It’s estimated that about 10% of Americans suffer from Restless Leg Syndrome (RLS). This condition is frequently misdiagnosed and can be a symptom of an underlying cause. Common underlying causes include chronic venous insufficiency. In order to obtain a proper diagnosis and treatment plan, it’s important to understand the symptoms and different causes of Restless Leg Syndrome, how vein insufficiency factors in, and what your healthcare provider will be looking for.
What is Restless Leg Syndrome?
Restless Leg Syndrome is considered a movement disorder since moving the legs is the only source of relief. Both legs are usually afflicted. Symptoms, which can range from mild to severe, include:
- Uncomfortable sensations described as throbbing, pulling or creeping in the legs
- Sensations are worse at night, typically while at rest or immobile for long periods of time
- Irresistible urge to move legs
While the disease affects both men and women, women are twice as likely to be afflicted. Restless Leg Syndrome can begin at any age, even childhood, but gets worse with age. Periods of remission lasting weeks or months have been reported with younger sufferers. More than 80% of RLS patients also have Periodic Limb Movement of Sleep (PLMS). This is involuntary leg twitching while sleeping, as often as every 15-40 seconds. PLMS can occur for part of or the entire night, and will often disrupt sleep. Sleep deprivation can aggravate RLS, creating an unhealthy cycle.
Causes of Restless Leg Syndrome
Restless Leg Syndrome has been linked to:
- Low levels of iron in the brain
- Parkinson’s, and other neurologic conditions
- Kidney failure
- Peripheral neuropathy
- Medications such as anti-nausea drugs, antipsychotics, antidepressants that increase serotonin, and cold and allergy treatments that contain sedating antihistamines
Alcohol and caffeine have been known to aggravate RLS symptoms.
The Link with Chronic Venous Insufficiency
RLS is also associated with chronic venous insufficiency (CVI). With CVI, venous reflux can trigger the uncomfortable sensations associated with RLS. Those with CVI typically have varicose veins, which is present in 25-35% of females and 10-20% of males – a statistic consistent with the more frequentÂ female RLS sufferers. Because patients with RLS have a high likelihood of having CVI, treatment of CVI can relieve symptoms. In fact, a study in the journal Phlebology found that 98% of patients treated for CVI found relief from their RLS symptoms, with 80% reporting long-term relief.
Restless Leg Syndrome Diagnosis
There is no specific test for RLS, but doctors will look for four things:
- Symptoms that are worse at night
- An overwhelming urge to move legs for relief
- Symptoms triggered by rest or periods of inactivity
- Relief only brought on by moving legs
To determine if the underlying condition is a vein disease, your doctor will need to do a complete physical examination and have a duplex ultrasound performed on the veins. The duplex ultrasound will help identify problems such as reflux and provide an overall picture of both the deep and superficial venous system. You will need to stand for this ultrasound, as this will reveal any blood flow concerns. If you lay down, venous insufficiency can be missed. Be sure to have your ultrasound done at a specialized vein center, as sonographers are specifically trained in finding venous insufficiency and produce more accurate results.
Restless Leg Syndrome Treatment
There are treatment options for venous insufficiency that can greatly reduce the symptoms of RLS. In the past, surgical stripping of veins was required, but technology has evolved and endovenous laser ablation (ELA) is the safe, nonsurgical procedure of choice. The ELA procedure works like this:
- A small, freckle-size incision is made in the skin
- An ultrasound guides a small probe with laser fiber to the damaged vein
- Pulses of laser light are sent to the vein, which causes the vein’s internal wall to collapse and seal shut
The entire procedure lasts less than an hour, and only local anesthesia is necessary. Patients can get up and walk the same day, and normal activities can be resumed in only a day or two. ELA boats a 98% long-term success rate at keeping the saphenous vein closed.
Sclerotherapy for Restless Leg Syndrome
Another treatment option is sclerotherapy, which is used to treat varicose or spider veins on the surface of the legs. During this procedure:
- A tiny needle injects a solution called sclerosant into the veins
- Sclerosant causes the veins to close
- The body absorbs the treated veins
An ultrasound may need to be used for guidance if deeper branches of the veins are present. Sclerotherapy usually requires multiple treatments.
Restless Leg Syndrome Doctor Utah
Don’t accept a lifetime of medication as your solution to Restless Leg Syndrome – find out if your RLS is caused by venous insufficiency. At the Vein Institute of Utah, we offer free leg screening twice a month to those in the Salt Lake Valley. Visit our website for more information or to sign up for a free leg screening.