Restless Legs Syndrome (RLS)

What is restless legs syndrome (RLS)?This is a condition characterised by unpleasant burning, prickling, tickling or aching sensations in the muscles of the legs. It is sometimes referred to as 'Ekbom's syndrome' after the doctor who first recognised it.

Conservative estimates suggest it affects up to 5 per cent of the population but some authorities believe the true number of people affected may be two or three times as many.The classic symptoms include 'fidgety', 'crawling' or 'jittery' feelings in the lower limbs usually occurring in bed at night, but occasionally developing after periods of prolonged sitting when the person affected is physically and mentally tired.The sensations are experienced mostly in the calves and although usually present in both legs, one side can be affected more severely than the other. Some times the symptoms can be so bad, that wanting to cut your legs off seems like the only form of relief NOT RECOMMENDED, but that is how this condition can make you feel.

Walking In some cases can ease RLS and the sufferer may spend much of the night pacing up and down to achieve any lasting improvement. Spasmodic jerking movement of the legs during sleep is a very common symptom of RLS and can also result in partners having a disturbed sleep too.

RLS tends to run in families and is most common in:
middle-aged women
the elderly
pregnancy
people who drink large quantities of caffeine-containing drinks
people who smoke heavily.

The underlying cause is unknown. No detectable abnormality of the nervous system, circulation or muscles has reliably been demonstrated. However, RLS has been associated with certain other conditions, such as Fibromyalgia which if treated, brings about an improvement in the symptoms of RLS. Deficiency of iron, vitamin B12 or folic acid, for example, when corrected can ease the symptoms. Nerve damage associated with rheumatoid arthritis, kidney failure or diabetes may also play a part.
Certain medications including lithium, anticonvulsants, antidepressants and beta-blockers have also been incriminated as potential triggers.

The diagnosis of RLS is reached through a combination of the characteristic symptoms and through investigations and examinations that rule out other possibilities. Sometimes the patient may be referred to a neurologist and if sleep disturbance is severe, special sleep studies can be arranged in a hospital setting.

Treatment involves general advice that encourages sound sleep and a regular sleep routine is always valuable. Correction of any iron or vitamin deficiency certainly helps as up to one third of elderly patients with RLS can benefit in this way. If medication for other conditions is potentially responsible, then stopping the treatment or changing over to an alternative is appropriate.Some medicines, such as levodopa (Madopar, Sinemet), bromocriptine (eg Parlodel), oxycodone (OxyContin, OxyNorm) and clonazepam (Rivotril), may help to control RLS.

However, as individual patients often respond better to one treatment than another, your doctor will be able to decide the most appropriate treatment for you.