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http://www.fitango.com/categories.php?id=369 Fitango Education Health Topics Restless Leg Syndrome

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Page 1: Restless Leg Syndrome

http://www.fitango.com/categories.php?id=369

Fitango EducationHealth Topics

Restless Leg Syndrome

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Overview

Restless legs syndrome (RLS) causes a powerful urge

to move your legs. Your legs become uncomfortable when you are lying down or

sitting. Some people describe it as a creeping, crawling, tingling or burning

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Overview

sensation. Moving makes your legs feel better, but not for long.

In most cases, there is no known cause for RLS. In

other cases, RLS is caused by a disease or condition, such as anemia or

pregnancy. Some medicines can also cause temporary RLS. Caffeine, tobacco and

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Overview

alcohol may make symptoms worse.

Lifestyle changes, such as regular sleep habits,

relaxation techniques and moderate exercise during the day can help. If those

don't work, medicines may reduce the symptoms of RLS.

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Causes**Faulty Use of Iron or Lack of Iron**

Research suggests that the main cause of

restless legs syndrome (RLS) is a faulty use of iron or a lack of iron in the

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Causes**Faulty Use of Iron or Lack of Iron**

brain. The brain uses iron to make the chemical dopamine (DO-pah-meen) and to

control other brain activities. Dopamine works in the parts of the brain that

control movement.

Many conditions can affect how much iron is

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Causes**Faulty Use of Iron or Lack of Iron**

in the brain or how it's used. These conditions include kidney failure, Parkinson's

disease, diabetes, rheumatoid arthritis, pregnancy, and iron deficiency. All of

these conditions increase your risk of RLS.

People whose family members have RLS also

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Causes**Faulty Use of Iron or Lack of Iron**

are more likely to develop the disorder. This suggests that genetics may

contribute to the faulty use of iron or lack of iron in the brain that triggers

RLS.

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Causes**Nerve Damage**

Nerve damage in the legs or feet and

sometimes in the arms or hands may cause or worsen RLS. Several conditions can

cause this type of nerve damage, including diabetes.

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Causes**Medicines and Substances**

Certain medicines may trigger RLS. These

include some:

Antinausea medicines (used to treat upset

stomach)

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Causes**Medicines and Substances**

Antidepressants (used to treat depression)

Antipsychotics (used to treat certain

mental health disorders)

Cold and allergy medicines that contain

antihistamines

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Causes**Medicines and Substances**

Calcium channel blockers (used to treat

heart problems and high blood

pressure)

RLS symptoms usually get better or may even

go away if the medicine is stopped.

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Causes**Medicines and Substances**

Certain substances, such as alcohol and

tobacco, also can trigger or worsen RLS symptoms. Symptoms may get better or go

away if the substances are stopped.

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Risks

Restless legs syndrome (RLS) affects about 5–15 percent of

Americans. Many people who have RLS have family members with the disorder.

RLS can affect people of any racial or ethnic group, but the

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Risks

disorder is more common in people of Northern European descent. RLS affects

both genders, but women are more likely to have it than men.

The number of cases of RLS rises with age. Many people who have

RLS are diagnosed in middle age. People who develop RLS early in life tend to

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Risks

have a family history of the disorder.

People who have certain diseases or conditions or who take certain

medicines are more likely to develop RLS. (For more information, go to "What Causes

Restless Legs Syndrome?")

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Risks

For example, pregnancy is a risk factor for RLS. It usually occurs

during the last3 months of

pregnancy. The disorder usually improves or goes away after giving birth. Some

women may continue to have symptoms after giving birth. Other women may develop

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Risks

RLS again later in life.

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Symptoms

The four key signs of restless legs

syndrome (RLS) are:

-- A strong urge to move your legs. This urge

often, but not always, occurs with unpleasant feelings in your legs. When the

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Symptoms

disorder is severe, you also may have the urge to move your arms.

