Restless legs syndrome (RLS) is characterized by unpleasant sensations in the legs and an irresistible urge to move them. Individuals affected with the disorder often describe the sensations as throbbing, pulling, or creeping. The sensations range in severity from uncomfortable to irritating to painful.
Symptoms commonly occur in late afternoon or evening and are most severe at night, when the person is resting. Moving the legs or walking typically relieves the discomfort but the symptoms often recur. RLS is both a sleep and a neurological sensory disorder.
RLS is generally a life-long condition for which there is no cure. Symptoms may gradually worsen with age. Some individuals have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear. If RLS symptoms are mild, do not produces significant daytime discomfort, or do not affect an individual’s ability to fall asleep, the condition may not have to be treated.
Treatment is directed toward symptom relief. For those with mild to moderate symptoms, many physicians suggest certain lifestyle changes and activities to reduce or eliminate symptoms. Decreased use of caffeine, alcohol, and tobacco may provide some relief. A trial of iron supplements is recommended for individuals with low or low-normal blood tests. Exercise may also provide relief from mild symptoms.
The Food and Drug Administration (FDA) has approved ropinirole, pramipexole, gabapentin enacarbil, and rotigotine to treat moderate to severe RLS. Drugs that increase the effect of dopamine (called dopaminergic agents) also have been approved to reduce symptoms of RLS. Certain opioid and benzodiazepine drugs may help individuals obtain a more restful sleep but their use must be monitored by a physician.
The FDA also has approved medical devices to treat RLS, including a foot wrap that puts pressure underneath the foot and a pad that delivers vibration to the back of the legs.