Restless Legs
“I started dreading every day because I knew that by evening I would have this burning sensation in my legs that just wouldn’t quit. I couldn’t sleep” Patient with Restless Legs
Do I have RLS?
Are you kept up at night due to experiencing unusual feelings in your legs? Do you have an uncontrollable need to keep your legs moving even when you are at rest? Do you feel better when you get up and move around? If so, you may have Restless Legs Syndrome (RLS), which is a nervous system disorder.
Not all people with RLS have the same symptoms. It has been described variously as:
A creepy-crawly feeling, tingling, itching, pricking, burning, pulling, tugging and aching in the legs.
As if bugs are crawling up my legs
It’s like soda bubbling through the veins of my legs
An itch deep in the bone that I am unable to scratch
Quite a painful, uncomfortable and disturbing experience
RLS is seen more in older adults and women, but is present in all age groups including children. Mild symptoms may start in early adulthood and become more severe with age.
What causes RLS?
According to experts, RLS could be due to low levels of iron in the brain or a dopamine imbalance. Genetics may also play a key role as almost 60% of those with RLS have a family history of the condition.
Vitamin deficiencies such as vitamin D and folate have been implicated.
Medications such as antidepressants, antipsychotic medications, anti-nausea medications can precipitate RLS symptoms. People with back pain, varicose veins, diabetes, kidney disease and peripheral neuropathy and neurodegenerative disorders like Parkinson’s disease are more likely to have RLS. It is also commonly seen during pregnancy (approximately 40% of pregnant women experience it).
What treatments are available for RLS?
Regardless of the cause of RLS, rest assured that help is at hand to treat and manage the condition.
If you have only mild symptoms, lifestyle modification may be enough. However, if your symptoms are bothersome and disruptive, you will most likely require a medication.
What lifestyle modifications will help reduce my RLS symptoms?
Manage stress
RLS symptoms get worse when you are under stress or anxious. Practice yoga and meditation. Develop relaxing habits to help you feel more calm.
Cut down on or
stop drinking Alcohol
Alcohol is known to worsen RLS symptoms, so be cautious about drinking in the evening.
Stop Smoking
Nicotine is a stimulant that impairs blood flow to muscles and can make restless legs worse, so it’s best to avoid smoking.
Caffeine
For some people with RLS, caffeine is a trigger. However, in others, caffeine may improve symptoms. To understand your response, try cutting out coffee, tea, and soft drinks and monitor your symptoms.
Exercise and Stretch
Daily exercise including both aerobic and muscle stretching can significantly improve RLS symptoms. Try to exercise for at least 30 minutes on most days of the week. Be patient since symptoms will first become worse, before you start to notice an improvement. If vigorous exercise makes your symptoms worse, avoid it and stick with lower intensity exercise.
Simple stretching exercises can be very helpful in reducing your symptoms.
Medications:
If your symptoms are bothersome, you will most likely require a medication. RLS can be treated with dopamine agonist and antiepileptic medications (gabapentin). Treating iron deficiency will be required if deficiency is found. Even people with normal iron levels, may benefit with treatment if their ferritin level (transport protein for iron) < 75 micrograms/ dl.