Restless Leg Syndrome: Treatment and Diagnosis is Stumping Physicians

Have you ever sat next to a particularly fidgety friend or loved one, and heard them make excuse after excuse for their errant limbs? Oftentimes they chalk their tremors up to restless leg syndrome.

But it turns out that restless leg syndrome, or RLS is actually a moderately serious neurological disorder which goes well beyond simply shaking your knee while eating dinner.

The syndrome is market by an overwhelming desire to move the legs, and can actually result in significant pain and disturbance of sleep patterns. The condition gets worse at night or when the person is at rest. While the precise cause of RLS is unknown, there is research that suggests that genetic factors, low levels of iron in the brain, or disturbances in the dopaminergic balance could all be responsible.

It has become enough of an issue that there’s an entire industry built around RLS—and one that is experiencing some decent growth. The global restless legs syndrome market is expected to grow at a CAGR of 11.46% from 2014-2019

Lack of proper diagnosis

While RLS can be a major issue, diagnosis is far from easy. Physicians usually prescribe blood tests and sleep tests and obtain information about the individual’s medical and family history to eliminate the presence of other conditions (such as Parkinson’s disease), but arriving at an actual diagnosis for RLS is definitely an imperfect science.

The International Restless Legs Syndrome Study Group (IRLSSG) recognizes the following symptoms for accurate diagnosis: an overwhelming urge to move the legs along with uncomfortable sensations such as itching or tingling, symptoms that occur or worsen when at rest or inactive, symptoms that are relieved by moving the legs or rubbing them, and symptoms that worsen during the evening or at night. However, this is not a comprehensive list and the symptoms can closely resemble those associated with other diseases. This can lead to misdiagnosis, and the condition might even remain undiagnosed.

High unmet medical need

And it turns out that even if you do manage to nab a proper diagnosis for RLS, treatment itself isn’t easy. The unknown etiology of the disease prevents the introduction of drugs that treat the exact cause of RLS. The drugs currently on the market only offer symptomatic relief, and the side effects of some of these treatments are downright nasty—nervous system disorders, gastrointestinal issues, depression, decreased libido, weight gain, increased appetite, vertigo, fatigue, irritability, and peripheral edema could all be yours, in your quest to stop your shaky legs!

Not a great trade off.

On the bright side, this means there are some huge unmet needs in the market, which means that any drug that can provide a complete cure with minimal side effects would experience widespread adoption

Increased preference for off-label drugs

But there a bright side! While there may not be a drug available to specifically treat RLS, more awareness about the condition is helping physicians figure out how to help patients, while also minimizing drug side effects.

Overall, the drugs used to treat RLS are generic drugs of different classes such as dopaminergic agents, opioids, anticonvulsants, and sedatives and hypnotics. For instance, Neurontin by Pfizer is used in the treatment of seizures, and can be used to help reduce sensory disturbances and pain in people with RLS. Drugs such as Restoril by Mallinckrodt, used in the short-term treatment of insomnia, help improve the sleep quality of patients.

It’s not a perfect solution, but more mergers and acquisitions between vendors in this market and the overall positive market projections are contributing to a sunny outlook for the global RLS market over the next four years.