Understanding Restless Legs Syndrome (RLS)

A Comprehensive Guide to Symptoms, Diagnosis, and Treatment

Neurology

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Last updated: Mar 24, 2025

What is RLS?

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations.

Key Symptoms

  • Uncomfortable sensations in legs described as:
    • Crawling
    • Creeping
    • Pulling
    • Throbbing
    • Itching
  • Symptoms typically worse in the evening or at night
  • Relief with movement
  • Symptoms interfere with sleep

Risk Factors

  • Age: Can occur at any age, but more common in middle age
  • Gender: More common in women
  • Genetics: Family history increases risk
  • Pregnancy: Especially in third trimester
  • Certain medical conditions:
    • Iron deficiency
    • Kidney disease
    • Diabetes
    • Parkinson's disease

Diagnosis

Diagnosis is based on five essential criteria:

  1. Urge to move the legs
  2. Symptoms begin or worsen during rest
  3. Relief with movement
  4. Symptoms worse in evening/night
  5. Symptoms not explained by another condition

Treatment Options

Lifestyle Changes

  • Regular exercise
  • Good sleep habits
  • Reducing caffeine
  • Leg massage
  • Hot/cold therapy

Medications

  • Dopaminergic drugs
  • Iron supplements (if deficient)
  • Anti-seizure medications
  • Opioids (in severe cases)

Managing RLS

  • Keep a regular sleep schedule
  • Create a comfortable sleep environment
  • Maintain a symptom diary
  • Identify triggers
  • Regular medical follow-up

When to See a Doctor

  • Symptoms interfere with sleep
  • Daily activities are affected
  • Quality of life is impacted
  • New symptoms develop

Complications

  • Sleep deprivation
  • Daytime fatigue
  • Mood changes
  • Difficulty concentrating

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