Total Joint Replacement Educational Series Part 15: Restless Leg Syndrome

RESTLESS LEG SYNDROME (RLS)

What is "restless leg syndrome?"

Restless leg is a neurological disorder in which people feel the urge to move the legs when at rest.  People often describe the sensation as burning, creeping, or pain in the legs, which can range from uncomfortable to extremely painful.  This sensation usually occurs deep inside the leg, between the leg and ankle, and less commonly in the feet, arms, thighs and hands. Because of this sensation to constantly move the legs that does relieve the pain, it is often difficult to sleep and stay asleep, causing extreme daytime fatigue and exhaustion.  The lack of sleep can then cause impaired memory, difficulty concentrating and inability to perform activities of daily living. 

Restless leg syndrome is slightly more common in women and usually occurs in patients middle aged and older.   Events which can trigger restless leg are long car trips, sitting in a movie or any other periods of prolonged inactivity.  In most cases the cause of restless leg syndrome is unknown, but it can be caused by certain medications, chronic medical conditions, pregnancy, and even caffeine, alcohol and tobacco.  Temporary restless leg syndrome can be caused by total joint replacement. 

RESTLESS LEG SYNDROME AFTER TOTAL JOINT REPLACEMENT

After a total joint replacement, patients can often experience a "restless leg-like syndrome."  That is not a true restless leg, but rather a temporary condition resulting from muscle and joint healing as well as the swelling from surgery.  It is more likely to occur after knee replacements, and it can involve a feeling of diffuse pain, calf pain, cramping or the sensation to move leg around.  It is mostly experienced at night and resolves as the muscles and joints heal - approximately 6-10 weeks after the surgery.

TREATMENT OF RESTLESS LEGS SYNDROME

AFTER TOTAL JOINT REPLACEMENT

Treatment of restless leg after total joint replacement involves just moving the leg.  When awakened at night by the sensation, the best thing to do is stretch and walk around.  Also, for most patients the symptoms are less noticeable in the early morning, allowing time to rest.  Decreasing caffeine intake and tobacco and alcohol use can also lessen RLS.  Moderate exercise, regular sleep patterns, ice and massage can help eliminate the urge to move the leg.

·      Walking

·      Exercising or moving your joint, especially at night

·      Stretching

·      Ice and massage

·      Regular sleep patterns

·      Anti-inflammatories or other medications on a case-by case basis

Please keep in mind that restless leg syndrome caused by total joint replacement is a temporary condition and usually will resolve 6-10 weeks after the surgery.