Restless Leg Syndrome (RLS) is a chronic, disruptive disorder where one feels an urge to move their legs to stop an unpleasant sensation such as pain, aching, itching or tickling in the muscles while lying down or trying to sleep.
Restless legs syndrome, also known as Willis-Ekbom disease, is a common condition of the nervous system that causes an overwhelming, irresistible urge to move the legs.
SYMPTOM CHECKERThe International Restless Legs Syndrome Study Group (IRLSSG) has proposed a set of RLS diagnostic criteria - the fifth of these criteria was recently added.
Diagnosis of Restless Legs Syndrome can be made if all of the five criteria are met:
1) A need to move the legs, usually accompanied or caused by uncomfortable, unpleasant sensations in the legs.
Any kind of sensation may be a manifestation of RLS and a wide variety of descriptions have been used ranging from "painful" to "burning" - some people say it feels like they have insects inside their legs or arms. Sometimes the need to move is present without the uncomfortable sensations and sometimes the arms or other body parts are involved in addition to the legs.
2) The need to move and unpleasant sensations are exclusively present or worsen during periods of rest or inactivity such as lying or sitting.
3) The need to move and unpleasant sensations are partially or totally relieved by movement such as walking or stretching at least as long as the activity continues.
4) The need to move and unpleasant sensations are generally worse or exclusively occur in the evening or night.
5) Symptoms are not solely accounted for by another condition such as leg cramps, positional discomfort, leg swelling or arthritis.
RLS often causes difficulty in falling or staying asleep, one of the chief complaints of the condition. Many people who have the disease also have Periodic Limb Movements (PLM) - jerking of the arms or legs that is often associated with sleep disruption.
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The severity of RLS symptoms are scored as:
Mild (total score of 1-10)
Moderate (11-20)
Severe (21-30)
Very severe (31-40)
The patient’s score can be used to decide whether pharmacological treatment would be beneficial.
Refer to a neurologist or sleep specialist if:
A SINGLE-QUESTION FOR RAPID SCREENING
The European journal or neurology reported a new single question for the rapid screening of RLS in the neurological clinical practice -
It is recommended that patients with RLS are given the following tests by their medical practitioner, as a minimum:
RLS SEVERITY SCALE
A scoring system for RLS symptom severity has also been developed by the IRLSSG. It is used in clinical trials and other studies to evaluate therapeutic effects of treatment.
Diagnosis of the severity of RLS is done through a series of 10 questions, each scored using a RLS rating of 0 to 4 and therefore leading to a maximum total score of 40.
Download a copy of the RLS Severity Scale to print.
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It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. The sensation is often worse in the evening or at night. Occasionally, the arms are affected too.
Restless legs syndrome is also associated with involuntary jerking of the legs and arms, known as periodic limb movements in sleep (PLMS).
Some people have the symptoms of restless legs syndrome occasionally, while others have them every day. The symptoms can vary from mild to severe. In severe cases, restless legs syndrome can be very distressing and disrupt a person's daily activities.
Many cases of RLS can be mild but in more severe cases the symptoms can often be intolerable.
The condition was first described in 1945 by Swedish nerve specialist Karl-Axel Ekbom. It is thought to be linked to an imbalance of the brain’s 'reward' chemical messenger dopamine. Women are more likely to be affected than men with many developing restless legs in the last few weeks of pregnancy. In children, the condition can be wrongly diagnosed as 'growing pains'. The symptoms usually worsen as people get older.
Having a sleepless night now and then can be annoying. However, when you have restless legs syndrome (RLS), going without sleep night after night can make life miserable. You may be so tired that you just feel like crying.
The condition is a symptom of severe magnesium deficiency. A quick look at the science of magnesium deficiency and the effect such deficiency has on muscles, nerves and the blood vessels easily sustains this medical view.
Dr. Carolyn Dean says, “The best treatment is with any form of magnesium because magnesium relaxes muscles and nerves. Furthermore, calcium causes contraction in skeletal muscle fibers, and magnesium causes relaxation. When there is too much calcium and insufficient magnesium inside a cell, you can get sustained muscle contraction: twitches, spasms, and even convulsions.
