*Restless leg syndrome (RLS* ☝ *Today about*☝ Definition Restless leg syndrome (RLS) or Willis-Ekbom disease(WED) is a common cause of painful legs. The leg pain of restless leg syndrome typically eases with motion of the legs and becomes more noticeable at rest. Restless leg syndrome also features worsening of symptoms and leg pain during the early evening or later at night. Restless leg syndrome Restless leg syndrome is often abbreviated RLS; it has also been termed shaking leg syndrome. Night time involuntary jerking of the legs during sleep is also known as periodic leg/limb movement disorder. History The first known medical description of RLS was by Sir Thomas Willis in 1672. Willis emphasized the sleep disruption and limb movements experienced by people with RLS. Initially published in Latin (De Anima Brutorum, 1672) but later translated to English (The London Practice of Physick, 1685), The term “fidgets in the legs” has also been used as early as the early nineteenth century. Subsequently, other descriptions of RLS were published, including those by Francois Boissier de Sauvages (1763), Magnus Huss (1849), Theodur Wittmaack (1861), George Miller Beard (1880), Georges Gilles de la Tourette (1898), Hermann Oppenheim (1923) and Frederick Gerard Allison (1943). However, it was not until almost three centuries after Willis, in 1945, that Karl-Axel Ekbom (1907–1977) provided a detailed and comprehensive report of this condition in his doctoral thesis, Restless legs: clinical study of hitherto overlooked disease. Ekbom coined the term “restless legs” and continued work on this disorder throughout his career. He described the essential diagnostic symptoms, differential diagnosis from other conditions, prevalence, relation to anemia, and common occurrence during pregnancy. Epidemiology Except perhaps in Asian populations, RLS is a common disorder, occurring in about 10% of the population. The age-adjusted prevalence of RLS determined by telephone interviews in a random population of 1803 adults in Kentucky was 10%. A Canadian survey of 2019 adults estimated the prevalence of RLS symptoms at 17% for women and 13% for men. A population-based survey in West Pomerania, Germany, of 4107 subjects found an overall 10.6% prevalence. Using standardized questions in face-to-face interviews, Rothdach et al. reported an overall prevalence of 9.8% in 369 participants ages 65-83 years in Augsburg, Germany. In a study from Japan, 4612 participants living in urban residential areas were assessed for a single symptom of RLS by a self-administered questionnaire of the following two items: (1) Have you ever been told you jerk your legs or kick sometimes and (2) have you ever experienced sleep disturbance due to a creeping sensation or hot feeling in your legs? The prevalence of RLS ranged from 3% in women ages 20-29 years to 7% in women ages 50-59 years and correlated with age. In contrast to the first three studies, RLS had a higher prevalence in men than women, with the difference reaching significance in those 40-49 years old; in men there was no positive correlation with age. Face-to-face interviews of 157 consecutive individuals ages 55 years and older participating in a health screening program and 1000 consecutive individuals ages 21 years and older from a primary health care center in Singapore yielded much lower prevalence data. Using IRLSSG criteria, the prevalence of RLS in this predominantly Asian population was 0.6% in the older (1 male) and 0.1% (1 female) in the younger cohorts. In the Kentucky and Singapore studies, there was no gender difference; however, in the two German studies, the prevalence was higher in women and in the Japanese study it was higher in men. The Canadian study reported a significantly higher occurrence of bedtime leg restlessness in women. Types Restless legs syndrome (RLS) can be either primary or secondary, and the causes vary. Primary RLS is a neurological disorder. Although the majority of people with RLS begin to experience symptoms in their middle years, some may have signs of the problem in childhood. Their symptoms may slowly progress for years before becoming a regular occurrence. Secondary RLS tends to be more severe than the primary type and stems from another underlying condition, including the following: Anemia or low blood-iron levels Folate deficiency Nerve damage due to diabetes or other conditions Kidney disease or dialysis Attention deficit disorder (ADD) Attention deficit/hyperactivity disorder (ADHD) Pregnancy Rheumatoid arthritis Parkinson’s disease Risk factors RLS/WED can develop at any age, even during childhood. The disorder is more common with increasing age and more common in women than in men. Restless legs syndrome usually isn’t related to a serious underlying medical problem. However, RLS/WED sometimes accompanies other conditions, such as: Peripheral neuropathy: This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism. Iron deficiency: Even without anemia, iron deficiency can cause or worsen RLS/WED. If you have a history of bleeding from your stomach or bowels, experience heavy menstrual periods or repeatedly donate blood, you may have iron deficiency. Kidney failure: If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys don’t function properly, iron stores in your blood can decrease. This, with other changes in body chemistry, may cause or worsen RLS/WED. Causes The cause of restless leg syndrome is unknown in most people. However, restless leg syndrome has been associated with Pregnancy, Obesity, Smoking, Iron deficiency and anemia, Nerve disease, Polyneuropathy (which can be associated with hypothyroidism, heavy metal toxicity, toxins, and many other conditions), Other hormone diseases such as