What is Restless Leg Syndrome?
Restless leg syndrome (RLS) is more than the occasional bouncing to pass the time that a lot of people assume it is. It is an uncontrollable urge to move your legs, and is usually accompanied by a highly uncomfortable sensation. This includes aching legs, legs twitching and or calf muscles twitching. To make matters worse, restless leg syndrome usually occurs at night, which means that there is significant trouble getting to and staying asleep. In fact, for this reason RLS is considered a sleep disorder due to its common occurrence surrounding sleep. It is also classified as a movement disorder since it is only relieved by moving the legs. Above all, however, RLS is categorized as a neurological sensory disorder since symptoms begin in the brain itself.
RLS is more than just twitching legs. Once it does manifest in your sleep, RLS can cause exhaustion and daytime sleepiness. This in turn can affect mood, concentration, attention and functionality on the job and in school. People affected by RLS report a 20 percent decrease in work productivity. Long term untreated RLS can finally lead to anxiety and depression. Sleep deprivation is a key cause of chronic stress and this alone can cause several health problems.
While the symptoms of RLS may be vast, the causes are less well-known. RLS can be caused by a variety of factors such as pregnancy, nicotine and caffeine use, already existing sleep disorders, iron deficiency and so on.
Restless Leg Syndrome Symptoms
Throbbing is the first description that individuals affected by RLS would use to describe the constant, uncomfortable pain and urge to move the limbs. Worse than the throbbing that might occur after a surgery or wound, throbbing with RLS seems to occur within the limb, not merely on top of it or on the skin’s surface. For this reason, this discomfort often leads to insomnia and the inability to sleep at night. Throbbing, like other symptoms, is more likely to occur at night. Though rarely, throbbing and other sensations can also occur in the arms (x).
This itching is also described as crawling and creeping. These symptoms are also worse at night, while individuals do report a short period of time in the mornings as a symptom-free period. If other events and activities are also keeping individuals awake at night, such as stress, schedule changes etc., symptoms are likely to worsen. Unfortunately, symptoms are not alleviated with a simple scratch. It usually takes movement or stretching to stop these sensations (x).
Constant Desire to Move Legs
The constant need to move the legs is a defining symptom of RLS. This sensation usually occurs on both sides and can rarely affect the arms.
This desire is not easy to explain. Unless you’ve had it, it is difficult to describe the feeling, but the desire to move the legs and feet is ever present, insistent and impossible to ignore. Once the legs have moved, such as through walking, stretching, pacing or just shaking the legs in general, the sensation alleviates (x).
There is a long list of symptoms that are attributed to restless leg syndrome. Unfortunately, many individuals with RLS might never seek medical attention because they fear they will never be taken seriously. Other symptoms may include an electric feeling in the legs, a pulling sensation, sleep loss, irritability and mood changes. Restless leg syndrome can have serious consequences that not everyone recognizes.
Loss of work productivity by up to 20 percent can negatively impact individuals’ careers and well-being. Significant loss of sleep can also impact an individual’s health and cause trouble driving, performing at school or work and lower the immune system. Needless to say, RLS is not something to be ashamed of (x).
Long Term Effects of Restless Leg Syndrome
Eighty percent of people with RLS also experience periodic limb movements of sleep. These are spasms of the limbs that occur every 15 to 40 seconds during sleep. While they may seem harmless, blood pressure and heart rate actually spike during these spasms as well. This puts an individual at risk of additional heart issues over time and negatively impacts their sleep.
Daytime sleepiness and other sleep issues can affect relationships and work. Individuals report feeling frustrated and helpless, which can put significant impact on their mental health including causing depression and anxiety.
RLS increases the risk of cardiovascular disease. Because RLS robs individuals of quality sleep, other aspects of health are at risk as well. Chronic sleep deprivation causes the person to be at greater risk for long term health issues, where one problem leads to another. For example, lack of sleep increases obesity, and obesity increases the risk of cardiovascular disease.
What Causes Restless Leg Syndrome?
There is no clear cause of RLS. There are risk factors which can be taken into account, and some — like pregnancy — mean that the RLS symptoms will subside after the risk factor is removed, but generally once RLS starts, it is not reversible.
Iron plays a vital role in the body, and there is a correlation between a decreased iron level at night and the nightly worsening of symptoms common with RLS. A study from 1950 showed that 25 percent of the subjects with RLS also had an iron deficiency (x, x).
