Medical Edge Newspaper Column

The Difference Between Shaky Leg Syndrome and Restless Legs Syndrome

March 5, 2006
DEAR MAYO CLINIC:
I was diagnosed with shaky leg syndrome (orthostatic tremor) a few years ago. Could you tell me the difference between shaky leg syndrome and restless legs syndrome? -- Austin, Minn.

ANSWER:
Though the names sound alike, shaky leg syndrome and restless leg syndrome are very different, both in symptoms and treatment.

With shaky leg syndrome, the legs visibly shake or jerk when you stand. Symptoms are relieved when you sit, lie down or lean against a wall. There is usually no feeling of pain or discomfort other than the unpleasant nature of the tremor.

Because the condition can disrupt balance, patients with shaky leg syndrome may not venture out much, and may become more dependent on others than they would like.

The condition is rare, affecting far less than 1 percent of the population. Anticonvulsant medications such as valproic acid (Depakote) and gabapentin (Neurontin) can provide some relief.

In contrast, restless legs syndrome causes the legs to feel extremely uncomfortable when sitting or lying down. People with restless legs syndrome describe the sensation as jittery, tingling, burning or aching feelings in the lower legs and thighs. The unpleasant feeling goes away when you get up and move around.

Restless legs syndrome is common, affecting an estimated 20 percent of the population. Symptoms can range from bothersome to incapacitating. They can fluctuate and even disappear for a time. Although restless legs syndrome doesn't lead to other serious medical problems, it often interferes with sleep, which can adversely affect quality of life.

Treatment for restless legs syndrome includes medications used to treat Parkinson's disease and epilepsy as well as opioid analgesics, muscle relaxants and sleep medications. Restless legs syndrome can be associated with iron deficiency, and any patient with restless legs syndrome should be evaluated for possible iron deficiency. Iron replacement may help to relieve symptoms.

Lifestyle changes and home care can relieve symptoms, too. Options include massaging your legs, applying warm or cool packs, using relaxation techniques such as yoga or meditation, exercising, and cutting back on caffeine, alcohol and tobacco.

Restless legs syndrome can be hereditary, whereas shaky leg syndrome usually is not. One aspect of restless legs syndrome and shaky leg syndrome is the same: Doctors aren't exactly sure of the cause of either one.

-- Jeffrey Britton, M.D., Neurology, Mayo Clinic, Rochester, Minn.