Restless legs syndrome is often described as a creeping, crawling, itching or burning sensation in the legs while resting.  These sensations result in an uncontrollable urge to move to relieve the unusual feelings.  Restless legs syndrome, or RLS, is more common than you might think.  In fact, it is often undiagnosed or misdiagnosed by healthcare professionals.

How common is RLS?
The National Sleep Foundation has estimated that 10% of adults suffer from RLS.  However, many people do not even realize they have RLS, or they believe it is something else.  RLS is often misdiagnosed as insomnia, nervousness, muscle cramps, arthritis or simply aging.  For example, the Restless Legs Syndrome Foundation have stated that about 40% of people with RLS complain of symptoms that would suggest depression, and the condition would be treated as depression if the physician was unaware or did not consider a sleep disorder.

What causes RLS?
The exact cause of RLS is often unknown in patients.  However, about 50% of cases have a family history of RLS, suggesting a genetic or inherited cause.  Other potential causes of RLS include the following:

• Chronic diseases like diabetes, Parkinson’s disease and kidney disease have been associated with RLS.  Treatment of the chronic disease will often lead to improved RLS symptoms.
• Some pregnant women, especially in their last trimester, will experience RLS.  
• People with low iron levels or anemia may be prone to RLS.  Once this is corrected, symptoms often improve.
• Prescription and non-prescription drugs can also cause RLS.  Some examples include drugs for seizures (like phenytoin), some medications for nausea and some cold and allergy medications (like antihistamines or decongestants).
• Caffeine, alcohol and tobacco have also been shown to aggravate symptoms.

What are the symptoms of RLS?
People with RLS often describe an almost uncontrollable urge to move the legs.  This urge is often accompanied with an unusual sensation that is sometimes described as a creeping, crawling, tingling, burning or painful sensation in the legs.  You could have no sensation, just an urge to move.  Although rare, this sensation can also occur at other areas of the body (hands, arms or face).  

Moving the legs often provides some relief, so this may lead to you tossing and turning in bed or pacing the house.  Symptoms are often worsened when lying or sitting down.  They typically occur at night when you are trying to go to sleep.  

In mild cases, symptoms occur only rarely and cause minimal problems.  People with moderately severe disease have symptoms that occur once or twice a week.  At this point, RLS can start to significantly impact the quality of your life.  In severe disease, symptoms occur more than twice a week, and the effects on your sleep and quality of life can be profound.

How is RLS diagnosed?
Unfortunately, there is no test to diagnose RLS.  A diagnosis is typically based on your symptoms alone.  Diagnostic criteria have been identified to help physicians diagnose RLS.  The following four criteria suggest a diagnosis of RLS:

1. You have a strong urge to move your legs.
2. Symptoms start or become worse when resting.
3. Symptoms get better when you move your legs.
4. Symptoms are worse in the evening, especially when lying down.