Also referred to as WED or the Willis-Ekbom disease, restless leg syndrome (RLS) is a disorder of the body’s neurological system. It manifests itself as a regular irresistible urge by the sufferer to move his or her legs. Although it most commonly occurs in the legs, it can also affect other parts of the body such as the head, torso and arms. Estimates within the US population put the disease at 5 percent prevalence for the general population and 10 percent for citizens over the age of sixty five. In addition, the number of infected women is twice as much as that of the men.
Symptoms experienced by RLS patients range in intensity from mild to fairly serious to very intolerable. In general however, the general symptom is that of restlessness usually in the legs. Occurring commonly when the sufferer is at rest, sensations of itchiness, ‘crawling’ or pins and needles are experienced. While they can be mild at times, they can also increase in severity during other periods of the day especially in the evening and at night.
In some people, RLS symptoms start early and get worse with age while in others, periods of remission occur. These remissions usually occur in the beginning stages of the disease and can last for a few weeks or even months.
Causes of RLS
The primary causes of the disease are yet to be fully uncovered and research is ongoing. Up to now, researchers have linked iron deficiency with a lot of RLS cases (20 percent). Other health conditions thought to be linked with RLS include rheumatoid arthritis, celiac disease, a deficiency in magnesium, sleep apnea and fibromyalgia. A number of medications are also associated with RLS. They include antidepressants, anti-nausea drugs, cold and allergy medicines and antipsychotic medications.
It has also been discovered that certain factors put some people at a much higher risk of getting RLS as compared to the rest of the population. One of these factors is pregnancy. A number of women experience RLS symptoms during the course of pregnancy. These symptoms quickly disappear around a month after the baby is born. Other predisposing factors include alcohol use, lack of sleep and depression.
Among all the known causes of RLS, there is one that has attributed to the highest number of cases (60 percent) and that is genetics. In these sufferers, a member of the family also has the same condition and passes it on to them.
Diagnosis and treatment of RLS
Doctors are yet to come up with a specific and sure test for restless leg syndrome. Sometimes, doctors will apply various tests to rule out other health conditions including vitamin deficiency. A proper diagnosis is made based on four symptoms.
1. An increase in the severity of the symptoms towards the evening and at night and noticeable reduction in severity in the morning. In severe cases however, symptoms may be experienced even during the day.
2. Sensations of tingling, pricking, numbness, pain and burning in the legs and arms, or both. These sensations produce an urge to move the affected limbs.
3. Increase in severity of symptoms during periods of rest and especially while asleep.
4. A temporary occurrence of relief when movement is initiated such as by walking or jogging.
Once the disease is successfully diagnosed, a proper course of treatment is determined. The goal of the treatment is to reduce symptoms and thus improve quality of life. Sifrol for restless leg syndrome is one of the most commonly used drugs and others include Levodopa, rotigotine and ropinirole. The treatment applied highly depends on the nature and situation surrounding the disease. While anti-convulsants are ideal for ‘pain’ symptoms, opioids are only used in severe situations where other medication fails to work. For moderate RLS symptoms, Gabapentin is used.
In February 2014, a medical report published by the New England Journal of Medicine, stated that certain long term RLS medications made the condition worse. It advocated for the use of pegabalin which was more effective and less likely to increase severity of symptoms.
In March of the same year, two major discoveries were made. One of the discoveries was that problems in early brain development could be a factor in the occurrence of RLS. The second, equally important discovery is that RLS may not just be a disease in itself but also as an indicator of deeper health problems such as hypertension and cardiovascular disease.