Restless legs syndrome

Overview

Restless legs syndrome (RLS) is a condition that causes a very strong urge to move the legs. The urge to move usually is caused by an uncomfortable feeling in the legs. It typically happens in the evening or at night when sitting or lying down. Moving eases the discomfort for a short time.

Restless legs syndrome can begin at any age and tends to get worse with age. It can disrupt sleep, which interferes with daily activities. RLS also is known as Willis-Ekbom disease.

Simple self-care steps and lifestyle changes may help relieve symptoms. Medicines also help many people with RLS.

Symptoms

The chief symptom of restless legs syndrome is an urge to move the legs. It's common to experience:

• Uncomfortable sensations that begin while resting. A feeling in the legs typically begins after you've been lying down or sitting for an extended time. It might happen while sitting in a car, airplane or movie theater.
• Relief with movement. The sensation of RLS lessens with movement. Stretching, jiggling the legs, pacing or walking may improve symptoms.
• Worsening of symptoms in the evening. Symptoms occur mainly at night.
• Nighttime leg twitching. RLS may be associated with another, more common condition called periodic limb movement of sleep. This condition causes the legs to twitch and kick during sleep, possibly throughout the night.

People typically describe RLS symptoms as compelling, unpleasant feelings in the legs or feet. They usually happen on both sides of the body. Less commonly, the sensations affect the arms.

The sensations are felt within the leg rather than on the skin. They're described as:

• Crawling.
• Creeping.
• Pulling.
• Throbbing.
• Aching.
• Itching.
• Electric.

Sometimes the feelings of RLS are hard to explain. People with RLS usually don't describe the condition as a muscle cramp or numbness. They do, however, consistently describe the desire to move the legs.

It's common for symptoms to get better and worse. Sometimes symptoms disappear for periods of time, then come back.

When to see a doctor

Talk with your healthcare professional if you have symptoms of restless legs syndrome. RLS can interfere with your sleep, cause daytime drowsiness and affect your quality of life.

Causes

Often, there's no known cause for restless legs syndrome. Researchers suspect the condition may be caused by an imbalance of the brain chemical dopamine. Dopamine sends messages to control muscle movement.

Heredity

Sometimes RLS runs in families, especially if the condition starts before age 40. Researchers have identified sites on the chromosomes where genes for RLS may be present.

Pregnancy

Pregnancy or hormonal changes may worsen RLS symptoms. Some people get RLS for the first time during pregnancy, especially during the last trimester. However, symptoms usually disappear after delivery.

Risk factors

Restless legs syndrome can develop at any age, even during childhood. The condition is more common with increasing age. It's also more common in women than in men.

RLS usually isn't related to a serious underlying medical condition. However, it sometimes occurs with other conditions, such as:

• Peripheral neuropathy. This damage to the nerves in the hands and feet is sometimes due to chronic diseases such as diabetes and alcohol use disorder.
• Iron deficiency. Too little iron in the body, known as iron deficiency, can cause or worsen RLS. People who have a history of bleeding from the stomach or bowels may have iron deficiency. Deficiency also may affect people who have heavy menstrual periods or who often donate blood.
• Kidney failure. If you have kidney failure, you also may have iron deficiency, often with anemia. When kidneys don't function properly, iron stores in the blood can decrease. This and other changes in body chemistry may cause or worsen RLS.
• Spinal cord conditions. Damage or injury of the spinal cord has been linked to RLS. Having had anesthesia to the spinal cord, such as a spinal block, also increases the risk of developing RLS.
• Parkinson's disease. People who have Parkinson's disease and take medicines called dopaminergic agonists have an increased risk of developing RLS.

Complications

Restless legs syndrome symptoms can range from being mild to having a serious impact on people's lives. Many people with RLS find it hard to fall or stay asleep.

Serious symptoms of RLS can affect quality of life and result in depression. Not being able to sleep may lead to excessive daytime drowsiness, but RLS may interfere with napping.