EDITOR'S NOTE: This weekly column by reporter Bill Kettler answers readers' questions about topics of general medical interest with information provided by doctors from PrimeCare, Jackson County's independent practice association.

I have leg cramps at night, sometimes moderate and sometimes very strong. I am a 69-year-old female, and I have had this problem off and on for about three years. It's quite painful and of course it disturbs my sleep. I have been working out at the gym three times a week for two years, but it's had no effect on my problem.

— Jan H., Medford

Leg cramps could be caused by any number of conditions, but one common source, especially among older people, is restless-leg syndrome.

Physicians look for four essential criteria to determine whether a patient has RLS, says Dr. Jeff Solomon, who specializes in physiatry (restoring the body's physical functions).

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"There's an urge to move the leg," Solomon says, "or unpleasant sensations in the leg. The sensations tend to be worse during periods of rest, like a long trip. They're generally worse at night, and the sensations are relieved by movement."

Solomon says this relatively common disorder earned its name because it typically affects the lower extremities, but it can occur in the arms or hands, too. It affects up to 6 percent of us, and strikes men and women in roughly equal numbers. It typically appears in the fourth or fifth decade of life, but it can appear in younger people, too.

It also tends to run in families — parents can pass it on to their children — and as many as 25 percent of pregnant women report RLS symptoms, but it usually disappears after pregnancy.

RLS is a problem because it often interferes with sleep. Solomon says people who have RLS fail to get the restorative sleep they need, which in turn can affect their ability to perform their daily activities and, in some cases, lead to other conditions such as depression or fibromyalgia.

The causes of RLS are unknown, and there are no specific tests to confirm its presence, so physicians try to eliminate other possible conditions before making a diagnosis. RLS is associated with iron deficiency, so physicians may want to do draw blood or perform other tests on patients who have symptoms of RLS.

Solomon says good sleep habits help some people manage RLS. Eliminating substances such as chocolate, caffeine and alcohol from one's diet may reduce symptoms. Regular exercise or pre-bedtime stretching help some people, too.

"You want to make sure your muscles have an outlet for their energy," he says, "so they aren't tight."

Drugs that are used to treat movement disorders such as Parkinson's disease also are used to treat RLS. Solomon says drugs that increase the body's level of dopamine (a chemical that transmits signals between nerve cells) often reduce symptoms dramatically, but those drugs also can cause side effects such as nausea and altered mental states. Drugs in the opioid family and benzodiazepine drugs are effective, too, but they have powerful side effects as well.

Alternative therapies such as acupuncture and massage also have been used to treat restless-leg.

Call Bill Kettler with your medical questions at 776-4492, or e-mail them to: bkettler@mailtribune.com or send them to: Mail Tribune, Ask Your Doctors, P.O. Box 1108, Medford OR 97501.