Restless legs syndrome

Restless legs syndrome (RLS) is a condition that is characterized by an irresistible urge to move one’s body to stop uncomfortable or odd sensations. RLS is a condition in which your legs feel extremely uncomfortable while you’re sitting or lying down. It makes you feel like getting up and moving around. When you do so, the unpleasant feeling of restless legs syndrome temporarily goes away.

No one knows the exact cause of RLS at present. Research and brain autopsies have implicated both dopaminergic system and iron insufficiency in the substantia nigra. Iron is an essential cofactor for the formation of L-dopa, the precursor of dopamine.

Most research on the disease mechanism of restless legs syndrome has focused on the dopamine and iron system.

Stretching the muscles in the legs can bring instant relief. When you stand up and bend over, make your hands reach for the ground (touch your toes if you can). Hold the position for 10–20 seconds. Repeat this 3 times. There is a theory that Restless Legs are caused by the muscles shrinking to a point where they ‘get too short’, creating tension which leads to the Restless leg symptoms.

According to some guidelines all people with RLS should have their ferritin levels tested; ferritin levels should be at least 50 µg for those with RLS. Oral iron supplements, taken under a doctor’s care, can increase ferritin levels. For some people, increasing ferritin will eliminate or reduce RLS symptoms.

An algorithm for treating primary RLS was created by leading researchers at the Mayo Clinic and is endorsed by the Restless Legs Syndrome Foundation. A number of simple self-care steps and lifestyle changes may help you:

Lifestyle changes

• Take pain relievers. For very mild symptoms, taking an over-the-counter pain reliever such as ibuprofen (Advil, Motrin, others) when symptoms begin may relieve the twitching and the sensations.

• Try baths and massages. Soaking in a warm bath and massaging your legs can relax your muscles.

• Apply warm or cool packs. You may find that the use of heat or cold, or alternating use of the two, lessens the sensations in your limbs.

• Try relaxation techniques, such as meditation or yoga. Stress can aggravate RLS. Learn to relax, especially before going to bed at night.

• Establish good sleep hygiene. Fatigue tends to worsen symptoms of RLS, so it’s important that you practice good sleep hygiene. Ideally, sleep hygiene involves having a cool, quiet and comfortable sleeping environment, going to bed at the same time, rising at the same time, and getting enough sleep to feel well rested. Some people with RLS find that going to bed later and rising later in the day helps in getting enough sleep.

• Exercise. Getting moderate, regular exercise may relieve symptoms of RLS, but overdoing it at the gym or working out too late in the day may intensify symptoms.

• Avoid caffeine. Sometimes cutting back on caffeine may help restless legs. It’s worth trying to avoid caffeine-containing products, including chocolate and caffeinated beverages such as coffee, tea and soft drinks, for a few weeks to see if this helps.

• Cut back on alcohol and tobacco. These substances also may aggravate or trigger symptoms of RLS. Test to see whether avoiding them helps.

• Stay mentally alert in the evening. Boredom and drowsiness before bedtime may worsen RLS.

Medication therapy

• Dopamine agonists such as ropinirole, pramipexole, carbidopa/levodopa or pergolide. Ropinirole (Requip) was first approved In 2005 by the US Food and Drug Administration (FDA) to treat moderate to severe Restless Legs Syndrome.
• Opioids such as propoxyphene, oxycodone, or methadone, and mainly tramadol
• Benzodiazepines, such as diazepam, which often in addition to symptom relief assist in staying asleep and reducing awakenings from the movements
• Anticonvulsants, such as carbamazepine, help people who experience the RLS sensations as painful.

More information:

Restless Leg Syndrome Foundation
NINDS Restless Legs Syndrome Information Page
Mayo Clinic Restless Legs

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Source: wikipedia.com / Mayo Clinic

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