Restless leg syndrome (RLS) causes spontaneous leg movements and unpleasant sensations in the legs called paresthesias. Symptoms come while you are resting and can often be made to go away by moving your legs. Five to 10% of the population may have mild cases of RLS. In some people, however, the symptoms may wake them from sound sleep and cause major discomfort. It is important to be sure that what you have is RLS rather than some other similar disorder, such as
- Leg cramps.
- Night starts–sudden contractions of the legs that begin shortly after you fall asleep.
- Nocturnal myoclonus–which is similar to night starts but happens during both waking and sleeping.
In many RLS cases, doctors are not able to identify the cause. But we know that RLS accompanies a number of other health problems. Pregnancy, low blood sugar, and low thyroid hormone levels have all been linked to RLS. Elderly patients with RLS often have low amounts of iron in their body. Oral iron supplements can help relieve their symptoms.
Varicose veins can also cause RLS by pressing on nerves. Almost all patients with varicose veins can get relief through a treatment called sclerotherapy. Among dialysis patients, RLS is a frequent complaint that will improve when anemia is treated–a common problem in this group. RLS is also a noticeable part of nerve damage and pain syndromes often develop in those who have diabetes mellitus. Finally, up to 25% of rheumatoid arthritis sufferers get RLS.
Treating RLS starts by trying to find and treat any health problems known to be linked to it. If you don’t have one of those problems, or if you have symptoms that just won’t go away, several therapies can be tried. Muscles in the back of the leg should be stretched before going to bed. Excess caffeine intake should be avoided.
Younger patients may respond to low doses of a sedative medication called clonazepam (Klonopin). Older patients may respond to medications that are traditionally used to treat Parkinson’s disease. Carbamazepine (Atretol or Tegretol), also used to treat seizure disorders, clonidine (Catapres), also used to treat high blood pressure, and propranolol (Inderal), also used to treat anxiety and heart arrhythmia, have all been used to treat RLS.
As a last resort, a class of medication known as opioids, most often used in the treatment of pain, can be tried for patients when other medicines fail.