diseases: Chronic kidney disease, Rheumatoid arthritis, Parkinson’s disease, diabetes, fibromyalgia are known to be having a predisposition tendency to cause RLS if left untreated for a long period of time.
Pregnancy: Most pregnant women tend to develop RLS, , but symptoms will start appearing usually from 27th weeks and gradually reduce and disappear about 4 weeks after the delivery.
In addition to above-mentioned causative agents, following factors are also known to be playing a major role in the etiology of RLS.
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Chronic smoking
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Caffeine
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Alcohol
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Obesity
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Stress
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Lack of physical exercise
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Drugs
-Antidepressants
-Antipsychotics
-Lithium – Treatment for bipolar disorder
-Calcium channel blockers – Treatment of high blood pressure
-Antihistamines
-Metoclopramide –Treatment of nausea
Diagnosis of Restless Leg Syndrome
A complete history of the types of symptoms and duration along with a thorough physical examination is highly important in making the diagnosis of RLS. However, various blood investigations, nerve conduction studies, and Doppler studies will be carried out in order to confirm the diagnosis.
Treatment for Restless Leg Syndrome
- Treating underlying medical conditions
- Practicing regular sleeping patterns
- Iron, folic acid, Magnesium and vitamin supplements on medical advice
- Regular exercises
- Symptom relief- Hot bath, legs massages, heating pad or ice packs
- Drugs such as Central nervous system depressants, opioids, and anticonvulsants (levodopa preparations and dopamine agonists)
Even though there is no exact cure for RLS, early diagnosis, and proper treatment plans will help to improve the quality of life by minimizing the possible disabilities and complications, in affected individuals.