However, it is not enough to get a simple blood test to measure iron. A protein called ferritin is a good indicator of the ability to store iron in the system. Have your ferritin levels checked at regular intervals. Supplementation can help with this, but it must be done carefully, as too much iron supplementation has negative health consequences (x).
Some medications can affect restless leg syndrome and exacerbate symptoms. These include anti-nausea drugs such a prochlorperazine or metoclopramide, antipsychotic drugs like haloperidol or phenothiazine derivatives, antidepressants that increase serotonin like fluoxetine or sertraline and some cold and allergy medications that contain older antihistamines such as diphenhydramine (x).
While no studies have been done on the effect of alcohol on RLS, there is anecdotal evidence that consumption of alcohol, particularly at night, causes a noticeable increase in symptom severity.
It is common for those with chronic kidney disease to experience RLS, though the cause of this correlation is unknown.
The onset of restless leg syndrome in pregnancy is thought to be caused by the significant hormonal shifts experienced by the mother.
Restless Leg Syndrome in Pregnancy
Restless leg syndrome in pregnancy is quite common, with approximately 1 in 5 UK mothers-to-be reporting an onset of symptoms. Because it is thought that hormonal changes are a trigger for restless leg syndrome, pregnancy is a prime candidate for triggering the onset. Generally, restless leg syndrome in pregnancy sets in during the third trimester. If the RLS is triggered by pregnancy and the accompanying change in hormones, the symptoms will generally subside after giving birth (x).
Restless Leg Syndrome Treatment
Vitamin D deficiency is a contributing risk factor linked to RLS, and supplementing with vitamin D can have a positive effect on RLS. Research indicates that vitamin D supplements improves the severity of RLS symptoms and concludes that vitamin D deficiency is linked to it (x).
Supplementing too much vitamin D3 can result in hypercalcemia and bone loss. General side effects include nausea, weakness, weight loss, heartbeat irregularity, irritability, constipation and seizures.
If you are experiencing kidney problems, you should avoid supplementing with vitamin D3 altogether.
Especially as an essential oil, rosemary can have a significant positive impact and decrease the symptoms of RLS. Rosemary is a natural analgesic, antispasmodic and has warming properties which make it ideal for use on muscle aches, pains and spasms. In addition, the warming and calming properties of rosemary make it ideal for RLS. Rosemary is recommended as a topical massage or in a hot bath (x).
Do not use rosemary extract if you have an aspirin allergy or suffer from seizures. Additionally, pregnant and nursing women should not take rosemary extract.
Iron therapy has been used since the 1950s to treat RLS. Studies show a strong relation between iron deficiency and the severity of RLS. Even just one dose per day for 3 months can quickly show improvement. Keep in mind that not all iron supplements are the same, and some work better than others. Taking iron can be tricky when an iron infusion is present (x).
Over supplementing with iron also has severe health consequences. Discuss all supplements with your doctor before adding them to a new regimen.
When it comes to RLS, moderate exercise daily is great for relieving symptoms, but strenuous exercise before bedtime is not ideal. Gentle exercises such as yoga, cycling and swimming are ideal exercises for individuals with RLS. There are also several stretches such as the calf stretch, front thigh stretches, and hip flexor stretch that can provide the movement needed for RLS, while quieting the symptoms.
Restless Leg Syndrome Medication
Medications and painkillers are an option. Unfortunately, the side effects of these medications include nausea, lightheadedness and fatigue. Other medication options include drugs that affect calcium channels and opioids. Opioids have surprisingly been known to reduce symptoms of RLS. On the other hand, these medications can be highly addictive. Always discuss your individual situation with your doctor before taking any prescriptions or medications.
The Bottom Line
Restless leg syndrome is one of the most common and most commonly underestimated conditions. The public thought of RLS is generally that someone wants to bounce their leg in an annoying way. However, the need and action is uncontrollable and painful. It damages sleep quality and affects many areas of life.
The symptoms of RLS often include throbbing, itching, aching, creeping, pulling and, most importantly, the uncontrollable desire to move one’s legs. Unfortunately, even with a condition so common, there is no known cause of RLS. There are risk factors which make it more likely to have RLS such as pregnancy, iron deficiency and use of alcohol and caffeine, but no known cause. If you find yourself faced with RLS, iron supplements, vitamin D, rosemary and regular moderate exercise can all be beneficial.