Signs and Symptoms of Restless Legs Syndrome

What Are the Signs and Symptoms of Restless Legs Syndrome?

Restless legs syndrome (RLS) has several major signs and symptoms:

• An almost irresistible urge to move the legs or arms when sitting or lying down
• An unpleasant feeling in the legs
• Difficulty falling asleep or staying asleep because of the unpleasant feelings in the legs or arms
• Daytime sleepiness, which results from a lack of restful sleep due to the repeated limb movements

Urge To Move

RLS gets its name from the urge to move the legs when sitting or lying down. This urge is due to unpleasant feelings in the legs that are relieved by movement. Typical movements are:

• Pacing and walking
• Jiggling the legs
• Stretching and flexing
• Tossing and turning
• Rubbing the legs

Unpleasant Feelings

The urge to move the legs usually is due to unpleasant feelings in the legs. People with RLS describe these feelings as:

• Creeping
• Crawling
• Pulling
• Itching
• Tingling
• Burning
• Aching
• Painful
• Hard to describe

Children may describe RLS symptoms differently than adults.
The unpleasant feelings in RLS usually occur in the lower leg (calf). But the feelings can occur at any place between the thigh and the ankle and also in the arm. The feelings are worse:

• When lying down or sitting for a long period of time
• During the evening or night, more so than during the day

The unpleasant feelings also:

• Make it hard to fall asleep or stay asleep
• Are not as bad or go away when you move

Duration and Severity

RLS symptoms tend to get worse over time. They may begin in childhood and develop slowly over several years. People with early symptoms are more likely to have other family members with RLS than people who develop RLS later in life. Symptoms tend to worsen faster when RLS occurs later in life. RLS that occurs later in life is also more likely to result from an underlying condition or illness than RLS that occurs early in life. People with mild symptoms may only notice them when they are still or awake for a long time, such as on a long airplane trip.

How Is Restless Legs Syndrome Diagnosed?

The way that you describe your symptoms is very important in diagnosing restless legs syndrome (RLS). Your doctor will:

• Take a complete medical history
• Do a complete physical examination
• Order other tests

The diagnosis of RLS usually requires the following four conditions be present:

1. An urge to move the legs due to an unpleasant feeling in the legs.
2. The urge to move the legs, or the unpleasant feelings in the legs, begins or gets worse when you are at rest or not moving around frequently.
3. The urge to move the legs, or the unpleasant feelings in the legs, is partly or completely relieved by movement (such as walking or stretching) for as long as the movement continues.
4. The urge to move the legs, or the unpleasant feelings in the legs, is worse in the evening and at night, or only occurs in the evening or at night.

Medical History

Your doctor will take a medical history and ask questions such as:

• Can you describe your symptoms?
• When did your symptoms first begin?
• When during the day or night do the symptoms usually occur?
• When are your symptoms worse?
• Do symptoms interfere with your sleep?

Your doctor will also ask about your sleep habits, such as:

• The time you go to bed and get up
• Your routine before going to bed
• Noise, light, and interruptions in the room where you sleep
• Whether you snore

Your doctor will ask about how you feel during the day, including whether:

• You are tired and sleepy when you wake up and during the day.
• You have trouble concentrating.
• You doze off or have difficulty staying awake doing routine tasks, especially driving.

Your doctor will ask questions to find out if your symptoms are a result of a possible underlying condition. Questions might include:

• Do members of your family have similar symptoms?
• What medicines (over-the-counter and prescription) do you take?
• Do you snore loudly and frequently?
• Do you gasp for air during sleep?
• Do you use caffeine, tobacco, or alcohol?

Physical Exam

A physical exam is done to:

• Identify any underlying condition that may cause RLS
• Rule out other disorders

Your doctor also will pay special attention to:

• The nerves in your spinal cord (especially) and legs and arms
• The blood flow in your legs and arms

Other Tests

There is no test currently available to diagnose RLS.
However, blood tests can be used to look for underlying conditions that can cause RLS. These tests check for:

• Low iron stores or iron deficiency
• Diabetes
• Kidney disease
• Other vitamin and mineral deficiencies