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Restless Legs Syndrome

(RLS)

Definition

Restless legs syndrome (RLS) is a neurologic disorder. It is characterized by:
  • Unpleasant sensations in the legs
  • An irresistible urge to move the legs

Causes

The cause of primary RLS is unknown. RLS may have some genetic component. In some cases, it may be caused by other conditions or certain medications. This is called secondary RLS.
Many people with RLS also have periodic limb movement disorder (PLMD). This is a related motor disorder characterized by:
  • Involuntary, repetitive, jerking movements
  • Interrupted sleep because of periodic leg movements

Risk Factors

Factors that may increase your chance of getting RLS include:
  • Family history
  • Pregnancy
  • Certain medications, such as antidepressants, antipsychotics, caffeine, theophylline, dopamine antagonists, and sedating antihistamines
Certain chronic diseases may lead to secondary RLS. These include:

Symptoms

Symptoms may include:
  • Feelings of tingling, creeping, pulling, prickling, pins and needles, or pain in the legs during periods of rest or inactivity—may also occur in the arms
  • Symptoms typically get worse at night
  • A strong urge to relieve uncomfortable sensations with movement
  • Restlessness, including floor pacing, tossing and turning in bed, and rubbing the legs
  • Difficulty falling asleep and staying asleep
Symptoms may begin at any age. But, they are most common in people older than 60 years old. Symptoms usually increase in the evening and during times of rest, relaxation, or inactivity. For this reason, people with RLS generally have insomnia, which may be severe.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical and neurologic exam will be done. The diagnosis is based mainly on your symptoms. There is no specific test for RLS.
Tests to check for conditions that may trigger RLS include:
Nerves of the Leg
Leg Nerves
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Treatment

There is no cure for RLS. Treatments are aimed at relieving or reducing symptoms.

Treatment for Mild Cases of RLS

Self-care
  • Massage your legs.
  • Use a heating pad or ice pack.
  • Take a hot bath.
  • Avoid using tobacco, alcohol, or caffeine.
  • Follow a sleep routine.
  • Begin a safe exercise program with the advice of your doctor.
  • Avoid the use of medications that may worsen RLS.

Treatment for Conditions That May Trigger RLS

Effective treatment of conditions that may trigger RLS can ease or resolve your symptoms:

Treatment for More Severe Cases of RLS

Medication
Dopamine agonists are the only drugs that are FDA approved to treat restless leg syndrome. They are often considered the most effective type of medication for this condition.
Other medications may be used to help control symptoms of restless leg syndrome. Some medication options include clonidine, anticonvulsants, and opioids. Your doctor will select the medication based on your symptoms and medical history.

Prevention

There are no current guidelines to prevent RLS because the cause is unknown.

RESOURCES

National Sleep Foundation http://www.sleepfoundation.org

Willis-Ekbom Disease Foundation http://www.rls.org

CANADIAN RESOURCES

Canadian Sleep Society http://www.css-scs.ca

Health Canada http://www.hc-sc.gc.ca

References

Cui Y, Wang Y, Liu Z. Acupuncture for restless legs syndrome. Cochrane Database Syst Rev. 2008;CD006457.

Explore restless legs syndrome. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/rls/. Updated November 1, 2010. Accessed June 27, 2013.

Restless legs syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 7, 2013. Accessed June 27, 2013.

Restless legs syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/restless%5Flegs/detail%5Frestless%5Flegs.htm. Updated June 13, 2013. Accessed June 27, 2013.

Salas RE, Gamaldo CE, Allen RP. Update in restless legs syndrome. Curr Opin Neurol. 2010;23(4):401-6.

What is Willis-Ekbom disease (WED)/RLS? Willis-Ekbom Disease Foundation website. Available at: http://www.rls.org/about-wed-rls. Accessed June 27, 2013.

11/26/2012 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Aurora R, Kristo D, Bista S, et al. The Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder in Adults—An Update for 2012: Practice Parameters with an Evidence-Based Systematic Review and Meta-Analyses. Sleep. 2012;35(8):1039-1062.

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