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Restless leg syndrome (RLS), aka Willis-Ekbom disease, is a condition where you have an intense urge to move your legs continuously, especially at night. Although it is not a painful condition, it is more of a cause for insomnia.

Involuntary muscle movements/spasms, a feeling of jitteryness or something crawling are the main symptoms that most patients present with. Common characteristics of RLS include:

  • Symptoms occur mainly at night, after worsening throughout the evening.
  • Movement such as walking, stretching or shaking the legs provide relief.
  • Sensations are triggered by, and start during a long period of inactivity such as sitting or lying down. 
  • Periodic Limb Movement of Sleep is a common condition which causes the legs to twitch and kick while you sleep, and RLS may be associated with this.

What Causes Restless Leg Syndrome?

It tends to be more common in women than men, and although there is no known cause some experts say it could be hereditary. An imbalance of the neuro hormone dopamine, which sends messages to the brain to control muscle movements, is one factor which can affect RLS. 

Other triggers could be:

  • Venous insufficiency,
  • Being on one’s feet for too long 
  • Certain medications, eg antidepressants, anti-emetics, or anti-psychotics 

 When dopamine drops, usually at end of the day, then RLS becomes more prominent. For most patients it could cause severe insomnia, which then leads to daytime sleepiness and impairment of physical and mental health.

Despite not being a serious condition in itself, RLS is often associated with other disorders, such as kidney failure or iron deficiency, so it is important to get a medical check-up if you suffer from it. 

How is RLS Diagnosed?

Your doctor will first get a proper history, check your blood pressure and the  blood circulation to your feet, as well as make routine blood tests, checking for markers such as  blood iron levels, blood sugar, thyroid, and vitamins B12 and D3.

How Can RLS Be Treated?

It goes without saying that a healthy diet, a good exercise programme and sufficient water intake are the foundation of good health.  In addition, supplements like magnesium, and grape seed extract could also assist.

Prescription medications that increase dopamine levels in the brain, for example, anti-Parkinson’s drugs and pregabalin (used to treat fibromyalgia) work well. In the US Rotigotine (Neupro) and pramipexole (Mirapex) are approved by the FDA for the treatment of RLS.

For severe symptoms, opioid painkillers may be prescribed (eg codeine, oxycontin, tramadol) but carry the risk of addiction.

As with all prescription medicines, the side effects need to be considered in case they outweigh the potential benefits.

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