What is Restless Leg Syndrome?

Restless Leg Syndrome (also known as Willis-Ekbom Disease) is a condition that causes the constant urge to move the legs, which is usually accompanied by discomfort. People with Restless Legs Syndrome often experience symptoms at night time and/or with inactivity/rest. While not life-threatening, this disorder can severely reduce the quality of sleep and life. According to The Royal Australian College of General Practitioners (RACGP) [1], around 10% of Australians will experience restless leg syndrome. Women and people over the age of 65 are particularly at risk of developing this condition. Some ways that patients can often describe restless leg syndrome include [2]:

“Pain in legs at night.”
“Creepy or crawly feelings”
“Jitteriness”
“Worms moving”
“Aching legs at night”
“Twitchy leg muscles”
“Difficulty or disrupted sleep”
“Itching bones”

Restless Leg Syndrome Symptoms and Signs

Symptoms are typically consistent from person to person. However, the main signs and symptoms seen in those with Restless Leg Syndrome include [1]:

The urge to move the legs and discomfort or pain in the legs (can be described as leg twitching and/or pain)
Commonly occurring when resting or not moving (e.g. sleeping, sitting, etc.)
Relief when moving (e.g. walking, stretching, etc.)
Occurring commonly OR only during the night/evening

These are four key signs of Restless Leg Syndrome, which may help with the diagnosis process.

What causes Restless Legs?

There is no single cause of Restless Leg Syndrome. Some people are more likely to develop this condition due to certain genetic variations [3]. Around 40-60% of those who have restless legs report a direct relative with the same symptoms [1]. Although researchers are still investigating exactly how Restless Leg occurs, studies have pointed to iron deficiency being a significant culprit [1][2][3]. Iron is a metal found in our blood cells that transports oxygen around the body. Having lower iron levels reduces the amount of oxygen being delivered to the body. Research shows that those with Restless Leg Syndrome experience more iron deficiency around the brain than in the body. This can disrupt brain activity, mainly dopamine, a neurotransmitter responsible for pleasure and muscle function [4]. Other potential Restless Legs causes include [1]:

Pregnancy
Diabetes (read more about diabetes type 2 here)
Fibromyalgia
Rheumatoid arthritis
Thyroid problems
Kidney failure

Tests and Diagnosis

There is no single test to confirm a diagnosis. However, GPs will be able to provide an evaluation based on your presentation and medical history. They may also ask about other potentially relevant information, such as your sleep quality, medication intake and general health. Tests may be performed to rule out other possible conditions, such as nerve pain or anaemia (a loss of red blood cells). Your GP may recommend additional blood tests, given the link between iron deficiency and this condition. Although not routinely needed, sleep studies may also be recommended (especially if there are any additional problems with sleep quality) [1].

Restless Leg Syndrome Treatment

Treatments for Restless Legs can vary person-to-person depending on factors, such as the cause and severity of the condition. Listed below are several treatments that your GP may recommend.

Medications

Medications prescribed by GPs can be taken several hours before bed to eliminate or reduce symptoms [1]. Drugs that increase dopamine are commonly prescribed due to their role in muscle tone and function. Research has shown the connection between dopamine imbalance and Restless Legs [2]. However, other options may be available depending on your unique circumstances and your GP’s advice.

Lifestyle Strategies

Your GP may also recommend strategies either in isolation or in combination with medications. Being consistent with these changes may slowly reduce symptoms and/or improve your sleep quality. Examples include:

Changing iron levels through dietary changes, supplementation [5] or other interventions
Reducing mentally stimulating activities before bedtime (e.g. video games, watching movies, etc.)
Reducing or eliminating caffeine, nicotine and/or alcohol
Changing your medication if necessary
Using compression stockings
Accessing information and support networks about Restless Leg Syndrome (please visit www.RLS.org.au)

Recovery

Restless Leg Syndrome can be a life-long condition without a cure. However, there are treatments available that can help improve symptoms, sleep and quality of life [6]. Those who are elderly and/or have an underlying condition may find that symptoms may gradually become more noticeable. However, there are certain individuals who may recover from Restless Legs that started from other certain causes. For instance, pregnant individuals may find that their symptoms are less or disappear after delivery [8]. Those with Restless Legs that are caused by kidney failure also find that their symptoms significantly improve after a transplant [7].

Complications

Restless Legs cause significant discomfort due to leg pain and the continuous urge to move the limb(s). Those with this condition often experience some form of sleep disturbance as symptoms often occur at night time and when the body isn’t moving. For most people with Restless Legs, symptoms often disappear during the day or while moving. However, disruptions to sleep patterns can cause sleepiness, poor quality of life and struggle with daily function. If symptoms worsen over time, those with Restless Leg Syndrome may also experience other complications, including [7][9]:

Headaches
Hypertension (also known as high blood pressure)
Depression
Insomnia

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

To make a telehealth appointment booking, simply click on the button below.

Book A GP

References

Yee, B., Killick, R., & Wong, K. (2009). Restless legs syndrome. Australian family physician, 38(5), 296-300.
Einollahi, B., & Izadianmehr, N. (2014). Restless leg syndrome: a neglected diagnosis. Nephro-urology monthly, 6(5), e22009. https://doi.org/10.5812/numonthly.22009
Allen R. P. (2015). Restless Leg Syndrome/Willis-Ekbom Disease Pathophysiology. Sleep medicine clinics, 10(3), 207–xi. https://doi.org/10.1016/j.jsmc.2015.05.022
Schwarz PB, Peever JH. Dopamine triggers skeletal muscle tone by activating D1-like receptors on somatic motoneurons. J Neurophysiol. 2011 Sep;106(3):1299-309. doi: 10.1152/jn.00230.2011. Epub 2011 Jun 8. PMID: 21653722.
Avni T, Reich S, Lev N, Gafter-Gvili A. Iron supplementation for restless legs syndrome - A systematic review and meta-analysis. Eur J Intern Med. 2019 May;63:34-41. doi: 10.1016/j.ejim.2019.02.009. Epub 2019 Feb 22. PMID: 30798983.
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
Silber, M. H., Buchfuhrer, M. J., Earley, C. J., Koo, B. B., Manconi, M., Winkelman, J. W., ... & Walters, A. S. (2021, July). The management of restless legs syndrome: an updated algorithm. In Mayo Clinic Proceedings (Vol. 96, No. 7, pp. 1921-1937). Elsevier.
Srivanitchapoom, P., Pandey, S., & Hallett, M. (2014). Restless legs syndrome and pregnancy: a review. Parkinsonism & related disorders, 20(7), 716-722.
Mansur A, Castillo PR, Rocha Cabrero F, et al. Restless Legs Syndrome. [Updated 2021 Dec 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430878/
http://www.RLS.org.au

Restless Leg Syndrome – Symptoms, Diagnosis, and Treatment