Restless Legs Syndrome (RLS) – or Willis-Ekbom disease – is a frustrating condition.
The symptoms of this neurological disorder can be unpleasant and even distressing. For some sufferers symptoms are mild, but for others they’re severe.
Restless Legs Syndrome affects up to 10% of people in the UK, including children, but is most common in women over the age of 40. People describe feeling sensations such as constant tickling, burning, fizzing, or even insects crawling over the skin. Some people also report pain or feeling hot or cold in the affected area. Symptoms are worse at night, interrupting sleep and causing tiredness and fatigue in the daytime. As a result, it’s also a sleep disorder.
RLS doesn’t just affect the legs – sufferers have reported odd sensations in their arms, head and other parts of the body.
We asked consultant neurologist Dr Lucio D’Anna of Dementech Neurosciences about RLS, what usually causes it, and what you can do at home to ease symptoms.
What is Restless Legs Syndrome?
‘Restless Legs Syndrome (RLS) is an “urge to move the legs. It’s usually accompanied by uncomfortable or unpleasant sensations in the legs”,’ says Dr D’Anna. He adds that symptoms must:
a) Begin or worsen during periods of rest in activities such as lying down or sitting.
b) Be partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
c) Occur exclusively or predominantly in the evening or night rather than during the day.
‘We must discount other medical or behavioural conditions first,’ he says. ‘These include myalgia (muscle pain), venous stasis (loss of function in the veins in the legs), leg edema (excess fluid), arthritis, leg cramps, positional discomfort, or habitual foot tapping.’
There are two types of Restless Legs Syndrome: primary and secondary. ‘Primary – or idiopathic RLS (idiopathic means the cause is unknown) – and secondary RLS, which causes the same symptoms as primary. The difference is that secondary RLS has an identifiable cause,’ he explains.
‘Medical Restless Legs Syndrome treatment, following a consultation with a neurologist, usually starts when symptoms interfere with a patient’s quality of life,’ says Dr D’Anna. ‘Diagnosis of RLS requires that its symptoms cause concern, distress, sleep disturbance, or other impairment. Mild or infrequent symptoms may not require treatment,’ he says, although the home remedies suggested below can help your symptoms.
What causes Restless Legs Syndrome?
‘The most common causes of Restless Legs Syndrome are pregnancy, iron deficiency, kidney failure and some types of medication. Also, sleep deprivation, peripheral neuropathy (nerve damage) and varicose veins,’ says Dr D’Anna. If any of these apply to you and you are getting restless legs, speak to your GP.
Evidence also links Restless Legs Syndrome to the brain chemical dopamine and dopamine receptors. Dopamine plays a part in muscle movement. According to an article in John Hopkins Medicine “marked improvement in RLS symptoms were seen with drugs that stimulate the dopamine system.”
Alcohol, nicotine, and caffeine can also trigger the condition, as can extreme temperatures.
Restless Legs Syndrome in kids
Restless Legs Syndrome in children is closely linked to other ailments. ‘Recent evidence demonstrates that restless sleep in children is commonly seen in association with other medical or sleep disorders,’ says Dr D’Anna. ‘These are sleep-disordered breathing, respiratory tract disorder, sleep-related movement disorder, neurologic or psychiatric disorders, neurodevelopmental disorder or other medical disorders,’ he explains.
According to the RLS charity RLS-UK, Restless Legs Syndrome is often mistaken for Attention Deficiency Hyperactivity Disorder (ADHD) in children. In fact, the charity website states that “recent research by sleep specialists indicates that at least 25% of the children who have a diagnosis of ADHD may truly have Restless Legs Syndrome.” This is because “children with RLS tend to seek relief from their discomfort by moving their legs – often by fidgeting, stretching, walking, running, rocking or changing position in bed.” They may also “sleep less well and are tired and hyperactive during the day,” reports the charity.
