The Multiple Signs and Symptoms of Restless Leg Syndrome

Restless Leg Syndrome or RLS involves pain in the leg(s) that results in restlessness and an uncomfortable condition. The painful symptoms and conditions accompanying RLS cause a huge toll on the health of the individuals concerned.

An overview of RLS symptoms in brief:

• A painful sensation in the legs urging them to keep in constant motion
• The pain causes difficulty in sleeping or lying down
• Lack of sleep during the night, resulting in daytime sleepiness
• An unpleasant and restless feeling in the legs, which usually worsens at night.

The very name RLS sources from the restlessness that is caused to the limbs due to the diseased condition. There is a great relief associated with the movement of the legs while the pain is constantly on its attack mode.

Patients find short-term relief from the pain by moving their legs, repeatedly tossing and turning, and stretching and flexing. Sometimes a fast-paced walk also offers respite to the uncomfortable situation. Other movements may include, jiggling of the legs, or rubbing the legs violently to get relief from the tremendous pain.

In addition to the strong inner urge to go for a walk, run fast or to make some alternative movement with the legs, there can be many unwanted and unpleasant sensations that might accompany this extreme condition. Sometimes a burning, creeping and aching feeling may strike the limbs from within, and at other times, a strange pull on the legs may leave the limb temporarily disabled and disturbed.

There are times when the pain and the overall condition go beyond any explanation or expression. It becomes impossible to bear the condition silently at rest without moving the legs from their resting status.

Children are also at risk of being affected with the syndrome - though the symptoms and signs in children are completely different from that of adults.

The severe condition of a painful sensation in the legs generally occurs in the lower calf of the legs, but the ripple of the pain is spread all across the legs, in the thigh and ankle. Even the arms may be affected.

The RLS sensation does not allow people to lie down in rest or enjoy a deep sleep at night. It causes sleeplessness and the patient finds it hard to fall asleep. There is a consistent daytime drowsiness associated with RLS - this is due to the lack of normal sleep at night.

Does Restless Leg Syndrome Send Nocturnal Blood Pressure Up?

It is a widely asked question whether Restless Leg Syndrome (RLS) contributes to the increase in Nocturnal Blood Pressure? A valid answer to the question can be extracted from the reports of Paola A. Lanfranchi, M.D., M.Sc., of the Hôpital du Sacré Coeur de Montréal, and colleagues. Their report published in the April 10 issue of Neurology clearly suggests that RLS may raise nocturnal blood pressure.

The population-based studies show a greater risk of coronary artery disease and hypertension with RLS. However, the reasons behind the higher risk have yet to be explored. In order to establish the relationship between RLS and increased blood pressure the researchers conducted a study on six men and four women. The study involved measuring of changes in both blood pressure and heart rate with periodic leg movements while sleeping. The average age of the patients was 47.3 years and they spent one night at the sleep lab.

Changes in blood pressure related to periodic leg movements during sleep were evaluated with the help of paired t-tests. Relationships between polysomnographic variables and cardiovascular changes were also calculated using Pearson correlation coefficients. These assessments revealed that the blood pressure rises to a significant extent with increased movements during sleep, with or without EEG signs of arousal from sleep.

The investigation showed that periodic leg movements during sleep cause a repetitive increase in cardiac afterload. This could affect the cardiac function and contribute to disease progression in heart transplant and systolic heart failure.

However, the study was conducted on a small sample size and this restricts the accuracy of the correlation or power analyses. Another limitation of the study was that the patients of RLS were untreated during sleep.

Reference: www.neurology.org

Is There A Relationship Between RLS And Rheumatoid Arthritis?

Restless Leg Syndrome is a distressing condition of the legs that is temporarily relieved by movement of the legs. The relationship between RLS and rheumatoid arthritis can be assessed from research that was conducted on three groups of patients. The first group comprised 70 consecutive cases of definite or classical rheumatoid arthritis admitted to the hospital. The group had 10 men and 60 women with a mean age of 59 years. The second group included 30 patients (4 men and 26 women) of osteoarthritis. Most of them were suffering from osteoarthritis of hips or knees and immobility, with a mean age of 68 years. The third group had 70 normal controls from the general population with rheumatoid arthritis. The age and sex of the patients in the group were matched.

The dysesthetic symptoms of RLS were evaluated in the group using standard questionnaire. Further, subjects related with such symptoms were also examined to eliminate clinically apparent polyneuropathy. Since RLS is a period condition, it was assessed whether any symptoms existed in the preceding year.

