All You Need To Know About Restless Leg Symptom (RLS)….. -Dr Kelechi Williams Igbokwe

Restless legs syndrome (RLS) also known as WILLIS-EKBOM disease, was named after Professor Karl-Axel Ekbom (born September 23, 1907) a Swedish neurologist who first described the disease in 1941.

WHAT IS RLS? Restless Leg syndrome (RLS) is a medical condition with sleep related disorder, characterized by an irresistible urge (push, desire) to move the legs which worsens especially when at rest or inactive (not doing anything). RLS isn’t just limited to the legs, it can start from one of the legs and then move to the other leg, it can also happen on both legs at the same time and can also affect other parts of the body (the hands, head, chest etc). Symptoms worsen towards evening and at night, causing sleep disturbances (marking it difficult for the individual to have a good sleep or to sleep at all). RLS affects all age groups and gender, but it’s occurrence is more in women and symptoms worsen when you get older.

Individuals who have RLS complain of feeling some abnormal and uncomfortable sensation in their legs after they have been inactive for long (eg: sitting in a movie theatre, travelling in a car or driving in traffic). These feelings they describe as crawling, burning, cramps, arching, itching, pulling, creeping, pins and needles, electric….. Whenever they have these uncomfortable sensations, they have the urge to move their legs or affected part of the body so as to make the sensation go away.

Here are some movements people with RLS make to temporarily relieve symptoms:

– Pace around

– Perform repetitive movements

– Move affected areas vigorously (like shaking or tapping the legs)

– Stretching

– Bending

– Rocking their legs…

WHAT CAUSES RLS?

No specific cause has been identified or implicated as a cause for RLS, however researchers suggest that a chemical in the Central nervous system-CNS (the brain and spinal cord) called Dopamine, responsible for transmitting nerve impulses to different parts of the body has a huge role to play in it.

– Hereditary: If any parent has RLS, There is a 50% chance of you transferring it to your unborn babies with each pregnancy.

– Iron Deficiency Anemia (shortage of blood caused by low iron) This is the most common cause of RLS in our environment.

– Kidney failure

– Pregnancy (pregnancy can cause iron Deficiency anemia)

– Drugs: Such as antidepressants, antipsychotic and anti nausea medications.

WHAT ARE THE SYMPTOMS OF RLS?

– Insomnia (difficulty/inability to sleep at night)

– Disrupted sleep pattern: This happens following frequent waking up at night because of the uncomfortable sensations that wakes the individual up with the urge to move around to relieve symptoms temporarily. This act, disrupts the person’s sleep.

– Excessive sleeping during the day: Lack of proper sleep at night makes the individual sleepy all thru the day.

– Repetitive movements of legs or any affected part of the body when sleeping (eg: bending the knee, hip ankle, extending big toe)

– Muscle jerks or uncontrollable movements of a particular muscle.

– Repeated tapping of the affected leg or any other part of the body.

Patients with mild to moderate symptoms experience less impact or interruptions in their sleep pattern, while those with severe symptoms have limitations in physical activities, body pains etc and symptoms afftect their general, societal and emotional well being. In Children, these symptoms can affect a child’s sleep, behaviour and concentration. This can affect the child’s performance with his/her school work.

HOW DO I KNOW I HAVE RLS?

Well you may wanna ask yourself some of these questions whenever you notice any of the above symptoms.

1. Do I have the desire to move my legs often that does not always come with an uncomfortable and unpleasant sensation in the leg?

2. Do I have the desire to move my legs, followed by an unpleasant sensation that starts or gets worse when I rest or when I am inactive (ie: lying down or sitting)?

3. Do I feel the desire to move my legs, followed by an uncomfortable sensation that relieves totally or partially when I move (walk, stretch, bend..etc)?

4. Do I feel the desire to move my legs, followed by an unpleasant sensation when I am resting which only happens or gets worse in the evening or at night more than during the day time?

HOW CAN RLS BE TREATED?

Treatment and management of RLS can be achieved with lifestyle remedies and medications. However for the purpose of this article and our environment I am limited to mention certain medications (so as to prevent people from self medicating). Medical treatments are basically aimed at managing the risk factors.

NOTE that you need to go see your doctor once you start noticing or feeling any of these symptoms.

Here are Some Lifestyle Remedies to Try:

– Warm Bath

– Massage the affected legs or part of the body: this helps relax the muscles.

– Apply warm or cold compress on affected part of the body: this helps reduce the sensation.

– Stay away from caffeine and caffeine containing products (chocolate, coffee, tea, soft drinks) for a while.

– Stay away from Nicotine containing substances.

– Stay away from alcohol.

NOTE: Caffeine, Alcohol and Nicotine are known to worsen symptoms of RLS.

– Exercise: Regular but moderate exercises can help. Please don’t do intense workout routines or work out at night as these may increase symptoms.

– Practice a good sleep routine: make sure your environment is quiet and every distraction (eg: phones, laptops, tv etc) kept away whenever, you want to sleep. Try to get up to 7 to 8 hours of sleep. If you find it difficult to sleep, I usually encourage my patients to lay facing the ceiling and count down from 100 to 0…… (this usually works as they come back saying they never knew when they slept off).

WHAT ARE THE COMPLICATIONS OF RLS?

Lack of sleep or difficulty to sleep (Insomnia) can affect an individual’s quality of life and can predispose them to:

– Depression

– Anxiety

– Reduced productivity.

HOW DO I HANDLE RLS?

1. Don’t resist the urge to move: when you try to resist or suppress the desire to move, it may worsen the symptoms.

2. Start and end your day with exercise and a massage.

3. Talk to your family, friends, loved ones and colleagues about your condition so they can better understand what you are going thru and help you with it

4. SEEK HELP!!!!

Note: My main aim and desire is to see you be safe, and live a healthy and good quality of life…

Thanks – Dr Kelechi Williams Igbokwe

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