-- Symptoms that start or get worse when

you're inactive. The urge to move increases when you're sitting still or lying

down and resting.

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Symptoms

-- Relief from moving. Movement, especially

walking, helps relieve the unpleasant feelings.

-- Symptoms that start or get worse in the

evening or at night.

-- You must have all four of these signs to be

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Symptoms

diagnosed with RLS.

**The Urge To Move**

RLS gets its name from the urge to move the

legs when sitting or lying down. This movement relieves the unpleasant feelings

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Symptoms

that RLS sometimes causes. Typical movements are:

-- Pacing and walking

-- Jiggling the legs

-- Stretching and flexing

-- Tossing and turning

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Symptoms

-- Rubbing the legs

-- Unpleasant Feelings

People who have RLS describe the unpleasant

feelings in their limbs as creeping, crawling, pulling, itching, tingling,

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Symptoms

burning, aching, or electric shocks. Severe RLS may cause painful feelings.

However, the pain usually is more of an ache than a sharp, stabbing pain.

Children may describe RLS symptoms

differently than adults. In children, the condition may occur with

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Symptoms

hyperactivity. However, it's not fully known how the disorders are related.

The unpleasant feelings from RLS often

occur in the lower legs (calves). But the feelings can occur at any place in

the legs or feet. They also can occur in the arms.

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Symptoms

The feelings seem to come from deep within

the limbs, rather than from the surface. You usually will have the feelings in

both legs. However, the feelings can occur in one leg, move from one leg to the

other, or affect one leg more than the other.

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Symptoms

People who have mild symptoms may notice

them only when they're still or awake for a long time, such as on a long

airplane trip or while watching TV. If they fall asleep quickly, they may not

have symptoms when lying down at night.

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Symptoms

The unpleasant feelings from RLS aren't the

same as the leg cramps many people get at night. Leg cramps often are limited

to certain muscle groups in the leg, which you can feel tightening. Leg cramps

cause more severe pain and require stretching the affected muscle for relief.

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Symptoms

Sometimes arthritis or peripheral

arterial disease (P.A.D.) can cause pain or discomfort in the legs.

Moving the limbs usually worsens the discomfort instead of relieving it.

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Symptoms**Periodic Limb Movement in Sleep**

Many people who have RLS also have a

condition called periodic limb movement in sleep (PLMS). PLMS causes your legs

or arms to twitch or jerk about every10 to 60 seconds during sleep. These

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Symptoms**Periodic Limb Movement in Sleep**

movements cause you to wake up often and get less sleep.

PLMS usually affects the legs, but it also

can affect the arms. Not everyone who has PLMS also has RLS.

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Symptoms**Related Sleep Problems**

RLS can make it hard to fall or stay

asleep. If RLS disturbs your sleep, you may feel very tired during the day.

Lack of sleep may make it hard for you to

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Symptoms**Related Sleep Problems**

concentrate at school or work. Not enough sleep also can cause depression, mood

swings, and other health problems such as diabetes or high blood

pressure.

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Diagnosis

Your doctor will diagnose restless legs

syndrome (RLS) based on your signs and symptoms, your medical and family

histories, a physical exam, and test results.

Your doctor will use this information to

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Diagnosis

rule out other conditions that have symptoms similar to those of RLS.

**Specialists Involved**

Your primary care doctor usually can

diagnose and treat RLS. However, he or she also may suggest that you see a

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Diagnosis

sleep specialist or neurologist.

**Signs and Symptoms**

You must have the four

key signs of RLS to be diagnosed with the disorder.

Your doctor will want to know how your

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Diagnosis

symptoms are affecting your sleep and how alert you are during the day.

To help your doctor, you may want to keep a

sleep diary. Use the diary to keep a daily record of how easy it is to fall and

stay asleep, how much sleep you get at night, and how alert you feel during the

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Diagnosis

day.

