Imagine settling into bed after a long day, only to feel a strange, creeping sensation in your legs that just won’t let you relax.
You feel an overwhelming urge to move your legs for relief.
If this sounds familiar, you might be experiencing Restless Legs Syndrome (RLS). RLS – also known as Willis-Ekbom disease – is a common neurological condition that causes an irresistible urge to move the legs due to uncomfortable sensations.
These sensations typically strike when you’re resting, especially in the evening or at night, and moving your legs often brings temporary relief.
What Exactly Is Restless Legs Syndrome?
Restless Legs Syndrome is essentially a problem of the nervous system that disrupts your ability to stay still.
People with RLS describe unpleasant sensations deep in their legs – as if something is crawling or tingling under the skin – which create a powerful urge to move.
It’s not just ordinary fidgetiness or nervousness; it’s a distinct sensation often described in vivid ways.
Many say it feels like itching, tingling, burning, or throbbing inside the legs, or even “like fizzy water is inside the blood vessels” of their legs.
Some describe it as a creepy-crawly feeling or an uncomfortable tugging sensation.
Whatever the description, the result is the same: you feel you have to move your legs to make the feeling go away, at least for a moment.
RLS sensations usually get worse at night or when you’re trying to relax.
You might notice it when you’re sitting still for a while – for example, during a long flight or while watching a movie.
The moment you start moving – stretching your legs, shaking or walking around – the discomfort tends to ease off.
Unfortunately, once you sit or lie down again, the feelings can creep back, which can make it very hard to fall asleep.
Occasionally, RLS can affect other parts of the body too.
While legs (especially from the knees down) are most commonly affected, some people experience the sensations in their calves, feet, or even their arms.
The severity of RLS varies widely.
Some people only get mild symptoms once in a while, whereas others have nightly episodes that severely disrupt their sleep and daily life.
Why Is It Also Called Willis-Ekbom Disease? (A Brief History)
RLS isn’t a new condition – it’s been vexing people for centuries.
In fact, a 17th-century physician named Sir Thomas Willis provided one of the first medical descriptions of the disorder back in 1672.
He noted patients who had sleep disturbed by jumpy, restless limbs.
Much later, in 1945, a Swedish doctor named Karl-Axel Ekbom published a comprehensive report on this puzzling “restless legs” condition.
Dr. Ekbom was the one who actually coined the term “restless legs”.
To honor these early pioneers, the syndrome is often referred to as Willis-Ekbom disease – combining Willis and Ekbom’s names.
You might still hear RLS called by other names.
For instance, it’s sometimes been known as Wittmaack-Ekbom syndrome, referencing another doctor (Theodor Wittmaack) who described similar symptoms in the 19th century.
However, “Restless Legs Syndrome” (RLS) remains the most commonly used and clear term.
Calling it Willis-Ekbom disease is just a nod to the medical history of the condition.
What Are the Symptoms of RLS?
The hallmark symptom of RLS is an overwhelming urge to move the legs, usually paired with those strange uncomfortable sensations we talked about.
To paint a clearer picture, here are some common ways people describe their RLS symptoms:
- Tingling or pins-and-needles: It may feel like a tingling or prickling sensation, as if your legs have “fallen asleep” and are prickling to wake up.
- Crawling or creeping feeling: Many say it feels like something is crawling under their skin, giving a creepy-crawly or itchy sensation in the legs.
- Burning or throbbing aches: Some experience a deep ache or burning in the muscles that isn’t exactly pain but is very uncomfortable.
- “Fizzy water” or bubbling feeling: As one vivid description puts it, it can feel “like fizzy water is inside the blood vessels in the legs” – a sort of bubbling or effervescent feeling inside the limbs.
- Restlessness and pulling: Others describe it as if something is tugging at their legs from the inside, creating an unrelenting restlessness until they move.
These sensations typically start or get worse when you’re resting – for example, lying down in bed or sitting quietly.
Because symptoms are often worse in the evenings and at night, RLS can make it really hard to fall asleep or stay asleep.
You might find yourself kicking your legs or getting up multiple times to walk around for relief.
Not surprisingly, this can lead to exhaustion and frustration.
It’s important to note that RLS symptoms can range from mild to unbearable.
In mild cases, people might just feel a bit fidgety in the evenings.
