Restless Legs Syndrome (RLS)

Restless legs syndrome (RLS) is characterized by unpleasant sensations in the lower limbs. Sufferers experience an uncontrollable urge to move their legs (and at times their arms), especially when at rest or relaxing. This disorder affects approximately 10% of adults and symptoms are generally more prominent in the evening and at night. Symptoms typically appear when sitting or lying for extended periods. Sitting in movie theatres, planes and conference rooms for example, tends to aggravate symptoms in sufferers.

Causes

There are two types of restless legs syndrome - primary and secondary. Although it is not known what causes primary restless legs syndrome, we do know that there is a genetic component. In other words, if either parent suffers from the disorder, their children are more likely to also suffer from RLS. It is thought that secondary restless legs syndrome is brought on by a shortage of dopamine (chemical messengers of the nervous system). A dopamine shortage can occur when there are other deficiencies such as iron, folic acid and vitamin B12 deficiencies, for example. Chronic diseases such as diabetes, kidney failure and hyperactivity can also cause restless legs syndrome. Pregnancy can also induce or aggravate symptoms.

Persons most at risk

Certain people are more prone to developing restless legs syndrome. For example, the elderly and pregnant women are more likely to suffer from the disorder. Persons with chronic illnesses (diabetes, kidney disease, etc.) or a family history of RLS also present a higher risk.

Symptoms

To be categorized as having restless legs syndrome, four criteria must be satisfied:

1. Unpleasant sensations in the legs or arms (itchiness, electric current, pain, tingling, creeping, crawling, etc.).
2. Uncontrollable urge to move legs especially when at rest (when seated or lying down).
3. Worsening of symptoms in the evening and at night.
4. Feeling of relief when moving the legs.

The discomfort brought on by RLS is often accompanied by other symptoms including:

• Insomnia and trouble falling asleep;
• Daytime drowsiness and fatigue (exhaustion after permanent movements);
• Involuntary leg movements at night (not to be confused with nighttime leg cramps or jerking);
• Concentration or memory problems.

Diagnosis

Restless legs syndrome can be diagnosed by a family physician based on the symptoms described by the sufferer. To help make the diagnosis, the doctor will also inquire about family history and current medications in connection with RLS. The physician may also suggest blood or muscle tests and may also refer the sufferer to a specialist who will perform a polygraph to assess the level of activity in the lower limbs during sleep.

Treatement

There are several treatment options available to relieve or eliminate restless legs syndrome. The first option involves treating the source of the disorder. For example, gaining better control over one's diabetes or addressing any vitamin deficiencies may prove effective in eliminating the symptoms.

The second option involves lifestyle changes. A balanced diet will help eliminate deficiencies that could be responsible for causing the syndrome. It is also recommended that stimulants be avoided (coffee, tea, cigarettes, alcohol and chocolate) since they increase the frequency and intensity of symptoms. Regular exercise and good stress management practices also help prevent attacks.

The third option involves taking prescription medication, as prescribed by the physician, in an effort to help alleviate symptoms.

• Dopaminergic agents: mimic the effects of dopamine, thereby reducing attacks.
• Sleeping pills: help overcome insomnia and problems falling asleep.
• Analgesics: alleviate pain.

Here are a few suggestions that may help improve the condition of sufferers. Frequently moving or massaging legs, taking warm baths, applying alternating hot and cold compresses or keeping the mind engaged can help those with restless legs syndrome cope with their symptoms.

For any questions regarding medication, don't hesitate to ask your pharmacist!