"I have had restless legs every night for the past 45 years. The severity has gradually increased over the years and has led to several visits to the doctor. I have been on 4 different medications, none of which helped. On a whim, I bought a tube of magnesium creme and have been using this twice a day on knees and calves. I have also started taking a magnesium supplement. My RLS symptoms have almost completely disappeared. I still feel twinges in the evenings but they do not last more than a few minutes. I apply the creme as needed. "
According to Dean, “A hundred years ago we enjoyed a diet high in magnesium with a daily intake of 500 mg. Today we are lucky to get 200 mg. However, calcium in the diet has never been higher. This high-calcium, low-magnesium diet, when coupled with calcium supplementation, can give calcium to magnesium imbalance of 10:1 or even higher — which constitutes a walking time bomb of impaired bone health and heart disease.”
Restless Leg Syndrome and Inflammation
Restless leg syndrome is obviously an inflammation and it ties in perfectly with the observation that RLS is a magnesium deficiency disorder. Magnesium puts the chill on inflammation and that is why it is the perfect RLS medicine as it is for all disease (inflammations) of the nerves, muscles and blood vessels.
Magnesium deficiencies feed the fires of inflammation and pain in the legs and that is why applying magnesium directly to the legs at night and during the day works so well to cool the restlessness.
Magnesium deficiency in general also leads to sleep disorders to it works not only on the legs but the entire nervous system helping to relax us and reset our nervous system to a less anxious and depressed tone.
Diagnosis and Treatment of Restless Leg Syndrome
Restless leg syndrome symptoms and anxiety are related to each other and result in:
Even a mild deficiency of magnesium can cause:
Restless legs syndrome, also known as Willis-Ekbom disease, is a common condition of the nervous system that causes an overwhelming, irresistible urge to move the legs.
SYMPTOM CHECKERThe International Restless Legs Syndrome Study Group (IRLSSG) has proposed a set of RLS diagnostic criteria - the fifth of these criteria was recently added.
Diagnosis of Restless Legs Syndrome can be made if all of the five criteria are met:
1) A need to move the legs, usually accompanied or caused by uncomfortable, unpleasant sensations in the legs.
Any kind of sensation may be a manifestation of RLS and a wide variety of descriptions have been used ranging from "painful" to "burning" - some people say it feels like they have insects inside their legs or arms. Sometimes the need to move is present without the uncomfortable sensations and sometimes the arms or other body parts are involved in addition to the legs.
2) The need to move and unpleasant sensations are exclusively present or worsen during periods of rest or inactivity such as lying or sitting.
3) The need to move and unpleasant sensations are partially or totally relieved by movement such as walking or stretching at least as long as the activity continues.
4) The need to move and unpleasant sensations are generally worse or exclusively occur in the evening or night.
5) Symptoms are not solely accounted for by another condition such as leg cramps, positional discomfort, leg swelling or arthritis.
RLS often causes difficulty in falling or staying asleep, one of the chief complaints of the condition. Many people who have the disease also have Periodic Limb Movements (PLM) - jerking of the arms or legs that is often associated with sleep disruption.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
The severity of RLS symptoms are scored as:
Mild (total score of 1-10)
Moderate (11-20)
Severe (21-30)
Very severe (31-40)
The patient’s score can be used to decide whether pharmacological treatment would be beneficial.
Refer to a neurologist or sleep specialist if:
- There is insufficient initial response despite adequate duration and dose of treatment.
- Response to treatment becomes insufficient despite an increased dose.
- Side-effects are intolerable.
- The maximum recommended dosage is no longer effective
- Augmentation develops (onset of symptoms earlier in the day, increased severity of symptoms, or the spread of symptoms to different parts of the body, such as the arms, trunk or face)
A SINGLE-QUESTION FOR RAPID SCREENING
The European journal or neurology reported a new single question for the rapid screening of RLS in the neurological clinical practice -
- "When you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walking or movement?“. This question has 100% sensitivity and 96.8% specificity for the diagnosis of RLS.
It is recommended that patients with RLS are given the following tests by their medical practitioner, as a minimum:
- Serum ferritin: RLS is frequently associated with iron deficiency.
- Renal function: RLS may be associated with renal failure.