For a sample sleep diary, go to the

National Heart, Lung, and Blood Institute's"Your

Guide to Healthy Sleep."

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Diagnosis**Medical and Family Histories**

Your doctor may ask whether you have any of

the diseases or conditions that can trigger RLS. These include kidney failure,

Parkinson's disease, diabetes, rheumatoid arthritis, pregnancy, and iron

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Diagnosis**Medical and Family Histories**

deficiency.

Your doctor also may want to know what

medicines you take. Some medicines can trigger or worsen RLS.

The most common type of RLS tends to run in

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Diagnosis**Medical and Family Histories**

families. Thus, your doctor may ask whether any of your relatives have RLS.

**Physical Exam**

Your doctor will do a physical exam to

check for underlying conditions that may trigger RLS. He or she also will check

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Diagnosis**Medical and Family Histories**

for other conditions that have symptoms similar to those of RLS.

**Diagnostic Tests**

Currently, no test can diagnose RLS. Still,

your doctor may recommend blood teststo

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Diagnosis**Medical and Family Histories**

measure your iron levels. He or she also may suggest muscle or nerve tests.

These tests can show whether you have a condition that can worsen RLS or that

has symptoms similar to those of RLS.

Rarely, sleep

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Diagnosis**Medical and Family Histories**

studies are used to help diagnose RLS. A sleep study measures how much

and how well you sleep. Although RLS can cause a lack of sleep, this sign isn't

specific enough to diagnose the condition.

Researchers continue to study new ways to

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Diagnosis**Medical and Family Histories**

diagnose RLS.

**Drug Therapy Trial**

If your doctor thinks you have RLS, he or

she may prescribe certain medicines to relieve your symptoms. These medicines,

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Diagnosis**Medical and Family Histories**

which are used to treat people who have Parkinson's disease, also can relieve

RLS symptoms. If the medicines relieve your symptoms, your doctor can confirm

that you have RLS.

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Treatment

Restless legs syndrome (RLS) has no cure.

If a condition or medicine triggers RLS, it may go away or get better if the

trigger is relieved or stopped.

RLS can be treated. The goals of treatment

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Treatment

are to:

-- Prevent or relieve symptoms

-- Increase the amount of sleep you're getting

and improve the quality of your sleep

-- Treat or correct any underlying condition

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Treatment

that may trigger or worsen RLS

Mild cases of RLS often are treated with

lifestyle changes and sometimes with periodic use of medicines. More severe RLS

usually is treated with daily medicines.

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Treatment**Lifestyle Changes**

Lifestyle changes can prevent or relieve

the symptoms of RLS. For mild RLS, lifestyle changes may be the only treatment

needed.

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Treatment**Preventing Symptoms**

Many common substances, such as alcohol and

tobacco, can trigger RLS symptoms. Avoiding these substances can limit or

prevent symptoms.

Some prescription and over-the-counter

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Treatment**Preventing Symptoms**

medicines can cause or worsen RLS symptoms. Tell your doctor about all of the

medicines you're taking. He or she can tell you whether you should stop or

change certain medicines.

Adopting good sleep habits can help you

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Treatment**Preventing Symptoms**

fall asleep and stay asleep—a problem for many people who have RLS. Good sleep habits

include:

-- Keeping the area where you sleep cool,

quiet, comfortable, and as dark as possible.

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Treatment**Preventing Symptoms**

-- Making your bedroom sleep-friendly. Remove

things that can interfere with sleep, such as a TV, computer, or phone.

-- Going to bed and waking up at the same time

every day. Some people who have RLS find it helpful to go to bed later in the

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Treatment**Preventing Symptoms**

evening and get up later in the morning.

-- Avoiding staying in bed awake for long

periods in the evening or during the night.

-- Doing a challenging activity before

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Treatment**Preventing Symptoms**

bedtime, such as solving a crossword puzzle, may ease your RLS symptoms. This

distraction may make it easier for you to fall asleep. Focusing on your

breathing and using other relaxation techniques also may help you fall asleep.

