if something is region restricted in the US then can you only use it in the US?
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Usually yes. But depends on the item at hand. Say if its currency like xbox gift card,psn,etc then yes its region restricted period. Now if the item is say a Game/DLC code for whatever platform even its region restricted to whatever country listed you can always use VPN service to redeem it in your country. Should work no problem from what I have heard. Never done it myself but friends have with no problem. Simple google search on how to do this is out there 
Thanks for the help! Much appreciated.
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No Problemo 
Sorry I have another question. So the thing I want is an digital code for an xbox game and the region restriction is in the US only and if I use a vpn to claim it will I still be able to play it and download it?
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Yes when you do the vpn method and it goes thru it will act like all your other games. You won’t have to do anything else. My buddy bought Destiny 2 Shadowkeep and it was Argentina code he used VPN to redeem it in US and worked like a charm. See no reason it wouldn’t work that way where you are from.
As long as that digital code is the xbox game and not currency that you are going to use for said game
If I claim this will I still be able to buy perks and stuff for this game in microsoft store for this game?
Yes just use Microsoft Store like you always have.
From what i heard using the correct vpn is the trick because a lot of the free ones don’t work as well. Buddy told me the guy he bought the code from recommended him to use a certain free vpn but it turned out to be trash n he just used his own n it worked right away. So yeah just a heads up if it doesn’t worked you may need to try Another. Good Luck