If you are experiencing leg pain at night, you may be wondering if you have restless leg syndrome (RLS). Nighttime leg pain can be caused by a variety of conditions, including RLS. However, it can also occur if you spend too much time sitting during the day, or sleeping in a way that restricts blood flow to your lower limbs. Leg pain can be common during pregnancy, or be a side effect of medication. Leg pain can also be caused by a chronic condition, like arthritis, peripheral artery disease, or diabetes.
How do you know that RLS is behind your leg pain, and not something else? Below we explain the symptoms that separate RLS from other conditions related to leg pain, and what you can expect during the diagnostic process.
Also known as Willis-Ekbom disease, restless leg syndrome has been described as both a neurological sensory disorder and a sleep movement disorder, characterized by uncomfortable sensations in the legs, usually when lying down, and an overwhelming urge to move them to experience relief.
How do you know if you have RLS? You may experience these symptoms:
If you’ve experienced these symptoms, you should consult a doctor.
There is no specific diagnostic test for restless leg syndrome. If you think you may have RLS, you should schedule an appointment with your doctor. They will perform a thorough history and physical exam to determine what’s causing your symptoms. Other tests and studies may be required to rule out medical conditions presenting with similar symptoms. Until then, you can track your RLS symptoms at home using a sleep diary.
Find a notebook or use the notes app on your phone to use as a sleep diary. Each night when you go to bed, and each morning when you wake up, answer the following questions. You’ll use this information to answer questions the doctor asks you during your appointment.
Sleep Quality Questions:
Within a few weeks, you may notice certain trends. For example, your symptoms may worsen when you drink caffeine. Make note of these trends to share with your doctor.
In general, the following Diagnostic Criteria must be met for a doctor to diagnose RLS:
A challenge of diagnosing RLS is, at least in part, the reliance on reporting of subjective symptoms, which makes use of a sleep diary critical in documenting one’s experiences.
When you meet with your doctor, they will perform an initial diagnostic interview for RLS. They may ask you screening questions like the ones below:
Your doctor will ask these questions to rule out other potential causes behind your RLS symptoms, like pregnancy, iron deficiency, or end-stage renal failure. Pregnant women are two to three times more likely to report RLS symptoms, especially during the third trimester, and individuals with chronic renal failure are two to five times more likely. A family history of RLS is another risk factor for RLS. Caffeine, alcohol, and nicotine use can also exacerbate symptoms, as can some medications, including anti-nausea drugs, antipsychotics, and antidepressants.
Based on your answers, your doctor may order a blood test or refer you to a sleep specialist. A blood test will help rule out an iron deficiency, a risk factor for RLS. An overnight sleep study, known as a polysomnogram, may be ordered if your doctor thinks your symptoms may be related to another sleep disorder, like periodic limb movement disorder or sleep apnea. These disorders can coexist with RLS or worsen symptoms.
Depending on your diagnosis, your doctor will develop a treatment plan for you. For example, a regimen of over-the-counter iron supplements may help address an underlying iron deficiency. Some mild to moderate symptoms of RLS can be relieved with lifestyle changes, such as reducing your alcohol and nicotine intake, or practicing better sleep hygiene. Other at-home remedies can be helpful in reducing symptoms, including leg massage, warm baths, RLS foot wraps, and hot/cold therapy.
For many people, RLS is a lifelong condition, but symptoms can be managed to enable you to experience less discomfort and get more sleep.