The group having rheumatoid disease was investigated for the number of inflamed joints, morning stiffness and acute phase response to inflammation (C reactive protein and erythrocyte sediment rate). Result of the analysis was determined through statistical methods. The findings of the research revealed that the prevalence of RLS was higher in the group with rheumatoid arthritis as compared to the osteoarthritis and control group. The patients with osteoarthritis and the control group showed no considerable difference.

Interestingly, the facts showed that all the patients showing symptoms of RLS were women. Further, the studies suggested that eight patients suffering from the symptoms lost an hour’s sleep everyday. Fourteen patients had sought medical opinion about dysesthesia. In the group with rheumatoid arthritis, there was no relation between the existence of symptoms within the previous year, or during questioning and laboratory or clinical index of the disease activity. Moreover, the patients of rheumatoid arthritis showing RLS symptoms could separate their synaesthesia from pain and stiffness of joints.

Finally, it was observed that the prevalence of RLS among the rheumatoid arthritis patients in the hospital was as high as 30%, far above the percentage found with the other two groups.

Leg Cramps During Pregnancy – Causes and Precautions

Leg cramps during pregnancy are associated with sharp pain in the muscles of the calf, thigh or foot. The pain often increases as the pregnancy progresses. Particularly during the last few months of pregnancy, there can a shooting pain during the night.

There is no definite reason that could define the cause of such pain, however, there are certain possibilities that could be held responsible. It is believed that such cramps occur due to the extra weight that has to be carried. In addition, this pain might also be attributed to the pressure of the expanding uterus on the blood vessels and nerves that carry blood to and from the legs.

Some of the most probable reasons behind leg cramps during pregnancy are:

- Increased chance of muscle fatigue during pregnancy
- Changes in circulation during pregnancy
- Weight of the uterus pressing on the nerves and blood vessels
- Inherited tendency for cramps
- Insufficient salt in the diet
- Mineral deficiencies, such as potassium, calcium and magnesium
- Consumption of food with high levels of phosphorus content. This might interfere with the calcium content absorption. (Foods with a high phosphorus content: meat, poultry, fish and seafood, wild game, eggs, dried beans and peas, milk and dairy products, nuts and seeds, chocolate, whole grain products)

Tips to prevent leg cramps during pregnancy:

- Avoid standing or sitting with the legs crossed for a long period of time.
- With physician’s approval, go for a short walk everyday
- Stretch the calf muscles regularly during the daytime and just before going to sleep
- Lie on the left side while sleeping as this will improve the circulation in legs
- Drink plenty of water to keep hydrated
- Try to rotate the ankles and move the toes while sitting for work or meals
- Have a warm bath in order to relax the muscles
- In some cases, magnesium supplements can be taken along with prenatal vitamins, however, it is important to consult a physician before taking any supplements.

The Relationship Between RLS And Lung Transplants

Prevalence of Restless Leg Syndrome (RLS) in the general population has been found to range between 2.5 and 15 percent. A cross-sectional study also suggests that around 45% of patients are victimized by RLS after heart transplantation. In another significant study of solid organ transplant, it was observed that RLS disappeared after kidney transplantation of the patients on hemodialysis.

Restless Leg Syndrome in lung transplant recipients

There has been no significant research for determining the relationship between transplant patients and RLS. However, some evidence can be extracted from a study that was conducted to measure the severity, prevalence and risk factors of RLS in a population of lung transplant recipients.

The study included 42 patients who had undergone lung transplant. The patients included in the study had no family history of RLS. Standard therapy was applied on all the patients that included prophylactic medication and immunosuppression. To determine the severity of RLS, and whether the patient fulfilled the criteria for RLS, the patients were supplied with two sets of questionnaires.

The outcome of the research suggested that 20 of 42 (47.6%) patients receiving lung transplant were victims of RLS. Out of the RLS affected patients, 80% of them showed severity in symptoms and were grouped in moderate to severe category. Interestingly, it was found that 75% of the population diagnosed with RLS was women.

All the patients with hypothyroid, 4 of 42 (9.5%), reported RLS. Another interesting revelation was that the patients with RLS had higher concentrations of calcium in their blood than those not suffering from RLS. Further, the study also uncovered that those affected with RLS have a greater chance of testing positive for Cytomegalovirus (CMV). This virus is found in the patients undergoing transplant due to immunosuppression medications.

This research study suggests that those receiving lung transplantation suffer from a greater risk of RLS, with an even greater risk for women. Associated risk factors would be hypothyroid, high levels of calcium, and testing positive for CMV.