Restless Legs Syndrome

Restless legs syndrome (RLS) is a common disorder characterized by uncomfortable sensations in the legs which are often described as pulling, crawling, tingling, prickly, and sometimes painful. Symptoms are more pronounced in the evening or at night, and during periods of inactivity such as long car trips and long-distance flights. The sensations are associated with an urge to move the legs which may give temporary relief. Patients will keep moving their legs, pace the floor, and toss and turn in bed.

The cause of RLS is unknown and there is no cure. RLS affects women slightly more than men and, although it may begin at any age, most patients are middle-aged or older. RLS causes difficulty falling asleep and staying asleep, and most patients report periodic leg jerks during which cause repeated awakening and disrupted sleep. If untreated, patients experience severe daytime sleepiness or fatigue which can impair daytime function and concentration. RLS has been associated with iron deficiency anemia, kidney failure, diabetes and peripheral nerve disease. Pregnant women may experience RLS, especially in their last trimester, with symptoms usually disappearing within 4 weeks of delivery.

Often misdiagnosed, RLS has symptoms that are often attributed to anxiety, stress, arthritis, muscle cramps, growing pains or aging. The treatment of RLS is symptomatic. Taking a hot bath, massaging the legs, and application of a heating pad may provide temporary relief. Various types of medications have been effective in relieving symptoms, including dopaminergic agents (e.g. pramipexole, pergolide), benzodiazepines, opioids (like codeine), and anti-convulsants (e.g. carbamazepine, gabapentin). Dopaminergic agents, which are also used to treat Parkinson disease, are considered the initial treatment of choice.