Restless legs syndrome (also known as Willis-Ekbom disease) is a common condition which affects the nervous system and - as you probably guessed – causes an overwhelming desire to move the legs. It affects up to 10 per cent of the UK population at some point in their lives.
What are the symptoms?
As well as the irresistible urge to move the legs the condition is accompanied by an unpleasant feeling in the feet, calves and thighs – often characterised by sufferers as a "creeping" or "crawling" sensation. The condition also sometimes affects the arms and can result in an involuntary jerking or movement of the limbs known as periodic limb movement (PLM) – this occurs in around 80 per cent of cases.
The severity of the condition varies greatly between cases and the symptoms are also described as a "fizzing" feeling, a tingling or burning sensation and cramping of the calves and legs. Symptoms are often worse at night and sleep can be disrupted as a result. Periodic limb movement can be violent enough to wake the sufferer and his or her partner.
Who does it affect?
Women are twice as likely to suffer from the condition as men - and it is most common in middle age. It can however begin at any age, including during childhood.
What causes it? The cause is unknown in the majority of cases, however there are a few theories and correlations to be aware of. A diagnosis of primary or "idiopathic" RLS means no direct cause has been found – however the condition has been linked to low levels of dopamine in the brain.
Dopamine levels naturally fall at night time, which has been held as further evidence for a link to RLS. RLS can also occur as a secondary condition however, and sometimes affects pregnant women, those with anaemia and people suffering from chronic health conditions such as kidney disease, Parkinson's disease, diabetes or fibromyalgia.
In addition, the condition can be triggered or worsened by use of anti-depressants, anti-psychotic drugs, lithium, calcium channel blockers, some anti-histamines and metoclopramide (a drug used to relieve nausea). Being overweight or obese, stressed, smoking or drinking excessively and consuming excess caffeine have also been recorded as triggers. A lack of exercise is another factor linked to the condition.
What are the treatments?
The first port of call, treatment-wise, is likely to be lifestyle changes. These might include avoiding caffeine, tobacco or alcohol in the evening, giving up smoking, taking regular exercise (but not just before bed) or getting into a regular sleeping pattern. When symptoms flare up, it can help to massage the legs, take a hot bath or apply a hot or cold compress to the legs.
Relaxation exercises such as yoga or tai chi have been found to help, as has just going for a walk. Painkillers such as codeine or tramadol may be prescribed to ease the discomfort in some cases. Some sufferers have been found to benefit from a "dopamine agonist" medication, which raises the level of dopamine in the brain. These include ropinirole, pramipexole and rotigotine – and all three can cause sleepiness, so it is advised to avoid driving or working with power tools after taking them.
Sleeping tablets such as temazepam and loprazolam can be prescribed in acute cases and a drug called levodopa is sometimes prescribed to patients with rarely recurring symptoms. The latter medication is taken when a bout of the illness begins – but if taken regularly it can make symptoms worse. Anticonvulsant drugs such as gabapentin may be tried if dopamine treatment is ineffective.
What is the prognosis?
If the underlying cause can be identified and dealt with then it is usual for the condition to go away. In pregnant women it is likely to ease after around four weeks. However it can become a long-term condition for some, leading to anxiety, depression and insomnia.
Information taken from the NHS Choices website, check it out for more details – and also see the RLS-UK website for support and additional information.
Do you suffer from restless leg syndrome? Leave a comment below...