Restless leg syndrome

The restless leg syndrome (RLS) is a symptom of neurological disorder in which the patient experiences an abnormal urge or sensation to shake the leg in response to pain, itching, discomfort or numbness. When returned to the resting stage, the restless leg syndrome patient can feel the pain and again they want to shake the leg to alleviate the pain. Mostly, the restless leg syndrome patients experience this problem in the late evening or in the night. There are two types of restless leg syndrome; they are: Primary restless leg syndrome, a problem that arises in the middle age and there will be a periodical attack and relapse, and secondary restless leg syndrome that occurs in the middle age of 40 years and there will be a constant pain sensation, which may be due to external factors such as drugs and environmental factors.

Causes 

The restless leg syndrome can be caused by a number of factors such as iron deficiency or anemia, obesity, renal problems, heavy metal toxicity and its associated neurotoxicity, smoking, alcohol, varicose vein, and excess caffeine intake and rarely hormone dysfunctions such as diabetes can also cause restless leg syndrome. Other factors such as the medicines prescribed to cure another disease can also cause restless leg syndrome. Some of the drugs such as anti-depressants, ranitidine and cimetidine can cause this disorder. Some of the reports claim that some neuro-psychiatric disorders and genetic/familial inheritance can also cause restless leg syndrome.

Symptoms

• Constant and intense leg pain

• Tingling

• Sprains and burning- or itching-like sensation due to neuritis

• Alterations in the sleep patterns due to episodic attacks of restless leg syndrome, mostly in the nights.

Diagnosis

There are no laboratory or radiological examinations available for the diagnosis of this disorder. But clinical examination and correlation of the clinical symptoms can be useful to diagnose restless leg syndrome and to rule out the other possible medical conditions. Some of the symptoms that need to be examined by the clinician are:

• A strong urge to move the leg frequently

• Relief of pain after shaking the leg

• Events of attacks in the evening or night

• Some of the physicians use color doppler study to examine the blood flow rate in the legs

• There will be a pathological increase in the blood flow rate and evidence of venous reflux in the legs.

Treatment Options

The medical management of restless leg syndrome starts with the drug therapy of dopamine antagonist and Gabapentin. The opioids, benzodiazepenes and anti-convulsant drugs are useful for the management of restless leg syndrome. The other options include the non-pharmacological therapies such as hot-water bath and application of hot packs in the legs, and mind-relaxing yogas are also reported to be useful but they lack scientific evidence.

Prognosis

The prognosis of restless leg syndrome depends on the age and the associated medical problems of the patient. In the advanced ages, the symptoms of this disorder may get worse. But the patient in the early and middle ages can get relief and the remission of restless leg syndrome and its episodic attacks can be decreased by medical management.

Prevention Strategies

No prevention methods are reported for restless leg syndrome

When to see a doctor

When you experience abnormal pain, burning or itching sensation that needs leg shaking movements to relieve the pain, leg cramps or sprains in the night time or if your symptoms worsen even after you took the medicines, you need to consult the medical doctor immediately.