Also known as the Wilks-Ekbom disease, restless legs syndrome (RLS) is a condition that causes an irresistible urge to move one’s legs or arms. The urge often arise whilst resting, which can make it hard for the affected person to sleep, work or study. One might also experience twitching of limbs during sleep. This condition can be caused by other underlying ailments but is often experienced as a primary condition. In the latter case, there is no absolute cure but medication can relieve you of your symptoms.
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What causes the restless legs syndrome?
Restless legs syndrome is a lifelong condition but might disappear for periods to later reemerge. Some symptoms related to the condition are as follows:
- Strong sensation urging you to move your limbs, often accompanied with discomfort
- Comes and goes with different levels of activity
- Worsened by night or in the evening
The feeling seems to come from deep down in the limbs, and the urge to move can be manifested through walking, jerking the limbs, tossing, turning, stretching and rubbing the legs or arms. The restlessness can move between the limbs and can affect more than one at the same time.
The experience of restless legs syndrome can be different for different individuals and may vary from mild to intense. Some people feel it occasionally whilst others have it daily. The sensation is felt in the muscles of the legs or arms and can range from a creeping sensation to pain. Moving the limbs will lightly mitigate the uneasiness. If the symptoms are severe, it might affect the person’s everyday life.
What causes restless legs?
There are different theories regarding what the ultimate cause of RLS actually is. One of the most acclaimed theories is one that claims that the body’s process of dealing with dopamine and iron is to blame. If the brain is not using iron the right way or is having a discrepancy of iron, it cannot produce the signal substance dopamine in the same way. The dopamine is partly in control of movements since it is active in the part of the brain that controls the nervous system. Levels of dopamine are often decreased during the day, which is the reason why symptoms often are increased during the evening and night.
Primary and secondary restless legs
Restless legs syndrome is often manifested in two types. The first one, primary RLS, often starts early in age, at least before the age of 45. Almost half of the people affected experience RLS before the age of 20.1 It is often inherent, as it runs in families, and will get worse with time.
Secondary RLS, the second type, starts after the age of 45. This form of RLS will stay consistent over time, but may start suddenly and might be experienced daily. This form is mainly associated with other conditions.
Complications
People with severe RLS can experiences that some parts of their everyday lives are affected by the condition. This is mainly due to the lack of sleep that can arise following the movements when trying to sleep. This can manifest through sleepiness during the day, low energy, irritability, depression and anxiety disorders.
Who can be affected?
There are a number of factors that can make restless legs more probable. These include, but are not limited to:
- Iron deficiency
- Parkinson’s disease
- Kidney failure
- Diabetes
- Rheumatoid arthritis
- Pregnancy
- ADHD
Some medicines can also trigger the onset of RLS, such as antihistamines, antidepressants, antipsychotics and calcium channel blockers.
Women are more likely to be affected than males. It is thought that the condition is inherited since 60% of the cases have genetic connections.
Diagnosis
The diagnosis of RLS is mainly done after the patient’s symptoms, after making sure that no other condition is the root cause. There are no tests for RLS specifically, so instead tests are taken to rule out other possible conditions2.
Treatment
Today, the restless legs syndrome does not have any definite cure. If the RLS has an underlying cause, this will be treated first and might mitigate your symptoms. In other cases the treatment is focused on easing the severity of symptoms to increase the quality of life. Dopamine agonists and gabapentin enacarbil can be used to help the body’s already existing substances to meet demands, and in severe cases, opioids can be prescribed. Finding the right medication for you can take some trial and error before you find the right substance and dosage. For example, taking dopamine stimulants has been connected to a tendency to an increase in activities such as excessive gambling, shopping or sexual activity.
Lifestyle changes are one of the treatments for milder forms of RLS. Physical activity such as taking walks can give temporary relief, but it is recommended to exercise regularly. Leg massages or warm baths have also been reported as being helpful. Some people might find taking iron supplements to be helpful, especially if iron deficiency is the root cause, but this does not account for all patients. Avoiding alcohol and nicotine can also be one triggering factor that can be eliminated.
Developing good sleeping habits is one way or helping yourself to get a better night’s sleep. Vibration boards have been developed specifically with RSL patients in mind. These devices help you relax the muscles and helps sleep onset.
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