- Other investigations for underlying possible cause include fasting blood glucose, magnesium, TSH, vitamin B12 and folate.
- If the neurological examination suggests an associated peripheral neuropathy or radiculopathy, electromyography and nerve conduction studies should be undertaken.
RLS SEVERITY SCALE
A scoring system for RLS symptom severity has also been developed by the IRLSSG. It is used in clinical trials and other studies to evaluate therapeutic effects of treatment.
Diagnosis of the severity of RLS is done through a series of 10 questions, each scored using a RLS rating of 0 to 4 and therefore leading to a maximum total score of 40.
Download a copy of the RLS Severity Scale to print.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. The sensation is often worse in the evening or at night. Occasionally, the arms are affected too.
Restless legs syndrome is also associated with involuntary jerking of the legs and arms, known as periodic limb movements in sleep (PLMS).
Some people have the symptoms of restless legs syndrome occasionally, while others have them every day. The symptoms can vary from mild to severe. In severe cases, restless legs syndrome can be very distressing and disrupt a person's daily activities.
Many cases of RLS can be mild but in more severe cases the symptoms can often be intolerable.
The condition was first described in 1945 by Swedish nerve specialist Karl-Axel Ekbom. It is thought to be linked to an imbalance of the brain’s 'reward' chemical messenger dopamine. Women are more likely to be affected than men with many developing restless legs in the last few weeks of pregnancy. In children, the condition can be wrongly diagnosed as 'growing pains'. The symptoms usually worsen as people get older.
Having a sleepless night now and then can be annoying. However, when you have restless legs syndrome (RLS), going without sleep night after night can make life miserable. You may be so tired that you just feel like crying.
The condition is a symptom of severe magnesium deficiency. A quick look at the science of magnesium deficiency and the effect such deficiency has on muscles, nerves and the blood vessels easily sustains this medical view.
Dr. Carolyn Dean says, “The best treatment is with any form of magnesium because magnesium relaxes muscles and nerves. Furthermore, calcium causes contraction in skeletal muscle fibers, and magnesium causes relaxation. When there is too much calcium and insufficient magnesium inside a cell, you can get sustained muscle contraction: twitches, spasms, and even convulsions.
"I have had restless legs every night for the past 45 years. The severity has gradually increased over the years and has led to several visits to the doctor. I have been on 4 different medications, none of which helped. On a whim, I bought a tube of magnesium creme and have been using this twice a day on knees and calves. I have also started taking a magnesium supplement. My RLS symptoms have almost completely disappeared. I still feel twinges in the evenings but they do not last more than a few minutes. I apply the creme as needed. "
According to Dean, “A hundred years ago we enjoyed a diet high in magnesium with a daily intake of 500 mg. Today we are lucky to get 200 mg. However, calcium in the diet has never been higher. This high-calcium, low-magnesium diet, when coupled with calcium supplementation, can give calcium to magnesium imbalance of 10:1 or even higher — which constitutes a walking time bomb of impaired bone health and heart disease.”
Restless Leg Syndrome and Inflammation
Restless leg syndrome is obviously an inflammation and it ties in perfectly with the observation that RLS is a magnesium deficiency disorder. Magnesium puts the chill on inflammation and that is why it is the perfect RLS medicine as it is for all disease (inflammations) of the nerves, muscles and blood vessels.
Magnesium deficiencies feed the fires of inflammation and pain in the legs and that is why applying magnesium directly to the legs at night and during the day works so well to cool the restlessness.
Magnesium deficiency in general also leads to sleep disorders to it works not only on the legs but the entire nervous system helping to relax us and reset our nervous system to a less anxious and depressed tone.
Diagnosis and Treatment of Restless Leg Syndrome
Restless leg syndrome symptoms and anxiety are related to each other and result in:
- severe sleep disorders.
- Magnesium deficiency
- often results in symptoms of
- anxiety,
- restless leg syndrome,
- sleep disorders,
- nausea,
- fatigue and
- depression.
Even a mild deficiency of magnesium can cause:
- increased sensitivity to noise,
- nervousness,
- irritability,
- mental depression,
- confusion,
- twitching,
- trembling,
- apprehension, and
- insomnia.