Restless Legs

Description


Body parts sometimes seem to have a mind of their own. Like that time when
you walked sixty miles through the snow to a chocolate shop without even
thinking about it. Or that time your elbow jumped out of its own accord and
jabbed your co-worker in the ribs during a disagreement at the office water
cooler. For some people, these independent body movements or impulses don’t
affect much. Unfortunately, those who have restless leg syndrome may find
that they grow tired of this bodily autonomy thing.

Restless leg syndrome (or RLS) doesn’t really mean that your legs get up
and carry you off without your brain’s direction. It does mean, however,
that you’ll experience unpleasant sensations or simply an uncontrolled urge
to move your legs. This usually happens when you’ve settled down for a rest
and, naturally, often leads to sleep disruption, difficulty while traveling
or sitting for other activities (like watching a movie in a theatre).

RLS tends to be a progressive disorder, and tends to affect older
individuals more than the young (although people of any age can have the
disorder). Women are also a little more likely than men to have restless
leg syndrome, and there’s a strong genetic link for the syndrome: RLS tends
to run in families. There is no known cure, although there are treatments
available to ease symptoms.

Although it isn’t certain what causes RLS, it’s suspected that the disorder
is related to lower than usual levels of dopamine in the brain. (Dopamine
helps produce smooth muscle movement.) RLS may also be related to having
certain other conditions, such as iron deficiency, neurological problems
such as diabetes (particularly those with peripheral neuropathy) or
Parkinson’s disease, kidney failure, and being pregnant (particularly
during the last trimester). Some medications might also influence the
development of RLS, including some antiseizure, antipsychotic and
antinausea medications, as well as some cold and allergy medicines. Using
or consuming tobacco, caffeine or alcohol may also make your symptoms
worse.

Symptoms


Restless leg syndrome often goes unnoticed during the daytime, or when
you’re active and up and doing things. However, when you stop all your
activity and sit or lie down for prolonged periods of time (especially in
the evening or at night), you may begin to notice crawling sensations,
itchiness, burning, aching, cramping, electric sensations, or other
feelings of tension and discomfort. Or you may just feel the urge to move
or touch your limbs. (Sudden urges to dance an Irish jig may also occur,
although they’re much less common.) These sensations often occur deep in
the legs (usually somewhere on the lower half of the leg), although they
can be felt in the feet, thighs, arms or hands as well. Because the
symptoms are often relieved by movement, you might find temporary relief by
jiggling your leg, walking around, stretching or exercising.

Many people with RLS also have a condition known as periodic limb movements
of sleep (PLMS) or periodic limb movements disorder (PLMD). (Yes, namers of
disorders are very fond of acronyms.) This other condition means that
during sleep your limbs flex and twitch without your conscious control.
Having PLMS often doesn’t affect sleep patterns if the limb movement isn’t
rigorous. However, restless leg syndrome itself may significantly interrupt
your sleep, making it difficult to perform normally the next day at work
and other activities.

Symptoms may disappear for periods of time (weeks, months or even years),
although they usually recur later.

Diagnosis


Restless leg syndrome is often misdiagnosed as stress, muscle cramps, or
nervousness, and in the case of children, attention deficit disorder or
growing pains. People may also refuse to see a doctor because they don’t
feel they can describe their symptoms adequately, and they’re afraid their
doctor won’t take them seriously. If you suspect you have RLS, be sure to
speak about it with a doctor you trust.

Unfortunately, there’s no definitive test for RLS, so your podiatrist will
likely make the diagnosis based on a history of your symptoms. He or she
may ask about your sleep patterns, whether you feel drowsy during the day,
as well as the sensations you experience in your legs or other limbs, and
how often and how intensely they occur. Your doctor will also probably
check with you to see if anyone else in your family has had restless leg
syndrome or symptoms.

Some tests may be performed to rule out other potential causes of your
symptoms. These may include tests for iron deficiency, nerve function, and
muscle activity. Your doctor may also recommend an overnight sleep study to
see if you have PLMS.

Treatment


When you find that your legs just simply want to get going on their own,
there are a few things you can do to rein them in a little. Medications are
one route, but there are also some home remedies that may prove effective.
Talk with your doctor about the best options for you.

Some things you can do on your own include the following:

• Take hot baths (as though this were a chore). Scented candles and
  scandalous novels are, of course, optional.
• Get massages (again, not exactly torture, here). You can massage your
  legs yourself (possibly while in the hot bath), or pay (or bribe)
  someone to do it for you.
• Alternate cold and heat on your legs, or simply try one or the other
  to see what works best for you.
• Relax with yoga or meditation. While stress doesn’t necessarily cause
  RLS, it can make symptoms worse. Relaxing may help a bit.
• Try exercising and stretching, although doing this too intensely or
  too late in the day may make your symptoms worse.
• Reduce your intake or use of alcohol, caffeine and tobacco. Quitting
  is tough, but so is taking a five-hour flight when you can’t stop
  moving your legs.
• Try to sleep or rest when your legs seem to be less troublesome. This
  might mean altering your sleep schedule if you can, such as going to
  bed and rising a bit later.
• Take lots of breaks during long car trips, during movies, etc.
• Try over the counter pain medications, such as ibuprofen, to relieve
  symptoms.
• Join a support group. RLS sufferers may find advice, support, and
  understanding from others who have the syndrome.

Your doctor may also suggest some other medications to help you control
your restless leg symptoms. These may include medications commonly used to
treat either Parkinson’s disease (they affect dopamine levels in the
brain)or epilepsy. Opioids can be very addictive, but taken in small
amounts they may be effective at easing symptoms. Your doctor may also
suggest medications to relax your muscles or help you sleep. You should be
aware, however, that many medicinal treatments of RLS tend to become less
effective over time, so you may need to switch medications at some point,
or try combinations of medications to find a solution that will work for
you.

It may be that your legs will always be a little independent. But, with the
right care, you can find a nice balance both you and your wandering limbs
can live with.