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Restless Leg Syndrome
Before you fall asleep do you develop an unpleasant wriggly sort of sensation in your legs? Does massaging your legs sometimes help, but otherwise you have to get up and walk around? Does it go on for ages and disturb your sleep? You just might be experiencing restless leg syndrome.

What is Restless Legs Syndrome?

Restless legs syndrome (RLS) is a common neurological disorder characterized by unpleasant sensations of the legs and an urge to move them for relief.  Individuals affected with the disorder describe the sensations as pulling, drawing, crawling, wormy, boring, tingling, pins and needles, prickly, and sometimes painful sensations that are usually accompanied by an overwhelming urge to move the legs.  Movement provides temporary relief from the discomfort.

What are common signs and symptoms of restless legs?

As described above, people with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down, accompanied by an irresistible urge to move about. These sensations usually occur deep inside the leg, between the knee and ankle; more rarely, they occur in the feet, thighs, arms, and hands. Although the sensations can occur on just one side of the body, they most often affect both sides.

Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations. They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.

Most people find the symptoms to be less noticeable during the day and more pronounced in the evening or at night, especially during the onset of sleep. For many people, the symptoms disappear by early morning, allowing for more refreshing sleep at that time. Other triggering situations are periods of inactivity such as long car trips, sitting in a movie theater, long-distance flights, immobilization in a cast, or relaxation exercises.

The symptoms of RLS vary in severity and duration from person to person. Mild RLS occurs episodically, with only mild disruption of sleep onset, and causes little distress. In moderately severe cases, symptoms occur only once or twice a week but result in significant delay of sleep onset, with some disruption of daytime function. In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function.

Symptoms may begin at any stage of life, although the disorder is more common with increasing age. Sometimes people will experience spontaneous improvement over a period of weeks or months. Although rare, spontaneous improvement over a period of years also can occur. If these improvements occur, it is usually during the early stages of the disorder. In general, however, symptoms become more severe over time.

People who have both RLS and an associated condition tend to develop more severe symptoms rapidly. In contrast, those whose RLS is not related to any other medical condition and whose onset is at an early age show a very slow progression of the disorder and many years may pass before symptoms occur regularly.


Is there any treatment?

Massage and application of cold compresses may provide temporary relief. Medications such as temazepam, levodopa/carbidopa, bromocriptine, pergolide mesylate, oxycodone, propoxyphene, and codeine are effective in relieving the symptoms.  Current research suggests that correction of iron deficiency may improve symptoms for some patients.

What is the prognosis?

RLS is a life-long condition for which there is no cure. Symptoms may gradually worsen with age.   Because symptoms are intensified by inactivity and lying down, RLS patients often have difficulty falling asleep and staying asleep.  Left untreated, RLS causes exhaustion and fatigue, which can affect occupational performance, social activities, and family life.
 
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