diabetes, and Kidney failure (which can be associated with vitamin and mineral deficiency). Some drugs and medications have been associated with restless leg syndrome including: Caffeine, Alcohol, H2-histamine blockers (such as ranitidine [Zantac] and cimetidine [Tagamet]), and certain antidepressants (such as amitriptyline [Elavil, Endep]). Occasionally, restless leg syndrome run in families. Recent studies have shown that restless leg syndrome appears to become more common as a person ages. Also, poor venous circulation of the legs (such as with varicose veins) can cause restless leg syndrome. Symptoms The International Restless Legs Syndrome Study Group described the following symptoms of restless legs syndrome (RLS): Strange itching, tingling, or “crawling” sensations occurring deep within the legs; these sensations may also occur in the arms. A compelling urge to move the limbs to relieve these sensations Restlessness — floor pacing, tossing and turning in bed, rubbing the legs Symptoms may occur only with lying down or sitting. Sometimes, persistent symptoms worsen while lying down or sitting and improve with activity. In very severe cases, the symptoms may not improve with activity. Other symptoms of RLS include the following: Sleep disturbances and daytime sleepiness Involuntary, repetitive, periodic, jerking limb movements that occur either in sleep or while awake and at rest; these movements are called periodic leg movements of sleep or periodic limb movement disorder. Up to 90% of people with RLS also have this condition. In some people with RLS, the symptoms do not occur every night but come and go. These people may go weeks or months without symptoms (remission) before the symptoms return again. Complications Restless legs syndrome rarely results in any serious consequences. However, in some cases severe and persistent symptoms can cause considerable mental distress, chronic insomnia, and daytime sleepiness. In addition, since restless legs syndrome (RLS) is worse when resting, people with severe RLS may avoid daily activities that involve long periods of sitting, such as going to movies or traveling long distances. Diagnosis and test There’s no single test for diagnosing restless legs syndrome. A diagnosis will be based on your symptoms, your medical and family history, a physical examination, and your test results. Your GP should be able to diagnose restless legs syndrome, but they may refer you to a neurologist if there’s any uncertainty. There are four main criteria your GP or specialist will look for to confirm a diagnosis. These are: an overwhelming urge to move your legs, usually with an uncomfortable sensation such as itching or tingling your symptoms occur or get worse when you’re resting or inactive your symptoms are relieved by moving your legs or rubbing them your symptoms are worse during the evening or at night Blood tests Your GP may refer you for blood tests to confirm or rule out possible underlying causes of restless legs syndrome. For example, you may have blood tests to rule out conditions such as anaemia, diabetes and kidney function problems. It’s particularly important to find out the levels of iron in your blood because low iron levels can sometimes cause secondary restless legs syndrome. Low iron levels can be treated with iron tablets. Sleep tests If you have restless legs syndrome and your sleep is being severely disrupted, sleep tests such as a suggested immobilisation test may be recommended. The test involves lying on a bed for a set period of time without moving your legs while any involuntary leg movements are monitored. Occasionally, polysomnography may be recommended. This is a test that measures your breathing rate, brain waves and heartbeat throughout the course of a night. The results will confirm whether you have periodic limb movements in sleep (PLMS). Treatment and medications Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms. Other non-drug RLS treatments may include: Leg massages Hot baths or heating pads or ice packs applied to the legs Good sleep habits A vibrating pad called Relaxis Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time. Drugs used to treat RLS include: Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain. Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed. Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness. Narcotic pain relievers may be used for severe pain. Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Neurontin, and Horizant. Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep. Lifestyle and home remedies Making simple lifestyle changes can help alleviate symptoms of RLS/WED. Try baths and massages: Soaking in a warm bath and massaging your legs can relax your muscles. Apply warm or cool packs: Use of heat or cold, or alternating use of the two, may lessen your limb sensations. Try relaxation techniques: such as meditation or yoga. Stress can aggravate RLS/WED. Learn to relax, especially before bedtime. Establish good sleep hygiene: Fatigue tends to worsen symptoms of RLS/WED, so it’s important that you practice good sleep hygiene. Ideally, have a cool, quiet, comfortable sleeping environment; go to bed and rise at the same time daily; and get adequate sleep. Some people with RLS/WED find that going to bed later and rising later in the day helps in getting enough sleep. Exercise: Getting moderate, regular exercise may relieve symptoms of RLS/WED, but overdoing it or working out too late in the day may intensify symptoms. Avoid caffeine: Sometimes cutting back on caffeine may help restless legs. Try to avoid caffeine-containing products, including chocolate and caffeinated beverages, such as coffee, tea and soft drinks, for a few weeks to see if this helps.

