Restless legs syndrome (patient information)

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 * Assistant Editor-in-Chief: Alexandra M. Palmer

Overview
Restless legs syndrome is a disorder in which there is an urge or need to move the legs to stop unpleasant sensations.

What are the symptoms of Restless legs syndrome?
RLS leads to sensations in the lower legs that make you uncomfortable unless you move your legs. These sensations:
 * Usually occur at night when you lie down, or sometimes during the day when you sit for long periods of time
 * May be described as creeping, crawling, aching, pulling, searing, tingling, bubbling, or crawling
 * May last for 1 hour or longer
 * Sometimes also occur in the upper leg, feet, or arms

You will feel an irresistible urge to walk or move your legs, which almost always relieves the discomfort.

Most patients have rhythmic leg movements during sleep hours, called periodic limb movement disorder (PLMD).

All of these symptoms often disturb sleep. Symptoms can make it difficult to sit during air or car travel, or through classes or meetings.

Note: Symptoms may be worse during stress or emotional upset.

What causes Restless legs syndrome?
Restless legs syndrome (RLS) occurs most often in middle-aged and older adults. Stress makes it worse. The cause is not known in most patients.

RLS may occur more often in patients with:
 * Peripheral neuropathy
 * Chronic kidney disease
 * Parkinson's disease
 * Pregnancy
 * Iron deficiency
 * Use of certain medications

A form of RLS may be passed down in families. This may be a factor when symptoms start at a younger age. The abnormal gene has not yet been identified.

Restless legs syndrome can result in a decreased quality of sleep (insomnia). This lack of sleep can lead to daytime sleepiness, anxiety or depression, and confusion or slowed thought processes.

When to seek urgent medical care?
Call for an appointment with your health care provider if:
 * You have symptoms of restless legs syndrome
 * Your sleep is disrupted

Diagnosis
There is no specific examination for restless legs syndrome. The health care provider will not usually find any abnormalities, unless you also have peripheral nerve disease. Blood tests (CBC and serum ferritin) may be done to rule out iron deficiency anemia, which in rare cases can occur with restless legs syndrome.

Examination and testing may be used to rule out other disorders with similar symptoms.

Treatment options
There is no known cure for restless legs syndrome.

Treatment is aimed at reducing stress and helping the muscles relax. The following techniques may help:
 * Warm baths
 * Gentle stretching exercises
 * Massage

Low doses of pramipexole or ropinirole (Requip) can be very effective at controlling symptoms in some people.

If your sleep is severely disrupted, your health care provider may prescribe medications such as Sinemet (an anti-Parkinson's medication), gabapentin and pregabalin, or tranquilizers such as clonazepam. However, these medications may cause daytime sleepiness.

Patients with iron deficiency will receive iron supplements.

Low doses of narcotics may sometimes relieve symptoms of restless legs syndrome.

Where to find medical care for Restless legs syndrome?
Directions to Hospitals Treating Restless legs syndrome

Prevention of Restless legs syndrome
Techniques to promote muscle relaxation and stress reduction may reduce the incidence of restless legs syndrome in people prone to the condition.

What to expect (Outlook/Prognosis)?
Restless legs syndrome is not dangerous or life-threatening, and it is not a sign of a serious disorder. However, it can be uncomfortable and disrupt your sleep.

Possible complications
Insomnia may occur.