Identifying and Treating Restless Leg Syndrome

By Dr. Samuel P. Martin

Restless leg syndrome (RLS) is a poorly understood condition that can have multiple causes. While often described as a “neurological disorder" characterized by an irresistible urge to move one’s body to stop uncomfortable or odd sensations, confusion with the symptoms of venous insufficiency is very widespread. This confusion complicates treatment and allows RLS to continue disrupting life for patients.

RLS most commonly affects the legs, particularly the lower leg area, but the arms and torso can also be impacted.According to estimates, 7-10% of the population of North American and Europe suffers from RLS, though the varying nature of symptoms can complicate these estimates. Many sufferers, or approximately 2.7%, experience daily or sever symptoms. Women are also twice as likely to suffer from RLS as men. With age, RLS also becomes more common and more severe.

Recognizing the Symptoms of RLS

Despite the confusion, some classic restless legs symptoms are easily identified:

• Itching
• Tickling in the muscle
• “Pins and needles” sensation
• Numbness or feeling that the leg has “fallen asleep”
• Limb jerking during sleep

These sensations generally appear at night, often shortly after lying down. Sufferers may also experience the sensations while traveling or sitting for long periods.

Identifying the Causes of RLS

“Classic” RLS has a genetic link with more that 60% of cases reporting a family history and is known as primary RLS. Similarly, venous insufficiency also has a significant genetic predisposition. Secondary RLS is RLS that is the result of underlying medical conditions or the use of certain drugs like antihistamines, antidepressants, some sedatives and sleeping pills and opiate withdrawal.

The most common medical condition associated with RLS is iron deficiency, though a number of other conditions have been associated with RLS:

• Folate deficiency
• Magnesium deficiency
• Fibromyalgia
• Uremia
• Diabetes
• Thyroid disease
• Auto-immune disorders
• Rheumatoid arthritis
• Parkinson’s disease
• Peripheral neuropathy

RLS can worsen with pregnancy and a high incidence of RLS symptoms is noted in patients with venous insufficiency. According to a 2007 study, 36% of patients in a vein clinic suffered from RLS.

How to Relieve the Symptoms of RLS

Getting up, moving and walking usually brings relief to patients with RLS. Massage, stretching or rapid movement of the legs may also provide temporary relief. The symptoms are very similar to those patients with venous insufficiency face, and some of the same techniques relieve the strain for both conditions. Movement or stretching frequently leads to relief.

Many physicians feel that patients with RLS symptoms and physical evidence of venous insufficiency should undergo an ultrasound evaluation of the legs. If venous disease is confirmed, then compression therapy should be started and consideration should be given to treating the venous insufficiency. These treatments may include laser and chemical sclerotherapy of abnormal veins. At Vascular Vein Centers, these treatments have been very gratifying, with over 80% of patients experiencing total or near total relief.

Treatment regimens for RLS are less straightforward and often include lifestyle changes. The first step towards managing symptoms of RLS is prevention. By working with a medical specialist, patients can discuss the lifestyle changes that may improve symptoms, including cutting back on caffeine, alcohol and tobacco. Increased exercise and supplements may also provide relief.

To determine if your symptoms are the result of RLS or venous insufficiency, reach out to our specialists at Vascular Vein Centers. We’ll help you identify the cause of your condition so you can get the fast treatment that gives you back your leg health.