On Restless Leg Syndrome (Series: Pt .1)

This blog post series features segmented parts of the article titled “Restless Leg Syndrome”, by Gary Polk, M.D. published in Panhandle Health, Winter 2012
Gary Polk, M.D.

Gary Polk, M.D., Amarillo Diagnostic Clinic P.A.

The Problem of RLS

“What’s the matter with you? Can’t you sit still? Quit wiggling your feet and relax!”

Maybe you’ve heard these words before and wanted to comply but couldn’t. A common disorder known as the Restless Legs Syndrome (RLS) may be the culprit.

The symptoms of RLS had been noted in the medical literature for centuries, but the clinical syndrome was first characterized by Ekbom in 1945. There are several complaints that make up the RLS symptom complex. The first is an urge to move due to an uncomfortable feeling while at rest. Terms used to describe the sensation are jittery, creepy crawly, internal itching or shock-like feelings. Many patiences describe the feeling as being painful. Other parts of the body can be affected, predominantly the arms.

A second characteristic associated with RLS is that the symptoms worsen if the person is required to remain still. People with RLS typically dread certain situations such as traveling long distances in a car or an airplane. Sitting in meetings or church services can be extremely difficult. The urge to move and the unpleasant leg sensations are relieved by activity. Often walking around is required but sometimes symptoms can be relieved by stretching of the legs or calf muscles or even wiggling the feet back and forth. A person may begin to experience relief immediately upon movement, but often the relief of the symptoms is temporary with the patient remaining symptom free for 30 to 60 minutes only.

Worsening in the Evening

A cardinal feature of RLS is that the symptoms worsen in the evening. Several factors may be involved including less activity in the evening with less commotion to distract the sufferer from their symptoms. There may also be a circadian rhythm to the symptoms of RLS. Studies have shown that the severity of leg discomfort does follow a circadian pattern with worsening of symptoms after midnight. An increase in the production of melatonin preceded the increase in symptoms, and a relationship between melatonin production and RLS symptoms has been proposed.

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