OsteoBlog: Restless Legs?
Restless Leg Syndrome (RLS) isn't widely known and it certainly isn't that common.
However, the symptoms can be very distressing and result in altered quality of life.
RLS is classed as a neurological movement disorder for which there is no cure and doctors don't really know what causes it. There are no tests which give a definitive diagnosis but some underlying diseases can precipitate it.
If these are controlled then the RLS tends to subside.
To be diagnosed with RLS, you have to fit a criteria of signs and symptoms:
A strong urge to move the legs, usually when you are resting, by tossing and turning, rubbing or jiggling.
Unpleasant and unusual sensations in the legs including burning, prickling, creeping, electric shock or aching pain.
Sensations are often relieved with movement.
Symptoms are worse in the evening or at night when you are tired or resting.
Sufferers often find it hard to get to sleep and then stay asleep if they have severe RLS.
Incidences of RLS tend to increase with age and the condition is twice as prevalent in women than men, particularly those that reside in Northern Europe.
It is believed that RLS can be caused by the faulty use or lack of iron in the brain. The brain uses iron to make dopamine, which is responsible for movement control. People with Parkinson's disease have problems with their dopamine driven pathways, but having RLS does not mean that you have Parkinson's.
Conditions that effect brain iron levels include kidney failure, diabetes, rheumatoid arthritis, pregnancy and iron deficient anaemia.
A strong family history increases the likelihood of suffering as well as having peripheral neuropathy (from diabetes or other causes). 3rd trimester of pregnancy can cause RLS with it subsiding after birth but can return later in life.
It is known that certain drugs can cause RLS and these include:
Anti-nausea drugs (prochlorperazine)
Serotonin producing anti-depressants (citalopram, prozac)
Calcium channel blockers used to treat cardiac conditions and high blood pressure.
There have also been links to low levels of magnesium.
Of course, once these medications have been stopped, the condition subsides.
RLS interferes with the activities of daily living due to extreme tiredness from disrupted sleep patterns. Poor concentration, depression, mood swings and other health problems can be as a result of the course of RLS. Mild RLS symptoms may subside by lying down if the sufferer gets to sleep quickly enough.
In children, RLS can be associated with attention deficit disorder. Early onset adult RLS tends to run in the family and begins before age 45. The condition then tends to stay around for life and may progressively get worse. Patients with later onset of the condition will have no family history, and the condition does not seem to get worse with perhaps months of remission from symptoms.
If the underlying cause is treated then the condition subsides.
Do not confuse RLS with leg cramps that many older people get at night where the muscles tighten and become stiff. It is not the same thing and can be treated differently.
Arthritis and peripheral artery disease can also give pain in the legs which is worse at rest so please see your doctor if you have new symptoms like this.
Diagnosis & treatment:
It is a good idea to keep a diary of symptoms and sleep problems.
Your GP should take your history and give you a physical exam which might require blood tests to rule out other diseases before diagnosing RLS.
You may or may not be referred to neurology depending on severity of symptoms.
Medications used to treat Parkinson's disease (dopaminergics) can be prescribed for RLS along with Gabapentin (for nerve type pain) or benzodiazepines (sedatives/muscle relaxants).
There will be a recommendation to reduce alcohol and tobacco use, and promote good sleeping habits with regular bedtimes and rising times.
Stop any current meds that may be causing RLS and get plenty of exercise.
Walking, stretching, massage, bathing and heat or ice packs are all useful treatment modalities to try and may just provide distraction from your symptoms.
Research is ongoing.
National institute of neurological disorders and stroke (U.S)
Please see your doctor if you think you may be suffering from any of the symptoms mentioned in this article. This article is not a substitute for getting timely medical help.
Thanks for reading.