Diagnosing and Treating Restless Leg Syndrome

Physicians diagnosis Restless legs Syndrome by conducting a detailed patient medical and symptom history, by doing a thorough medical and neurological examination and by using an assessment scale that helps to diagnosis and grade the severity of the condition.

The physician will be looking for the following indicator of the condition:

An intense desire to move limbs at rest

Extreme motor restlessness

A definitive worsening of symptoms when lying down or when sitting that are at least in part reduced by activity.

Symptoms become worse in the evening hours and overnight.

The physician may also consider sleep patterns and may ask the patient to participate in a sleep study. During the sleep study any involuntary limb movement will be monitored.

Since most cases of RLS are idiopathic there should be an absence of neurological findings; unless there are underlying conditions such as diabetes, or peripheral neuropathy.

The physician will look for a history of familial RLS

A history of worsening of symptoms with age (if condition onset was earlier than the visit to the physician)

The physician may order laboratory tests to check ferritin levels, which is a test that measures iron storage.

Treatment for restless legs syndrome involves a combination of lifestyle changes, relaxation techniques and medications. Treatments are individualized to the patient based on severity of the symptoms. Treatment is aimed at improving the activities of daily living, reducing any sleep deprivation, and reducing symptoms while lying down or sitting. The first step in treatment focuses on lifestyle changes that will improve the health and sleep patterns of the patient and include the patient learning relaxation techniques to use while sitting or resting. Lifestyle changes may include the elimination of caffeine, tobacco and alcohol from the patient’s daily routine and to help the patient improve the dietary habits and exercise habits that they follow daily.

Patients have also found that when they have regular sleep habits their symptoms are eased. It is important for patients to have a regular bedtime and bedtime routine that is relaxing. The sleeping environment should be quiet, and the temperature comfortable.

It is best to not exercise at least 6 hours prior to bedtime. It is also helpful to take a warm bath and perhaps have a massage prior to lying down to sleep.

It is equally important that if RLS symptoms are experienced while sitting for long periods of time that the patient learn how to occupy the mind during these times by bending, rocking, stretching, massaging, or jiggling the limb that is affected by the symptoms. Relaxation techniques come in hand during these times as well.

Medications may be prescribed for RLS patients if lifestyle changes alone are not satisfactory. Medications that may be prescribed include anticonvulsants, benzodiazepines - which are central nervous system depressants, dopaminergics, and also opioids. Ropinirole, the only drug approved by the U.S. Food and Drug Administration in 2005, specifically for the treatment of moderate to severe symptoms of restless legs syndrome is the drug of choice.

Patients have found that anti-nausea medications, neuroleptic medications, and antidepressants also have an undesired affect on their RLS symptoms and should be avoided if possible with a doctor’s knowledge.