ABC OF : RESTLESS LEG SYNDROME vs SCIATICA. MAY BE USEFUL. *** Restless Legs Syndrome ( RLS ) :- SYMPTOMS OF RLS : People with restless legs syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations....... The sensations are usually worse at rest, especially when lying or sitting....... *** SCIATICA :- SYMPTOMS OF SCIATICA : Sciatica is a term that describes symptoms of PAIN, NUMBNESS, AND/OR WEAKNESS that RADIATE ALONG the SCIATIC NERVE FROM the LOWER BACK TO the BUTTOCKS AND LEG....... The vast MAJORITY of sciatica symptoms result from lower back DISORDERS BETWEEN the L4 AND S1 levels that put pressure on or cause irritation to a lumbar....... *** Six Most Common Causes of Sciatica :- 1. Lumbar herniated disc 2. Degenerative disc disease 3. Isthmic spondylolisthesis 4. Lumbar spinal stenosis 5. Piriformis syndrome 6. Sacroiliac joint dysfunction.......

please guide me my mother ( age 42 years )have Rest Less Leg syndrom since 8 months with loss of muscle power more in right leg she is on following medication since 6 month 1.pregabalin 75 mg plus methylcobalamin 750 mg HS 2. tablet toscal gem with calcium ,vit D3, and minerals symptoms 1 irregistable urge to move the legs 2 the urge is partially or totally relieved by movements 3) the urge to move legs is worse in the evening or at night than during the day or occurs only in the evening or at night 4 severe heel pain on both the legs with calf muscles pain 5 Symptoms cause significant distress or impairment in social, occupational, educational, academic. behavioral or other areas of functioning 6 Sleep disturbances and Daytime fatigue please give me the appropriate guidance for reliving the symptoms.

ABC OF : RESTLESS LEG SYNDROME ( RLS ). MAY BE USEFUL. *** Restless leg syndrome (RLS) IS A COMMON CAUSE OF PAINFUL LEGS. The LEG PAIN of restless leg syndrome TYPICALLY EASES WITH MOTION of the legs and becomes MORE NOTICEABLE AT REST. Restless leg syndrome also features WORSENING of symptoms and leg pain DURING the EARLY EVENING OR LATER AT NIGHT....... Restless leg syndrome is often abbreviated RLS; it has also been termed SHAKING LEG SYNDROME. Nighttime involuntary jerking of the legs during sleep are also known as PERIODIC LEG/LIMB MOVEMENT DISORDER....... ***** Restless leg syndrome (RLS) FACTS :- ** RLS s a condition marked by UNPLEASANT LEG SENSATIONS WHILE RESTING....... ** Restless leg syndrome frequency LEADS TO INSOMNIA....... ** The CAUSE of restless leg syndrome is UNKNOWN IN MOST INDIVIDUALS, BUT MANY CONDITIONS have been ASSOCIATED WITH IT....... ** SYMPTOMS of restless leg syndrome are aching and an URGE TO MOVE THE LOWER EXTREMITIES....... ** TREATMENT of RLS is DIRECTED TOWARDS ANY UNDERLYING ILLNESS, IF KNOWN....... ** MEDICATIONS are AVAILABLE FOR RLS....... ** HOME REMEDIES for restless leg syndrome INCLUDE :- QUITTING SMOKING, REDUCING CAFFEINE, WEIGHT REDUCTION for the overweight, WALKING, QUININE WATER, and IRON SUPPLEMENTATION for those that are iron deficient....... ** RLS IS GENERALLY NOT CONSIDERED CURABLE, MAY PERSISTS