In severe cases, the sensations are so distressing they can significantly disrupt sleep and daily activities.
One night of bad sleep is manageable, but when RLS keeps happening night after night, it can really take a toll on your well-being.
Another symptom often associated with RLS is something called periodic limb movements (PLM).
In fact, over 80% of people with RLS also experience periodic limb movements during sleep.
PLM are basically involuntary leg jerks or twitches that occur off and on while you’re sleeping.
If you have PLM, your legs might kick or twitch every 20 to 40 seconds without you realizing it.
These movements can sometimes be strong enough to wake you (or your bed partner) up throughout the night.
While PLM happens during sleep, some people with RLS also notice their legs twitch when they’re awake and resting.
PLM and RLS often go hand-in-hand, and treating RLS can sometimes help reduce those nightly leg twitches as well.
Primary vs. Secondary RLS: What’s the Difference?
Doctors classify RLS into two types: primary and secondary. Understanding which type you have can help identify the cause and best treatment approach.
Primary RLS (Idiopathic RLS)
This is RLS that exists on its own, without any obvious underlying cause.
“Idiopathic” basically means “of unknown cause.”
Primary RLS often runs in families, suggesting a genetic component.
If a parent or grandparent had those “restless legs,” you might inherit the tendency.
Primary RLS usually begins earlier in life, often before age 40, and can persist on and off for many years.
People with primary RLS may go through periods where the symptoms improve or even disappear for a while, only to return later.
Because there’s no single identifiable cause, managing primary RLS focuses on controlling symptoms.
Secondary RLS
This form of RLS is called “secondary” because it’s believed to be the result of something else – another condition or factor triggering restless leg.
In secondary RLS, if you address the underlying cause, the RLS symptoms often improve or even go away.
There are several known health issues and situations that can lead to secondary RLS.
Common culprits include:
Iron deficiency or anemia
Low iron levels in the body can trigger RLS symptoms in some people.
Iron is important in brain processes that control movement, and an iron deficiency (with or without anemia) is a well-known RLS trigger.
The good news is that if low iron is the cause, iron supplements or treatment of the anemia can relieve RLS symptoms.
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- Chronic diseases: Conditions like kidney disease, diabetes, Parkinson’s disease, rheumatoid arthritis, or peripheral neuropathy have been linked with RLS. Treating or managing these conditions can sometimes lessen the RLS.
- Pregnancy: There’s a strong link between pregnancy and RLS. In fact, about 1 in 5 pregnant women experience RLS symptoms in their last trimester (the last 3 months of pregnancy). If you’re pregnant and noticing restless legs at night, you’re definitely not alone. Researchers aren’t entirely sure why pregnancy brings this on – it could be due to changing hormones, low iron levels, or other shifts in the body. The comforting news for expectant moms is that pregnancy-related RLS usually goes away on its own within a month or so after giving birth.
- Other factors: Sometimes RLS can be brought on or worsened by certain medications (like some antidepressants or antihistamines) or lifestyle factors (such as lack of sleep, high caffeine or alcohol intake, or stress). These don’t cause RLS outright, but if you’re prone to it, they can make symptoms worse. Cutting back on triggers can help.
In summary, primary RLS has no clear cause and often runs in families, whereas secondary RLS is associated with an identifiable cause or condition.
Determining which type you have is important – for example, if your RLS is secondary to iron deficiency or another illness, treating that root cause can significantly improve your restless legs.
How RLS Affects Daily Life
If RLS was only a nighttime quirk, it might not be such a big deal. But because it disrupts sleep and rest, it can have a big impact on daily life.
Imagine losing an hour or two (or more) of sleep every night because your legs feel jumpy.
Over time, that adds up to serious daytime sleepiness, fatigue, and difficulty concentrating.
People with RLS often feel drained during the day, which can make it hard to be productive at work or fully present with family and friends.
You might find yourself dozing off at inappropriate times or needing naps to get through the day.
The constant sleep disruption doesn’t just make you tired – it can also affect your mood.
It’s common for those with long-term, untreated RLS to experience irritability or even symptoms of anxiety and depression.
After all, not getting good sleep and feeling like your body is out of your control at night can be pretty stressful.
In fact, studies have found higher rates of depression and anxiety disorders in people with RLS.
