Restless Legs Diagnosis

  • Diagnosis

    Restless legs syndrome (RLS) is a common neurological disorder that causes burning, creeping, or pulling sensations in the legs, as well as an uncontrollable urge to move in order to stop the discomfort.

    Experts estimate that 5% to 15% of the people in the U.S. suffer from the condition. For some, it’s a mild annoyance. It severely disrupts the lives of others.

    The symptoms are usually worse at night, and often lead to loss of sleep. This results in feelings of exhaustion and irritability during the day.

    About 80% of the people with restless legs syndrome also suffer from a separate condition called periodic limb movements in sleep (PLMS). Periodic limb movements in sleep are involuntary jerking movements in an extremity; the extremity repeatedly moves or jumps. You can have PLMS without having RLS, and vice versa.

    While there is no cure for most types of RLS, you can treat the underlying causes, if any, and adopt changes in lifestyle and diet to help reduce symptoms.

    In most cases, the cause of RLS remains unknown; there may in fact be more than one cause.

    The condition runs in families; children of RLS sufferers are more likely than other people to develop RLS.

    Some studies point to an imbalance in a chemical messenger in the brain called dopamine. In addition, medications, chronic conditions, and consuming certain foods may bring about the sensations.

    A medical condition (such as iron deficiency), caffeine, or medication can cause or contribute to RLS. If your restless legs symptoms are due to a medical condition, treating that illness may decrease your symptoms. Anemia, vitamin deficiencies, diabetes mellitus, alcoholism, peripheral neuropathy, cancer, renal failure, and arthritis are some of the disorders associated with RLS. An imbalance in the body’s minerals can also cause RLS symptoms. You may be able to correct a vitamin deficiency by taking supplements, and therefore stop the creeping feeling. Drinking coffee or consuming other beverages (colas, teas) or foods (chocolate) containing caffeine may increase the symptoms. Therefore, eliminating caffeine from your diet may be a good idea.

    Restless legs syndrome frequently occurs during pregnancy. About 15% of pregnant women develop RLS symptoms during the last few months of their pregnancy. The sensations usually stop after the woman delivers the baby.

    Classic symptoms of restless legs syndrome include burning, creeping or pulling sensations, and the uncontrollable urge to move in order to stop the discomfort. The uncomfortable sensations have also been described as pulling, drawing, wormy, tingling, pins and needles, pricking, itching, or achy. About 20% of patients find the sensations to be painful. Symptoms may last for a few minutes, or for several hours. The symptoms seem worse in the evening, or when you are lying down or sitting.

    RLS sensations usually occur between the ankle and the knee. However, you may also feel them in the feet, thighs, or sometimes the arms or trunk. Most often you will feel the sensations in both legs rather than just one. One side may seem more severe at times, or you may feel the sensations more often in one leg than the other.

    Symptoms occur at night or when the legs are at rest. The sensations often prevent sufferers from falling asleep. You may become sleep-deprived, feel tired during the day, and have difficulty concentrating.

    Moving the limb temporarily lessens the sensations. Sufferers are sometimes referred to as nightwalkers, because they get up and walk to relieve the sensations. Not moving your legs while driving or watching television may bring on the symptoms.

    Symptoms often grow worse over time. Even if self-care lifestyle changes initially bring relief, the sensations are likely to come back and progress.

    If you have a parent who has RLS, your chances of developing it are higher than average.

    RLS occurs more frequently in middle-aged and older adults. Restless legs syndrome usually occurs in people over the age of 30. However, children may also suffer from RLS. Many people with the genetic form of RLS remember having similar symptoms during childhood. When young, they may have been told they had growing pains, or were hyperactive because they constantly fidgeted.

    Taking certain medications (for high blood pressure, for example) and suffering from various medical conditions (such as diabetes) increases the risk. Drugs that can bring on or increase RLS symptoms include calcium-channel blockers, used in treating high blood pressure and other heart conditions; drugs to treat nausea; some cold and allergy products; major tranquilizers; and some drugs used to treat depression. Medical conditions such as diabetes mellitus, kidney failure, or vitamin, mineral, and other deficiencies raise your risk.

    Doctors generally diagnose RLS based on the symptoms. Your health care provider will ask many questions about your medical history, and about whether you are experiencing the classic symptoms of RLS: unpleasant sensations that increase in severity at rest, the urge to move the affected limb, and relief of symptoms with movement. In addition to a physical exam, the doctor will also perform a neurological exam.

    Several blood and other tests will be ordered to determine if another condition may be contributing to the symptoms. There are no tests to diagnosis RLS. However, simple blood tests can check for anemia, vitamin deficiencies, diabetes mellitus, and arthritis. Treating an underlying disorder can often decrease or eliminate RLS symptoms.

    An overnight sleep study may be ordered to assess for PLMS and sleep disruption. If a doctor recommends that you participate in a sleep study, it will mean you will go to a hospital or a special sleep clinic to be monitored for one night. In order to monitor your sleep, various sensors will be applied to your head, face, chest, and legs. These sensors will enable a doctor to look at your breathing patterns, oxygen levels, and sleep stages during the night to determine the severity to which your sleep is being disturbed by RLS.

    Monitoring and treating underlying disorders is the only available prevention method.

  • Prevention and Screening

    Monitoring and treating underlying disorders is the only available prevention method.

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