LIFELONG BUT TREATMENTS CAN SUBSTANTIALLY LESSEN OR ERADICATE SYMPTOMS....... **** D / D :- Other CONDITIONS that my MIMIC restless leg syndrome include :- POOR CIRCULATIONTO THE LOWER EXTREMITIES, PARKINSON'S DISEASE, FIBROMYALGIA, MUSCLE DISEASES, JOINT CONDITIONS, NERVE PROBLEMS such as PERIPHERAL NEUROPATHY caused by diabetes (DIABETIC NEUROPATHY), and CIRCULATION DIFFICULTIES. *** IN CHILDREN, RLS IS OFTEN MISDIAGNOSED AS "GROWING PAINS." ***** CONDITIONS ASSOCIATED WITH RLS :- * PREGNANCY, * OBESITY, * SMOKING, * IRON DEFICIENCY AND ANEMIA, * NERVE DISEASE, * POLYNEUROPATHY (which can be associated WITH HYPOTHYROIDISM, HEAVY METAL TOXICITY, TOXINS, and many other conditions), * other hormone diseases such as DIABETES, and * KIDNEY FAILURE (which can be associated WITH VITAMIN AND MINERAL DEFICIENCY). *** SOME DRUGS AND MEDICATIONS HAVE BEEN ASSOCIATED WITH RLS INCLUDING : CAFFEINE, ALCOHOL, H2-HISTAMINE BLOCKERS and CERTAIN ANTIDEPRESSANT (such as amitriptyline....... ** OCCASIONALLY, RLS RUN IN FAMILIES. ** RECENT STUDIES have SHOWN that restless leg syndrome appears to become MORE COMMON AS A PERSON AGES. Also, POOR VENOUS CIRCULATION OF THE LEGS (such as with VARICOSE VEINS) can cause restless leg syndrome....... *** SYMPTOMS OF RLS :- Many different symptoms are described by people with restless leg syndrome, for example: LEG PAIN, CRAMPS, TINGLING, ITCHY, BURNING....... DIAGNOSIS OF RLS :- The National Institutes of Health (NIH) SAYS that FOUR CRITERIA must be met FOR the DIAGNOSIS OF RLS in a person (ADULT or CHILD) : 1. A STRONG URGE TO MOVE LEGS. This urge OFTEN, but NOT ALWAYS, occurs with UNPLEASANT FEELINGS in legs. 2. WHEN the disorder is SEVERE, patient also may have the URGE TO MOVE her/his ARMS. SYMPTOMS that start or get WORSE WHEN patient is INACTIVE. The urge to move increases when she /he is sitting still or lying down and resting. 3. RELIEF FROM MOVING. Movement, ESPECIALLY WALKING, HELPS relieve the unpleasant feelings. 4. SYMPTOMS that start or get WORSE IN the EVENING OR AT NIGHT. Rx :- TREATMENT of restless leg syndrome is first DIRECTED TOWARDS ANY UNDERLYING ILLNESS, if known. FOR EXAMPLE: BLOOD TESTING to reveal underlying IRON DEFICIENCY ANEMIA may reveal the underlying cause. If VARICOSE VEINS are thought to be the cause, then SURGERY to repair the circulation may be considered. REDUCTION OR ELIMINATION of CAFFEINE, NICOTINE, and ALCOHOL from a person's diet can be very HELPFUL. STOPPING SMOKING can significantly diminish or prevent symptoms. Getting BETTER SLEEP and EXERCISE can HELP some persons affected by restless legs. ** PREGNANT WOMEN who do not sleep well at night AND other PEOPLE WITH SLEEP DISORDERS MAY DEVELOP RLS. MEDICATIONS USED TO TREAT RLS :- Considering the situation MEDICATIONS used to treat restless leg syndrome INCLUDE : NATURAL SUPPLEMENTS (such as IRON), CARBIDOPA-LEVODOPA, OPIOIDS, CARBAMAZEPINE, CLONAZEPAM, DIAZEPAM, TRIAZOLAM, TEMAZEPAM, BACLOFEN, BROMOCRIPTINE, CLONIDINE, GABAPENTIN, GABAPENTIN ENACARBIL, ROPINIROLE and PRAMIPEXOLE.......

