Restless Leg Syndrome & Other Leg Symptoms

What is Restless Leg Syndrome?

Restless leg syndrome (RLS) is a neurological disorder that causes an uncontrollable urge to move someone’s legs and is frequently described as a creepy-crawly sensation.

It triggers uncomfortable sensations, such as tingling or aching. These symptoms typically worsen in the evening or at night, making it difficult to relax or get restful sleep.

While the exact cause of RLS varies, it is frequently linked to venous insufficiency, a condition in which veins struggle to return blood to the heart efficiently.

Quick Insights About RLS

• Symptoms primarily at night when a person is relaxing or at rest 

• Moving the lower extremities relieves the discomfort, therefore RLS is classified as a movement disorder

• Up to 10 % U.S. population affected

• More common in middle-aged or older individuals

• Women are more likely to experience RLS than men

How we Treat RLS at Miller Vein

The most important thing to remember about the treamtent of restless leg syndrome is that venous reflux disease is a cause. Prior to taking any medications, a venous reflux workup is necessary.

Our minimally invasive treatments—including endovenous thermal ablation with ClosureFast™, VenaSeal™, Varithena™, and ultrasound-guided foam sclerotherapy—can improve circulation and alleviate the discomfort associated with RLS.

What is Venous Reflux?

Normally, veins carry blood from your legs up to your heart using one-way valves. When veins get weak, these valves no longer function, and blood may flow backward towards your feet.

This abnormal flow is called venous reflux or venous insufficiency. Pooled blood leads to varicose veins, spider veins and a variety of symptoms, such as restless leg syndrome.

Treatment is Proven to Help

A large sleep study demonstrated that 50% of individuals suffering from RLS also had venous reflux or venous insufficiency. Other studies have shown even greater percentages.

More importantly, study after study demonstrates that 87% of patients treated with endovenous ablation experience RLS symptom improvement.

One study revealed that 89% of patients had a decrease in their RLS score by at least 15 points! (The scale ranges from 0 to 40, making 15 points a significant improvement.)

Information on RLS Medications

Dopamine agonists (DAs) are no longer recommended as first-line treatment

• Efficacy of treatment wanes over time

• Long-term use of DAs often causes augmentation and may cause impulse control disorders

Augmentation is a drug-induced worsening of RLS symptoms

• Earlier onset of symptoms in the afternoon or evening

• Increased symptom severity

• Faster onset of RLS symptoms at rest

• Progression of RLS symptoms to other body parts

Alpha-2-delta ligands (ex. gabapentin and pregabalin) are currently first-line treatment for RLS (if venous workup is negative)

• Side effects:

• Fatigue

• Dizziness

• Sedation

• Somnolence

• Ataxia

• Peripheral edema and weight gain

Tonic motor activation (TOMAC)

• Novel nonpharmacological therapeutic device indicated for treatment of moderate-severe refractory RLS

• Worn bilaterally on the legs over the peroneal nerve at the head of the fibula

• Modulates afferent fibers of the peroneal nerve and evokes tonic motor activation of the tibialis anterior muscle, thereby mimicking the neural signals associated with voluntary leg movements

Other Leg Symptoms Related to Chronic Venous Insufficiency (CVI)

Most Common Leg Symptoms

• Heaviness – A sensation of weight or fatigue in the legs

• Pain or aching – Often described as a dull, heavy, or throbbing pain

• Swelling (edema) – Especially around the ankles and lower legs, which typically worsen throughout the day

• Throbbing — A throbbing sensation in the legs

• Itching, burning, or tingling sensation – May feel like pins and needles

• Cramping – Especially at night and after prolonged standing or sitting

Skin and Vein Changes

• Varicose veins – Enlarged, twisted veins, often visible on the surface of the skin

• Spider veins – Smaller, web-like veins appearing on the legs

• Skin discoloration (hyperpigmentation) – A brownish or reddish discoloration, especially around the ankles

• Lipodermatosclerosis – Hardening and tightening of the skin due to chronic inflammation

• Eczema (stasis dermatitis) – Dry, itchy, flaky, or scaly skin, often near the ankles

• Open sores or ulcers (venous stasis ulcers) – Slow-healing wounds, usually near the ankles

• Skin warmth or redness – Due to increased inflammation

Untreated Vein Disease Leads To...

• Frequent skin infections (cellulitis) – Weakened skin barrier can lead to infections

• Severe leg swelling (lymphedema) – Prolonged CVI can cause fluid buildup

• Tightness in the calves or ankles – Due to chronic swelling and fibrosis

• Deep vein thrombosis (DVT) risk – In severe cases, poor circulation can contribute to clot formation

Peripheral Neuropathy

The symptoms of peripheral neruopathy and Vein Diease frequently overlap. Studies illustrate improvement in peripheral neruopathy symptoms after endovenous ablation treatments.

Intersting Note: Notice how many of the symptoms listed above are frequently described by people diagnosed with peripheral neuropathy.

Don't Wait to Feel Better

If you’re struggling with restless, uncomfortable legs, schedule a consultation with our team to explore whether venous treatment can help you find lasting relief.

References

Yolgosteren, A., Kose Leba, L., & Bican Demir, A. (2020). Investigation of chronic venous insufficiency in patients with sleep disorders due to restless leg syndrome. Phlebology, 35(10), 771–776.

Hayes, C. A., et al. (2008). Effect of ELA on RLS. Phlebology, 23, 112–117. https://doi.org/10.1258/phleb.2007.007051