Restless Legs Syndrome

Diagnosis begins with a conversation about your medical history and symptoms. We may conduct a physical and a neurological exam and order blood tests for iron deficiency. Occasionally, our team will refer you to a sleep specialist for more tests. 

Criteria for an RLS diagnosis includes: 

• An almost irresistible urge to move your legs
• Uncomfortable tingling or crawling feeling in the muscles of your legs 
• Symptoms that are worse at night and are absent or barely noticeable the next day 
• Partial or temporary relief from activity, such as walking or stretching 
• Symptoms occur mostly at night

Symptoms of RLS may vary in severity and disappear for periods of time and then return. This continuous need to stretch or move can cause insomnia or prevent you from falling asleep, which can lead to excessive daytime sleepiness and low function during the day. Ultimately, these sensations can lead to anxiety and depression. 

Patients with RLS have a strong — nearly irresistible — urge to move their legs. They may experience: 

• Involuntary jerking or twitching movements in the legs while sitting or lying awake 
• An uncontrollable urge and uncomfortable sensation in the legs, or possibly the arms 
• A creepy, crawly feeling that occurs more often in the evening 

RLS affects 5 to 15% of the population at some point in their lives — 80% of people with RLS may also have symptoms of periodic limb movement disorder (PLMD). The condition is more common in older people and can occur in both men and women at any age.  

Although it’s unclear what causes RLS, researchers suspect it may be a result of an imbalance in dopamine, a brain chemical that controls muscle movement. RLS may also run in families. Additionally, symptoms can develop in women during pregnancy and may disappear after delivery. 

RLS can also be caused by underlying medical conditions, such as: 

• Iron deficiency 
• Kidney failure 
• Peripheral neuropathy (damage to the nerves in the hands and feet due to diseases such as diabetes) 
• Thyroid problems 
• Varicose veins 

Treatment of RLS should only begin after other possible medical causes are ruled out. If RLS is caused by a treatable medical condition, the symptoms may disappear once the underlying cause has been resolved. Our neurologists and sleep specialists diagnose and offer treatment options unique to each patient’s condition, including: 

• Caffeine and tobacco avoidance 
• Heat or ice therapy 
• Hot baths 
• Massage 
• Meditation and yoga 
• Pain relievers 
• Regular exercise 

When these methods do not provide relief, one of several medications may be effective. These include: 

• Gabapentin, or medicines that affect calcium channels 
• Muscle relaxants 
• Opiates  
• Pramipexole, or medicines that increase dopamine in the brain 

Since everyone responds differently to medication, you may need to try several medications until you find one that is effective.