WHAT IS RESTLESS LEGS SYNDROME? Restless legs syndrome (RLS) is a cause of insomnia (trouble sleeping) for many people. Restless legs syndrome is aching, twitching, tingling, burning, or prickling feelings in the lower leg muscles when you lie in bed. You have a strong urge to move your legs. This may also happen when you are sitting. Moving your legs or getting up and standing or walking may make your legs feel better, but not for long. True restless legs syndrome is different from night-time leg cramps or occasional sudden jerks of leg muscles at night. WHAT IS THE CAUSE? The exact cause of RLS is not known. It tends to run in families. It is more common after middle age and occurs more often in women than in men. Many people with RLS can remember having what they called growing pains in their legs during childhood. It may be that a nerve malfunction is involved. RLS has also been linked with alcohol dependence, smoking, too much caffeine (usually from drinking coffee), rheumatoid arthritis, anemia, and diabetes. Use of some medicines may make symptoms worse. The problem may get worse when you are not active for a long period of time. For example, it might get worse when you have been lying in bed, sitting in a theater, working at a desk, or riding in a car for a long time. WHAT ARE THE SYMPTOMS? Symptoms include: Strong urges to move your legs Aching, twitching, tingling, burning, prickling in the lower legs when you are lying down or sitting Relief from the symptoms when you move, especially if you get up and walk The symptoms start or get worse in the evening or at night. Leg cramps and occasional, sudden jerking of legs or arms are not symptoms of restless legs syndrome. A day of heavy exercise can lead to a tight cramp in your calf (sometimes called a charley horse). Stretching and jiggling the calf muscle helps the cramp ease off and usually you can go back to sleep without having a relapse. Many people also have an occasional night jerk where their arm, leg, or half their body twitches once as they are falling asleep. This may wake you up, but it is not serious. Almost always you can go back to sleep without a second occurrence. During sleep it is not unusual to have uncontrolled movements of your arms or legs. This is called periodic limb movements of sleep, or PLMS. Usually, you are not aware of these movements and you sleep through them. By themselves, they usually are not bothersome to the sleeper, although they may disturb a bed partner. People can have RLS or PLMS or both. Treatment of PLMS alone usually is not needed. HOW IS IT DIAGNOSED? The diagnosis of RLS is based on your medical history. Your healthcare provider will examine you and may order blood tests or other tests to check for an underlying medical problem, such as anemia, rheumatoid arthritis, or diabetes. HOW IS IT TREATED? Studies have found that over half of the people who have RLS describe their problems as mild or minor. If your symptoms are mild, you may not need medical treatment. Here are some things you can do that may help relieve your symptoms: Stretch or massage the leg muscles before going to sleep. Practice relaxation methods. Wear long socks to bed. Sometimes elastic compression socks up over the calf are helpful. Ask your provider about these socks. Use a covered hot water bottle or cold moist cloths on painful areas before you go to sleep. Take a warm bath before bedtime. If these steps do not help, your healthcare provider may prescribe medicine to relieve the symptoms and help you sleep better. Quite a few medicines have been tried as treatments. Some are helpful but none are a cure. Drugs that may be recommended are: Levodopa, a drug normally used for Parkinson’s disease Pramipexole and ropinirole Low-dose narcotic medicines or benzodiazepines, such as Valium Getting more iron if you are iron deficient sometimes helps ease the symptoms. If you have RLS every day and the usual treatments don’t help, the RLS is called refractory. Medicines that may be prescribed in this case include gabapentin and cabergoline. These are much more expensive medicines. HOW CAN I TAKE CARE OF MYSELF? Follow your healthcare provider's advice for relief of your RLS symptoms. You may need to: Avoid or cut back on caffeine (coffee, tea, cocoa, cola). Avoid or cut back on alcohol. Improve your general health by eating a healthy diet and exercising regularly. For many people who have RLS, it is a great relief just to learn that there are other RLS sufferers like themselves and that they are not alone. Also, it is good news to hear that RLS does not keep getting worse or become disabling. It does not lead to other diseases. If nondrug treatments work well enough, then not taking a drug for RLS is generally wise.