May 2, 2004
Dr. R. O'Brien
Medical News Today
Restless leg syndrome (RLS) is a condition in which the person develops an urge to move in order to relieve discomforting symptoms or sensation, usually arising in the legs.
Although physicians use the term "restless", most people with the condition describe it more as a tenseness, tightness or creepy - crawly or burning feeling.
Usually the sensation is most severe in the evenings and brought on by rest or relaxation, and relieved by movement including stretching, massaging, bicycling the legs or walking about.
The symptoms usually come on gradually after age 20 and may fluctuate over time, becoming more noticeable or aggravating in the 50's and 60's. They usually interfere with falling asleep or may waken the sufferer at night. They may be accompanied by periodic leg movements in sleep, usually consisting of extension of the big toe and flexion of the ankle, knee and hip.
What causes RLS?
On most occasions RLS occurs spontaneously and is of unknown cause. It can, however, be associated with other conditions including kidney insufficiency, peripheral neuropathy, sciatica, Parkinson's disease, iron deficiency, low thyroid state, rheumatoid arthritis, vitamin deficiency of B12 or folate, spinal cord disease, multiple sclerosis or even pregnancy. Some drugs also tend to bring on or exacerbate the symptoms such as caffeine, alcohol, some anti depressants and some anti psychotic and anti nausea medications.
Can other problems look like RLS?
Several other conditions can resemble RLS including akathisia which is a generalized restlessness that occurs both during the day and at night, leg cramps, and the syndrome of "painful legs and moving toes" which also tends to occur throughout the day.
What can I do about it?
Several non-medical treatments have been advocated for RLS including vein surgery, transcutaneous nerve stimulation, acupuncture, and herbal remedies. There is no clear evidence to show that any of these treatments are effective.
There are several medications which have been reported as effective in suppressing RLS symptoms, but again there are few formal studies to compare effectiveness. These drugs generally fall into 4 categories, including dopamine agonists (example, ropinirole, pergolide), opiates (example: Oxycodone), benzodiazepines (example: clonazepam), and anticonvulsants (example: Gabapentin or Carbamazepine).
The first step is to consult your physician to ensure the diagnosis
is correct and to review your medications and make sure that other causes
of RLS have been excluded. Reduce caffeine and alcohol intake. Since symptoms
fluctuate, if medication is used, it should be kept to the minimum dose
that suppresses symptoms to a tolerable limit.
This data is provided for informational purposes only. It does not substitute for individualized advice from a qualified physician. Although attempts have been made to ensure the material is accurate and up to date it is provided in an 'as is' state. Neither the author nor Neurology BC assumes any liability for errors or omissions or any problems that might arise due to them. Always consult your physician or qualified health professional before acting on information that concerns your health.
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