From the Guidelines
Yes, females can experience restless leg-like symptoms in their upper extremities and trapezius muscles, known as restless arms syndrome or restless limb syndrome. These symptoms typically include uncomfortable sensations such as crawling, tingling, or aching that create an irresistible urge to move the affected area.
Key Points to Consider
- The pathophysiology likely involves dysfunction in the brain's dopamine pathways, similar to what occurs in traditional restless legs syndrome 1.
- For treatment, medications used for restless legs syndrome may be effective, including dopamine agonists like pramipexole (0.125-0.5 mg daily) or ropinirole (0.25-4 mg daily), gabapentin (300-1200 mg daily), or in some cases low-dose opioids 1.
- Lifestyle modifications can also help, such as maintaining regular sleep patterns, avoiding caffeine and alcohol before bedtime, engaging in moderate exercise, and practicing relaxation techniques.
- These symptoms may be related to underlying conditions like iron deficiency, pregnancy, kidney disease, or certain medications, so it's essential to consult with a healthcare provider for proper diagnosis and to rule out other neurological conditions 1.
Important Considerations for Treatment
- The American Academy of Sleep Medicine suggests the use of ferrous sulfate over no ferrous sulfate in patients with appropriate iron status, and the use of bilateral high-frequency peroneal nerve stimulation over no peroneal nerve stimulation 1.
- The use of opioids for RLS is conditional, with a low risk of abuse and overdose in appropriately screened adults, and selection of a particular opioid can be tailored to the patient based on side effect profile, pharmacokinetics, and other factors 1.
- Iron treatment is an important addition to the treatment of RLS, with evidence pointing to the efficacy of slower-release, high-dose formulations of IV iron, including ferric carboxymaltose, ferumoxytol, and LMW iron dextran 1.
From the Research
Restless Leg Syndrome in Females
- Restless Leg Syndrome (RLS) is a neurological disorder characterized by an uncomfortable urge to move the legs, typically worsened by rest and improved by movement 2, 3.
- The prevalence of RLS is higher in women than in men, with some studies suggesting that women are up to twice as likely to experience RLS symptoms 3, 4.
- RLS symptoms can spread from the legs to other body regions, including the arms, in some cases 2.
Upper Extremity and Trapezius Involvement
- While RLS is typically associated with leg symptoms, some studies suggest that symptoms can occur in other body regions, including the arms 2.
- Augmentation, a complication of RLS treatment, can cause symptoms to spread from the legs to other areas, including the arms 2, 5.
- However, there is limited specific evidence on the involvement of the upper extremities and trapezius region in RLS 2, 3, 5, 6, 4.
Gender-Specific Factors
- Hormonal changes, particularly fluctuations in estrogen levels, may contribute to the higher prevalence of RLS in women 4.
- Pregnancy and increased parity are also known risk factors for RLS in women 3, 4.
- Iron deficiency, which is more common in women, may also play a role in the development of RLS symptoms 2, 4.