The frustration of an unseen condition that others might not understand can also contribute to feeling low or anxious.
Daily activities can be impacted in other ways too. RLS can make it difficult to sit still for long periods.
Long meetings, car rides, plane flights, or even relaxing to watch a film can become challenging if your legs start acting up.
Some people with RLS end up avoiding situations where they know they’ll have to sit still, or they find ways to take breaks and stretch to keep symptoms at bay.
In severe cases, people might be late to work or leave events early due to exhaustion or the need to move around.
Over time, such difficulties can affect a person’s work performance, social life, and overall quality of life.
It’s not all doom and gloom, though – many people with RLS find tricks to cope day-to-day, like brief walks or stretches, keeping their mind distracted during rest, or using relaxation techniques.
With proper treatment (which we’ll get to in a moment), much of this daily disruption can be reduced or resolved.
The key is recognizing that these problems – like daytime fatigue or mood changes – stem from RLS, so that they can be addressed alongside the leg sensations.
Who Gets RLS? (How Common Is It and Who’s at Risk)
RLS is a fairly common condition – chances are you know someone who has it, even if they haven’t talked about it.
Estimates vary, but by some studies, roughly 2% to 3% of the adult population have moderate to severe RLS symptoms, and if you include milder intermittent cases, the numbers might be higher.
One survey in the U.S. found that about 3% of people have significant RLS symptoms that interfere with life.
To put it another way, perhaps as many as 1 in 10 people experience RLS sensations at least occasionally.
It’s not super rare – it’s just that many people don’t talk about it, or they might not realize it has a name and treatment.
Women are about twice as likely as men to develop RLS.
We’re not entirely sure why, but hormonal differences or iron levels might play a role.
RLS can start at any age, even in childhood, but it’s more typical to see it begin in adulthood.
Many people first notice symptoms in middle age or later, and the chance of having RLS seems to increase the older you get.
In younger people and kids, RLS sometimes gets overlooked or misinterpreted (more on that in the next section).
Pregnancy is a big risk factor, but as mentioned earlier, that form of RLS is often temporary.
Besides pregnancy, if you have a family history of RLS, you’re more likely to get it. Certain medical conditions (like those chronic illnesses listed under secondary RLS) also increase your risk.
Even lifestyle habits can contribute – for instance, heavy coffee drinkers or those with very disrupted sleep schedules might notice RLS symptoms more.
The bottom line is anyone can get RLS – men or women, young or old.
But it tends to favor women and people who either have relatives with RLS or who have another condition that predisposes them.
Being aware of this can help you and your doctor consider RLS if you’re having those telltale leg symptoms.
RLS or Something Else? (Misdiagnosis and Diagnosis Challenges)
One tricky thing about Restless Legs Syndrome is that there’s no lab test or scan that can definitively diagnose itama-assn.org. Diagnosis is usually based on what you describe to the doctor – your symptoms, when they happen, and how they feel. Because it relies on patient history and symptom reporting, RLS is often underdiagnosed or even misdiagnosedama-assn.org, especially if the doctor isn’t very familiar with the condition or if the patient doesn’t mention the leg sensations. Many people with mild RLS might just think they’re “restless sleepers” or blame it on stress, and thus never seek help. On the flip side, some doctors might mistake RLS for other problems.
There are a few conditions that can mimic RLS symptoms. For example, muscle cramps, arthritis, nerve problems in the legs, or simple anxiety can all cause leg discomfort that might be confused with RLS. In children and teens, RLS is often misdiagnosed as “growing pains”en.wikipedia.org. Think about it: a kid complaining of weird leg feelings at night – it’s easy to write that off as just normal growth-related aches. Unfortunately, that means some young people with RLS might not get proper treatment for years, until it’s recognized later in life.
The formal criteria for diagnosing RLS include things like: an overwhelming urge to move the legs (usually with strange sensations), symptoms worse at rest and at night, symptoms relieved by movement, and no other medical explanation for them111.wales.nhs.uk111.wales.nhs.uk. Doctors will often do blood tests or check for other issues to rule out causes like neuropathy or arthritis or an iron deficiency, to make sure nothing else is causing the symptoms111.wales.nhs.uk111.wales.nhs.uk. In some cases, if sleep is very disturbed, a sleep study might be done to look for those periodic limb movements during sleep (PLMS) – this isn’t to diagnose RLS per se, but to document how much it’s affecting your sleep111.wales.nhs.uk.
