Restless legs syndrome was described back in the mid-twentieth century by one fairly well-known neurologist from Switzerland - Karl Axel Ekbom. And although this disease has long been studied, but this problem is still very relevant.
Pathology Description
This syndrome is a neurological disease, which is manifested by paresthesia of the lower extremities and their excessive motor activity when at rest or during sleep.
According to statistics, 10-25% of the world's population have signs of this syndrome. Despite the fact that this disease can appear at any age, it is most common among middle-aged and elderly patients, although there have been cases of restless legs syndrome in children. There is also an assumption that women suffer from this ailment one and a half times more often than men.
A similar disorder is often present in pregnant women, therefore, women develop severe insomnia and mental disorders, which cannot be compatible with full-fledged bearing.
We will consider the treatment of restless legs syndrome in this article.
The manifestation of pathology in children
A similar pathology in children is often falsely referred to as a syndrome called “growth pain”. There are clinical studies with which it was found that the syndrome of restless legs in childhood is due to a lack of attention on the part of parents, resulting in psychological disorders. Other experts believe that this disorder is a consequence of motor hyperactivity in children during the day. The exact and unambiguous reasons for the development of this syndrome in children and adolescents have not yet been elucidated, but it has already been proven that the disease has a tendency to progress over the years and cannot be eliminated on its own.
Syndrome in pregnant women
Restless legs syndrome is often observed during pregnancy - in about 15-30% of cases. Most often, the symptoms begin to appear in the third trimester, and then the disease goes away by itself during the first month of motherhood. But you also need to know that such a disorder can be directly related to existing problems in the body, including iron deficiency anemia.
Causes of restless legs syndrome
The primary reason is hereditary. This syndrome in 40-60% of cases is in close relatives. We are talking about autosomal dominant and recessive types of inheritance.
Secondary causes of restless legs syndrome:
- low hemoglobin;
- iron deficiency;
- diabetes;
- disruption of the endocrine organs;
- prolonged current hypovitaminosis;
- rheumatoid arthritis;
- kidney disease, leading to a delay in the body of toxic substances;
- chronic obstructive pulmonary disease;
- severe alcohol poisoning;
- diseases of the cardiovascular system;
- autoimmune processes in the body;
- neurological disorders;
- injuries of the spinal cord and peripheral nervous system, as well as peripheral neuropathies of various origins.
During pregnancy, hormonal disruptions, venous congestion in the lower extremities and a lack of folic acid and iron can occur.
Who else is celebrated?
Restless legs syndrome is sometimes noticed in patients suffering from such diseases:
- Parkinson's disease;
- essential tremor;
- Tourette's syndrome ;
- Huntington's disease;
- amyotrophic lateral sclerosis;
- post poliomyelitis syndrome.
It still remains unclear whether this combination is due to random coincidence (due to the high prevalence of the syndrome), the presence of common pathogenetic mechanisms, or improper use of drugs.
Irrational use of drugs
Restless legs syndrome is often a side effect of certain medications (antihistamines, antidepressants, seizures, vomiting medications, and hypertension). Rarely, there are cases when abuse of drinks with a high caffeine content leads to this phenomenon.
How does restless legs syndrome manifest? About it - further.
Symptoms
Many patients say that restless legs syndrome is when you go to bed, but you can’t fall asleep. Convulsions, itching, burning, crawling, numbness in the legs appear. Some describe their sensations as follows: tingling, twitching, sensation of discharge of electric current, trembling, moving under the skin. As a result, there is a great desire to move your legs or other parts of the body in order to remove discomfort in the limbs or at least slightly reduce it. Symptoms also include involuntary movements of one or both legs at distinct intervals. If both legs are involved at once, then they move simultaneously, in rare cases, the movements of each are possible with different intervals.
Feature
Distinctive feature: pain in the syndrome depends on physical activity and posture. It happens that pains appear and intensify when a person is motionless or in a sitting position, but more often they appear when lying down and decrease when moving. In order to eliminate the discomfort that arises, a person tries to stretch or bend his limbs, rub, massage, shake them, spin in bed, get up and move around the room, or simply step over from foot to foot. Each has its own set of movements that help him eliminate unpleasant sensations in the limbs. In this case, the discomfort becomes less or goes away, but as soon as a person lies down, and sometimes just stops moving, these feelings are repeated again.
Manifestations of the symptoms of this syndrome usually have a clear schedule, appearing and growing in the evening or at night. In extremely severe cases, the typical circadian rhythm disappears, and discomfort is constantly present.
It happens that the symptoms of an idiopathic or primary syndrome worsen over time, but some people can go away for weeks or months without observing any signs of the disease at all. If restless legs syndrome appeared due to illness, while taking medication or pregnancy, then it can disappear as soon as the provoking factor disappears. How to treat restless legs syndrome is of interest to many. About it - further.
Treatment for restless legs syndrome
With the syndrome, treatment must first be directed to eliminating the primary disease. So, with diabetes, you need to normalize the balance of glucose and insulin, take Metformin so that the pain in the lower extremities disappears, and you also need to make up for the lack of iron, folic acid and other vitamins and minerals. Therapy is symptomatic, and along with taking medications they resort to non-pharmacological measures. What does it mean?