-- Regular, moderate physical activity also can

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Treatment**Preventing Symptoms**

help limit or prevent RLS symptoms. Often, people who have RLS find that if

they increase their activity during the day, they have fewer symptoms.

-- Relieving Symptoms

Certain activities can relieve RLS

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Treatment**Preventing Symptoms**

symptoms. These include:

-- Walking or stretching

-- Taking a hot or cold bath

-- Massaging the affected limb(s)

-- Using heat or ice packs on the affected

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Treatment**Preventing Symptoms**

limb(s)

-- Doing mentally challenging tasks

-- Choose an aisle seat at the movies or on

airplanes and trains so you can move around, if necessary.

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Treatment**Medicines**

You may need medicines to treat RLS if

lifestyle changes can't control symptoms. Many medicines can relieve or prevent

RLS symptoms.

No single medicine works for all people who

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Treatment**Medicines**

have RLS. It may take several changes in medicines and dosages to find the best

approach. Sometimes, a medicine will work for a while and then stop working.

Some of the medicines used to treat RLS

also are used to treat Parkinson's disease. These medicines make dopamine or

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Treatment**Medicines**

mimic it in the parts of the brain that control movement. (Dopamine is a chemical

that helps you move properly.)

If medicines for Parkinson's disease don't

prevent or relieve your symptoms, your doctor may prescribe other medicines.

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Treatment**Medicines**

You may have to take more than one medicine to treat your RLS.

Always talk with your doctor before taking

any medicines. He or she can tell you the side effects of each RLS medicine.

Side effects may include nausea (feeling sick to your stomach), headache, and

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Treatment**Medicines**

daytime sleepiness.

In some cases, RLS medicines may worsen

problems with excessive gambling, shopping, or sexual activity. Sometimes,

continued use of RLS medicines may make your RLS symptoms worse.

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Treatment**Medicines**

Contact your doctor if you have any of

these problems. He or she can adjust your medicines to prevent these side

effects.

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Living and coping

Restless legs syndrome (RLS) often is a

lifelong condition. Symptoms may come and go often or go away for long periods.

Symptoms often get worse over time.

If a condition or medicine triggers RLS,

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Living and coping

the disorder may go away if the trigger is relieved or stopped. For example,

RLS that occurs due to pregnancy tends to go away after giving birth.

Although RLS has no cure, treatments can

relieve or prevent RLS symptoms. Mild cases of RLS often are treated with

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Living and coping

lifestyle changes and sometimes with periodic use of medicines. More severe RLS

usually is treated with daily medicines. (For more information, go to "How

Is Restless Legs Syndrome Treated?")

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Living and coping**Ongoing Medical Care**

If you have RLS, see your doctor regularly

so he or she can watch for changes in your symptoms. This will show whether

your treatment is working and whether it will continue to work over time.

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Living and coping**Ongoing Medical Care**

Call your doctor if you notice your

treatment is no longer working or if you have new symptoms.

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Living and coping**Other Considerations**

Try to plan long car trips and other long

periods of inactivity at the times of day when your symptoms are least severe.

Give yourself time to stretch or take walking breaks.

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Living and coping**Other Considerations**

Choose an aisle seat at the movies or on

airplanes and trains so you can move around if needed.

Consider finding a work setting where you

can stand or walk around.

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Living and coping**Emotional Issues and Support**

Living with RLS may cause anxiety and

stress. It's important to talk about how you feel with your health care team.

Joining a patient support group may help

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Living and coping**Emotional Issues and Support**

you adjust to living with RLS. You can see how other people who have the same

symptoms have coped with them. Talk with your doctor about local support groups

or check with an area medical center.

Support from family and friends also can

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Living and coping**Emotional Issues and Support**

help relieve stress and anxiety. Let your loved ones know how you feel and what

they can do to help you.

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