Because RLS is largely a diagnosis of exclusion (meaning you diagnose it by making sure nothing else explains the symptoms), it can be a bit of a journey to get the right diagnosis. If you suspect you have RLS, it helps to keep track of your symptoms – what time of day, how they feel, what relief you get – and share this with your doctor. Awareness is growing, and more healthcare professionals are recognizing RLS as a real condition. So don’t hesitate to speak up about these symptoms; getting RLS properly identified is the first step to relief.
Finding Relief: Treatments and Hope for RLS Sufferers
The great news for anyone dealing with RLS is that there are ways to manage and treat it. You don’t have to just “live with it” and endure sleepless nights. While there’s no permanent cure for primary RLS, many people find significant relief through a combination of lifestyle changes and, if needed, medication.
Lifestyle tweaks are often the first recommendation for mild RLS. Since symptoms tend to get worse with things like fatigue, caffeine, and inactivity, it helps to:
- Stick to a regular sleep schedule – going to bed and waking up at consistent times can improve sleep quality.
- Avoid stimulants in the evening – cutting down on caffeine (coffee, tea, energy drinks) and alcohol, especially late in the day, can reduce RLS symptoms at night111.wales.nhs.uk. Nicotine (smoking) can also make RLS worse111.wales.nhs.uk, so quitting smoking is beneficial for many reasons, including calmer legs.
- Exercise moderately – getting regular daily exercise or activity can help with RLS111.wales.nhs.uk. Even a daily walk or some stretching/yoga can make a difference. Just avoid very intense exercise right before bedtime, as that might actually trigger symptoms for some.
- Leg care and relaxation – during an RLS episode, people find relief in various at-home tricks. Stretching or massaging the legs, taking a warm bath in the evening, or applying heat pads can soothe the urges111.wales.nhs.uk. Some also find that distracting the mind with a book or calming music while waiting for the sensations to pass can help111.wales.nhs.uk.
- Review medications and diet – if you’re on any medicines (like certain antidepressants or antihistamines) that might worsen RLS, talk to your doctor about alternatives111.wales.nhs.uk. And ensure you’re eating a balanced diet to avoid deficiencies; sometimes vitamin or mineral supplements (especially iron, folate, or magnesium if levels are low) can improve symptoms.
If RLS is more severe or persistent, doctors may recommend medications to help calm your legs and improve sleep. The choice of medication depends on the individual, but some common options include: medicines that increase or adjust dopamine levels in the brain (these can reduce the urge to move), certain nerve pain medications or sedatives, and iron supplements if you’re low in iron111.wales.nhs.uk. In cases where RLS is secondary to another condition, treating that condition (for example, controlling diabetes or correcting anemia) can, in turn, alleviate the RLS. Not every medication works for everyone, so it might take some trial and error under a doctor’s guidance to find what works best for you. The encouraging part is that many people do find a treatment that significantly helps – it could be a single medication or a combo of lifestyle changes plus medicine.
Lastly, remember that RLS is not life-threatening111.wales.nhs.uk. It is disruptive and can be very uncomfortable, but there is hope and help available. Support groups and organizations (like RLS-UK in the UK111.wales.nhs.uk or the Restless Legs Syndrome Foundation in the US) exist to share tips and raise awareness. If you’ve been struggling with symptoms, reach out – you’re not alone, and sometimes just understanding what’s happening can be a huge relief in itself.
In conclusion: Restless Legs Syndrome is a common and real neurological condition that can steal your sleep and comfort, but with proper knowledge and management, you can take back control. Whether it’s simple changes like cutting out that late-night coffee or getting medical treatment for more stubborn cases, there are paths to peaceful nights. Don’t lose hope – most people with RLS can find ways to quiet those restless legs, get better sleep, and improve their quality of life. Sweet dreams are very much possible again!
Sources: Restless Legs Syndrome information from NHS Wales111.wales.nhs.uk111.wales.nhs.uk111.wales.nhs.uk111.wales.nhs.uk, Wikipediaen.wikipedia.orgen.wikipedia.orgen.wikipedia.org, and the American Medical Associationama-assn.orgama-assn.org, among others.