Restless Legs Syndrome (RLS)

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According to the Restless Legs Syndrome Foundation, up to 8% of the US population may suffer from RLS. Other researchers estimate that RLS affects as many as 12 million Americans. Prevalence is difficult to pinpoint because the syndrome is often unrecognized or misdiagnosed. Often, patients are not diagnosed until 10-20 years after symptom onset.

RLS is characterized by unpleasant sensations (known as dysesthesias) in the legs.  Individuals affected with the disorder describe the sensations as burning, creeping, tugging, or like insects crawling inside the legs. These sensations usually occur during periods of inactivity and are accompanied by an overwhelming urge to move the legs. Movement provides temporary relief from the discomfort.

Restless Legs Syndrome (RLS): Symptoms

People with Restless Legs Syndrome describe the sensations they experience in many ways. In 1995, the International Restless Legs Syndrome Study Group (IRLSSG) categorized RLS symptoms into four major areas that must be present for diagnosis:

  1. There is a compelling urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs (paresthesias/dysesthesias).
  2. The symptoms are partially or completely relieved by movement, as long as the movement continues.
  3. The symptoms begin or worsen during periods of rest or inactivity, such as lying or sitting.
  4. The symptoms are worse or only occur in the evening and at night.

Other symptoms of RLS include:

  • Sleep disturbances and daytime sleepiness.
  • Involuntary, repetitive, periodic, jerking limb movements that occur either in sleep or while awake and at rest. These movements are called periodic leg movements of sleep (PLMS) or periodic limb movement disorder. About 80% of people with RLS also have this condition.

Restless Legs Syndrome (RLS): Diagnosis

There is no laboratory test to confirm a diagnosis of RLS. However, a thorough examination followed by laboratory tests, can reveal temporary disorders, such as iron deficiency, that may be associated with RLS.

If a patient’s description of symptoms and history suggests RLS, blood tests may be performed to rule out conditions like anemia, decreased iron stores, diabetes, and renal dysfunction. Electromyography (EMG) and nerve conduction studies may also be recommended to measure electrical activity in muscles and nerves. Likewise, Doppler sonography may be used to evaluate muscle activity in the legs. Negative results from these tests may indicate RLS.

Restless Legs Syndrome (RLS): Treatment

Once correctly diagnosed, RLS can usually be treated effectively by relieving symptoms; in some secondary cases, it can even be cured.

Many patients find that walking, stretching, taking a hot or cold bath, massaging the affected limb, or applying hot or cold packs can be very effective, although temporary, solutions to managing symptoms. Acupressure and relaxation techniques (such as biofeedback, meditation, or yoga) may also help to reduce or relieve symptoms.

Additionally, patients with mild RLS who are sensitive to caffeine, alcohol, or nicotine are advised to avoid these substances. Likewise, offending medications should be discontinued. Finally, your physician may suggest additional lifestyle changes and activities to help reduce or eliminate symptoms.

There are also a number of pharmacological options for patients who do not respond to diet and lifestyle changes.

  • In May of 2005, the FDA approved the first drug for treatment of restless legs syndrome. The medication, Ropinirole (the generic form of Requip), is for patients who experience 15 or more episodes monthly..
  • There are several other drugs (approved for other conditions) that have undergone clinical studies in RLS and have been found to be helpful as well.
  • Mirapex (Pramipexole) was approved in 2006 by the FDA to treat RLS.  This medication is also available now in its generic from.

Your physician can you advise you on the best way to treat your RLS symptoms.

Restless Legs Syndrome (RLS): Resources

Restless Legs Syndrome Foundation
1610 14th St NW, Suite 300
Rochester, MN 55901
Tel: 507-287-6465
Fax: 507-287-6312
E-mail: rlsfoundation@rls.org

National Sleep Foundation
1522 K Street NW
Suite 500
Washington, DC 20005
nsf@sleepfoundation.org
Tel: 202-347-3471 (no public calls please)
Fax: 202-347-3472

WE MOVE (Worldwide Education & Awareness for Movement Disorders)
204 West 84th Street
New York, NY 10024
wemove@wemove.org
Tel: 212-875-8312
Fax: 212-875-8389

National Organization for Rare Disorders (NORD)
NORD Washington Office
1779 Massachusetts Avenue,
Suite 500
Washington, DC 20036
Tel:  202-588-5700
Voice Mail: 800-999-NORD (6673)
Fax: 202-588-5701
orphan@rarediseases.org

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