If your child is experiencing symptoms it’s important that they see a GP. If your child is low in iron this can result in Restless Legs Syndrome, as can the side effects of some drugs. For example, certain over-the-counter medicines for allergies or colds. Your child should avoid anything that contains caffeine, such as chocolate and cola, and go to bed only to sleep – so no reading or watching TV in bed.
Restless Legs Syndrome treatment: How to stop restless legs with home remedies
‘Regular daily exercise can help,’ says Dr D’Anna. ‘But avoid exercising close to bedtime,’ he warns. Talk to your doctor about a plan that could work for you.
2. Find ways to relax
‘Relaxation exercises, such as yoga or tai chi, may help relieve your symptoms,’ says Dr D’Anna. So can ‘activities that distract your mind, such as reading or watching television,’ he suggests. A leg massage late in the day may also relax you and reduce RLS symptoms.
3. Say goodbye to stimulants
‘Avoid stimulants in the evening, such as caffeine, tobacco and alcohol,’ says Dr D’ Anna. In some cases, caffeine makes the symptoms of Restless Legs Syndrome worse. Try to avoid drinking tea and coffee and see if it makes a difference. Alcohol can also cause issues so consider giving up booze. According to the RLS-UK website, “alcohol consumption also increases the span or intensity of symptoms for most individuals” and smoking won’t help your symptoms either, so cut down or give up. These NHS services can help you quit.
4. Try hot and cold therapy
A warm bath before bed can help you relax and may ease symptoms. Alternatively, ‘apply a hot or cold compress to your leg muscles,’ says Dr D’Anna. You can also alternate between hot and cold compresses to relieve the twitching or pain.
5. Give magnesium a go
There is some evidence to suggest that a magnesium deficiency causes RLS in some people, while another study indicated that “magnesium treatment may be a useful alternative therapy in patients with mild or moderate RLS insomnia.” Experiment with a magnesium supplement – the recommended daily amount for women is 270mg – though it’s advisable to check with a health professional beforehand, particularly if you’re pregnant or breastfeeding.
Magnesium is known to relax the muscles thus easing symptoms so it’s worth trying transdermal magnesium, which is absorbed directly through the skin to the blood vessels and muscles. Try BetterYou’s Magnesium Oil Body Spray (£12.99, 100ml) or another product in the BetterYou Magnesium range.
Alternatively, add more magnesium-rich foods to your diet, such as leafy greens, nuts, bananas, and salmon and mackerel. Avoid too much sugar, alcohol, caffeine and stress, which can deplete magnesium levels.
6. Get your iron levels checked
‘New insights into the pathophysiology of RLS found an involvement of abnormal iron metabolism, multiple neurotransmitters, and the central opiate system (which controls pain),’ says Dr D’Anna. ‘Also, several genetic variants are associated with an increased risk of RLS, mainly neural development and iron metabolism.’
According to the World Health Organisation, 40% of pregnant women worldwide are anaemic. It’s also common in menstruating women. Get your iron levels checked and if you’re deficient choose a good quality supplement, such as Spatone natural liquid iron supplement with vitamin C (£8.99, Amazon). Eat plenty of iron-rich foods, including red meat, liver (though avoid liver during pregnancy), beans, nuts, dried fruit and fortified breakfast cereals.
7. Practice good sleep habits
A lack of sleep can have numerous detrimental effects. ‘Try going to bed and getting up at the same time every day, not napping during the day, and taking time to relax before going to bed,’ advises Dr D’Anna.
8. Avoid certain medications
‘Avoid medicines that trigger the symptoms or make them worse,’ says Dr D’Anna. ‘If you think medication is causing your symptoms, continue to take it and see your GP,’ he advises. Don’t come off prescribed medications without the advice of a health professional.
Culprits include some antacids, antidepressants, antihistamines, cold and sinus medicine, anti-psychotic medicine and anti-nausea drugs. If you’re on any of these and think they are making your symptoms worse, speak to your doctor about possible alternatives.