Non-drug activities
The following measures are non-pharmacological:
- moderate exercise throughout the day;
- an evening walk;
- evening contrast shower;
- a balanced diet with the exception of the use of coffee, strong teas and other products that contain caffeine in the evening and daytime (chocolate, Coca-Cola, etc.);
- restriction in the consumption of alcoholic beverages;
- to give up smoking;
- establishing a normal full-fledged daily regimen.
Baths and massage
Warm foot baths or a light warming massage before bedtime will definitely help improve your condition. Sleeping is recommended in a cool, quiet room. Physiotherapeutic procedures are shown:
- vibration massage;
- magnetotherapy - the use of magnetic fields that have analgesic, anti-inflammatory and decongestant effects;
- the use of mud therapeutic applications.
Since the causes and treatment of restless legs syndrome are interconnected, it is necessary, as already mentioned, to direct all actions to eliminate provocative factors.
It is also necessary to observe a quiet sleep regimen, create comfortable conditions for falling asleep (well-ventilated, quiet room). Diuretics should be avoided. A very useful habit is going to bed and getting up at the same time every day. Gradually, you need to reduce the light intensity in the room about an hour before bedtime, you can also read some interesting book before bedtime.
Drug use
Special drugs for restless legs syndrome should be prescribed only in cases where the pathology noticeably affects the patient's vital activity, thereby causing stable sleep disturbance. In cases of severe discomfort, you have to choose drugs from four main groups:
- dopaminergic agents;
- anticonvulsants;
- opioids;
- benzodiazepine.
Benzodiazepines contribute to the onset of sleep, but with prolonged use can cause dependence. There is also a side effect of their use - drowsiness during the day, low libido, episodic confusion at night. Therefore, such drugs can only be used for a strictly limited time and under the supervision of a physician.
Dopaminergic drugs are very effective for symptoms of restless legs syndrome. But they can cause side effects such as dry mouth, headaches, nausea, dizziness, muscle cramps, and irritability. True, in most cases this all manifests itself in a mild way.
Dopamine receptor agonists (ADRs) can be taken daily for a long time without significant damage to health. Side effects from them: headache, nausea, high fatigue, dizziness, drowsiness in the daytime. In order to avoid such manifestations, take the drug with small doses. It should be noted that, eliminating the symptoms of restless legs syndrome, dopaminergic drugs do not always help normalize sleep, so you need to take them in combination with sedatives.
Folic acid, preparations of magnesium, iron, vitamins C, B, E are taken in order to replenish the body with useful substances. In rare cases, it happens that especially intense pain cannot be eliminated by taking other drugs, then opioids are prescribed. But their use can be dangerous because they are drugs and can be addictive. Anticonvulsants are used as an aid in restless legs syndrome. During pregnancy, second-generation iron preparations are recommended that do not harm the baby.
Very effective for restless legs syndrome “Mirapex”. Relieves negative symptoms. It can be used for a long time.
What to exclude?
It is necessary to exclude the use of substances and medicines that can enhance the manifestations of restless legs syndrome:
- Drugs containing alcohol. Such an intake of alcohol can and can alleviate the symptoms for a while, but in the future the manifestations of the disease will significantly worsen.
- Antiemetic drugs, such as Raglan, Metoclopramide, Compazin, Prochlorperazine. They significantly aggravate the symptoms of the syndrome. If there is an urgent need to suppress nausea and vomiting, you must use Kitril or Zofran.
- Antihistamines - Diphenhydramine and other over-the-counter antipyretics.
- Tricyclic antidepressants - "Asafen", "Amitriptyline" and the like.
- A selective serotonin reuptake inhibitor (Prozac, Trazodon), although in some cases there was a positive effect when taking these drugs, especially Bupropion.
- Lithium preparations.
- Calcium channel blockers (Finoptin, Corinfar).
- Typical antipsychotics (phenothiazines).
- Atypical antipsychotics (Risperidone Olanzapine).
- Anticonvulsants ("Zonizamide", "Metsuximide", "Phenytoin").
Lifestyle
If you still can’t fall asleep due to uncomfortable sensations in your legs, doctors advise:
- change the position of the body in the bed;
- take aspirin - this will muffle the symptoms, but do not forget that aspirin will not save you from the disease and is only good as a one-time measure;
- stand up and walk when the legs need movement, do not refuse them;
- wear cotton socks.
Prevention
There are no specific preventive measures against the primary restless legs syndrome. You can only delay its development. To do this, you need to walk a lot, do not drink coffee, alcohol and tobacco, eat a balanced diet.
Prevention of the secondary syndrome is the timely treatment of the diseases that cause this pathology. Only, for example, during pregnancy, no treatment can help. In such cases, the doctor should simply explain to the woman that this is a short-term phenomenon, and after delivery everything should go away.
Restless Leg Syndrome Reviews
Reviews about this pathology are contradictory. Someone has an illness on their own, someone does not help treatment. All individually. But maintaining a healthy lifestyle will help smooth out the symptoms.