3 Questions to Determine if Growing Pains Could Be RLS
Did you know that difficulties falling asleep or staying asleep due to “growing pains” might be restless legs syndrome (RLS)?
While RLS can present as only pain in the legs, if a patient describes creepy-crawly, tingling, buzzing, ants crawling, or firecracker sensations in their legs, you should be suspicious.
Since RLS is diagnosed by clinical complaint, it is important to screen your patients in order to provide treatment. Here are 3 questions to ask your patients about RLS.
#1 - Do the pains or uncomfortable sensations only occur or get worse in the evening?
There is a clear circadian component to RLS, so when the leg discomfort gets worse in the evening, or only occurs at bedtime/during the night, this is a symptom of RLS.
#2 - Do you feel an urge to move or rub your legs?
Not only will kids feel discomfort, they will also have an urge to move or rub their legs if they have RLS. Some parents may describe a specific need to give their child a leg massage to help them fall asleep. This could be a sign that a younger child is experiencing RLS.
#3 - What makes the pain or sensations better?
When children and parents tell you that over-the-counter pain relievers or ice are sufficient to address leg pains, that is probably not RLS. But if they tell you they have to walk around or rub their legs to make the pain or discomfort stop, then RLS is likely.
Children with RLS may be also be described as restless sleepers, or have kicking or twitching during sleep. However, these are not diagnostic criteria.
If you suspect RLS in your patients, order a serum ferritin. Ferritin less than 50 ng/mL is associated with RLS.
A three month course of iron therapy is often sufficient to treat RLS, although a child should be re-evaluated for both ferritin levels and clinical complaints at the end of treatment, as some children may need a second course of iron therapy.
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