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Continuing Education

Restless Legs Syndrome

Posted on March 30, 2016 at 12:05 AM




This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns


The specific causes of restless legs syndrome (RLS) are not known. RLS is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them. Symptoms occur primarily at night when a person is relaxing or at rest and can increase in severity during the night. Moving the legs relieves the discomfort. Patient's report that the sensations range in severity from uncomfortable to irritating to painful. Research is being done in the areas of abnormalities in brain chemicals (neurotransmitters) that help regulate muscle movements, or to abnormalities in the part of the central nervous system that controls automatic movements. The two common conditions linked to RLS are iron-deficiency anemia (low blood count) and peripheral neuropathy (damage to the nerves of the arms and legs, often caused by underlying conditions such as diabetes). A couple of things that might be useful to note and discuss with your physician: Certain medications and hypothyroidism have been discussed as possible culprits that may aggravate symptoms.


A few things that you might find helpful:

Restless legs syndrome, makes it hard to sleep. Your legs may ache, burn, tingle, twitch, or jerk. To get the deep sleep you need, try going to bed a little later and sleeping later in the morning. Those morning hours may be some of your best rest. Going to sleep and waking up at the about the same time every day helps just about everyone sleep better. This strategy may stop a bad cycle where fatigue makes your symptoms worse, and then the twitching and tingling ruins your sleep for another night.

Gentle stretching before bed might help. For a calf stretch, step forward and bend your front leg while keeping your back leg straight, in a small lunge. You can put your hand on a wall for support. Repeat on the other side. Stretching also helps if you've been sitting for a long time.

Reduce caffeine: Caffeine can make your RLS symptoms worse, even hours later. Cut out this stimulant and you may find it easier to fall asleep and stay asleep. If you cut down, keep in mind that caffeine can affect some people for as long as 12 hours.

A warm bath before bedtime relaxes you and makes it easier to fall asleep. So it's probably not surprising that this classic way to wind down also reduces the symptoms of RLS.

Heating pad or ice pack? Go with whatever feels good. Either change in temperature can be soothing.

Moderate exercise during the day pays off with better sleep at night. Walk, jog, lift weights, or find any exercise you enjoy. One study found that exercise led to less leg movement and longer and deeper sleep for people with RLS. Be careful not to overdo it. Intense exercise or working out just before bedtime could make your symptoms worse.

When your legs ache or twitch, moving them may ease those uncomfortable feelings. Sometimes just shaking or moving your legs can help. Choose an aisle seat in a movie theater or airplane so you can get up easily.

Stress makes RLS symptoms worse. Release the tension by taking slow, deep breaths. It also helps to dim the lights and listen to soothing music before you go to bed.

A calf massage before bed might calm your RLS symptoms and help you get to sleep. You can do it yourself or trade mini-massages with a family member. Give your partner a 10-minute shoulder rub, then stretch out for a leg massage and relax deeply.

Yoga combines three remedies that can reduce mild RLS symptoms: stretching, deep breathing, and relaxation. Try a class or video to learn the right posture and pace for each move. Once you know the poses, you can do them on your own.

Discuss any labs you may have had to evaluate your iron. The usual test is a Complete Blood Count. (CBC). The CBC measures many parts of your blood. This test checks your hemoglobin and hematocrit. . Hemoglobin is an iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of infection, a blood disorder, or another condition. Finally, the CBC looks at mean corpuscular volume (MCV). MCV is a measure of the average size of your red blood cells There has been shown a correlation between low levels of iron in their blood and RLS. It makes sense since your body needs iron to make dopamine, a brain chemical that helps control movement.

Discuss any medicine/drug therapy that your doctor may think useful for you and your specific concerns.


Resources:: Practice parameters with an evidence-based systematic review and meta-analyses. Sleep, 35(8): 1039–1062.

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Reply Elmerked
7:10 PM on January 20, 2017 
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