Restless legs syndrome was described in the middle of the 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.
Description of pathology
This syndrome is a neurological disease that is manifested by paresthesia of the lower extremities and their excessive motor activity at rest or during sleep.
According to statistics, 10-25% of the world's population have signs of this syndrome. Although this disease can appear at any age, it is most common among middle-aged and elderly patients, although cases of restless legs syndrome have been seen in children. There is also an assumption that women suffer from this disease one and a half times more often than men.
Such a violation is often present in pregnant women, therefore, women develop severe insomnia and mental disorders that cannot be compatible with a full-fledgedgestation.
Treatment of restless leg syndrome will be discussed in this article.
Manifestation of pathology in children
Such a pathology in children is often falsely attributed to a syndrome called "growing pains". There are clinical studies that have found that restless legs syndrome in childhood is caused by a lack of attention from 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 clarified, but it has already been proven that the disease tends to progress over the years and does not resolve itself.
Syndrome in pregnant women
Restless legs syndrome is often observed during pregnancy - in about 15-30% of cases. Most often, 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 Leg Syndrome
The primary cause is hereditary. This syndrome in 40-60% of cases is present in close relatives. We are talking about autosomal dominant and recessive types of inheritance.
Secondary causes of restless leg syndrome:
- low hemoglobin level;
- deficitiron;
- diabetes;
- endocrine disorders;
- prolonged current hypovitaminosis;
- rheumatoid arthritis;
- kidney disease leading to retention of toxic substances in the body;
- 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 lack of folic acid and iron can occur.
Who else is celebrating?
Restless Leg Syndrome is sometimes noticed in patients suffering from the following conditions:
- Parkinson's disease;
- essential tremor;
- Tourette syndrome;
- Huntington's disease;
- amyotrophic lateral sclerosis;
- post-polio syndrome.
It is still unclear whether this combination is due to a coincidence (due to the high prevalence of the syndrome), the presence of common pathogenetic mechanisms or misuse of drugs.
Irrational use of medicines
Restless legs syndrome is often a side effect of certain medications (antihistamines,antidepressants, anti-seizure medications, anti-vomiting medications, and anti-hypertensive medications). Rarely, there are cases when the abuse of drinks with a high content of caffeine leads to this phenomenon.
How does Restless Leg Syndrome manifest itself? More on that later.
Symptoms
Many patients say that restless legs syndrome is when you go to bed, but you can’t fall asleep. There are convulsions, itching, burning, crawling, numbness in the legs. Some describe their sensations like this: tingling, twitching, feeling of an electric current, trembling, stirring under the skin. As a result, there is a great desire to move the legs or other parts of the body in order to remove discomfort in the limbs or at least reduce it a little. Symptoms also include involuntary movements of one or both legs at regular intervals. If both legs are involved at once, then they move simultaneously, in rare cases, the movements of each are possible at different intervals.
Feature
Distinctive feature: soreness in the syndrome depends on motor activity and posture. It happens that pains appear and intensify when a person is motionless or is in a sitting position, but more often they appear when lying down and decrease when moving. In order to eliminate the resulting discomfort, a person tries to stretch or bend the limbs, rub, massage, shake them, turn around in bed, get up and move around the room, or simply step overon foot. Everyone has his own set of movements that help him eliminate discomfort in the limbs. At the same time, the discomfort becomes less or goes away, but as soon as a person lies down, and sometimes just stops moving, these sensations are repeated again.
Manifestations of signs 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 always present.
It happens that the symptoms of the idiopathic or primary syndrome increase over time, but some people can go for weeks or months without observing any signs of illness at all. If restless legs syndrome appeared due to an illness, against the background of taking medications or pregnancy, then it may disappear as soon as the provoking factor disappears. How to treat restless legs syndrome is of interest to many. More on that later.
Treatment for Restless Leg Syndrome
In the syndrome, treatment should first of all be directed to the elimination of 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 also resort to non-drug measures. What does this mean?
Non-drug interventions
Non-drug treatments include the followingEvents:
- moderate exercise throughout the day;
- evening stroll;
- evening contrast shower;
- balanced diet with the exclusion of coffee, strong teas and other products that contain caffeine (chocolate, coca-cola, etc.) in the evening and during the day;
- restriction on the consumption of alcoholic beverages;
- quitting smoking;
- establishing a normal full day regimen.
Baths and massages
Warm foot baths or a light warming massage before bed will definitely help. It is recommended to sleep in a cool, quiet room. Physiotherapy treatments shown:
- vibromassage;
- magnetotherapy - the use of magnetic fields that have analgesic, anti-inflammatory and decongestant effects;
- application of mud healing applications.
Since the causes and treatment of restless legs syndrome are interrelated, it is necessary, as already mentioned, to direct all actions to eliminate the provoking factors.
It is also necessary to observe a calm sleep pattern, create comfortable conditions for falling asleep (well-ventilated, quiet room). Diuretics should be avoided. A very useful habit is to go to bed and get up at the same time every day. Gradually, you need to reduce the intensity of the lighting in the room about an hour before bedtime, you can also read some interesting book before bedtime.
The use of drugsfunds
Special drugs for restless legs syndrome should be prescribed only in cases where the pathology significantly affects the patient's life, thereby causing a stable sleep disturbance. In cases of severe discomfort, one has to choose drugs from four main groups:
- dopaminergics;
- anticonvulsants;
- opioids;
- benzodiazepine.
Benzodiazepines promote sleep, but long-term use can cause addiction. 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 doctor.
Dopaminergic drugs are very effective for the symptoms of restless leg syndrome. But they can cause side effects such as dry mouth, headaches, nausea, dizziness, muscle spasms and irritability. True, in most cases, this all manifests itself in a mild way.
Dopamine receptor agonists (DRA) can be taken daily for a long time without significant damage to he alth. Side effects from them: headache, nausea, high fatigue, dizziness, drowsiness in the daytime. In order to avoid such manifestations, start taking the drug with small doses. It should be noted that, while eliminating the symptoms of restless legs syndrome, dopaminergic agents do notalways help to normalize sleep, so they should be taken in combination with sedatives.
Folic acid, magnesium, iron preparations, 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 narcotic substances and can be addictive. Anticonvulsants are used as adjuvants for restless leg syndrome. During pregnancy, second-generation iron supplements are recommended that do not harm the baby.
Very effective for restless leg syndrome Mirapex. Relieves negative symptoms. Can be used for a long time.
What to exclude?
It is necessary to exclude the use of substances and medicines that can increase the manifestations of restless leg syndrome:
- Preparations containing alcohol. This intake of alcohol can and can relieve the symptoms for some time, but in the future the manifestations of the disease will worsen significantly.
- Antiemetics such as Reglan, Metoclopramide, Compazine, Prochlorperazine. They significantly aggravate the symptoms of the syndrome. If there is an urgent need to suppress nausea and vomiting, Kytril or Zofran should be used.
- Antihistamines – Dipheningidramine and other OTC antipyretics.
- Tricyclic antidepressants - Azafen, Amitriptyline andsimilar.
- Selective serotonin reuptake inhibitor (Prozac, Trazodone), although there have been some positive effects with 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 sleep because of uncomfortable sensations in your legs, doctors advise:
- change body position in bed;
- take aspirin - this will muffle the symptoms, but do not forget that aspirin will not relieve you of the disease and is only good as a one-time measure;
- get up and walk around when your legs need movement, don't refuse them;
- wear cotton socks.
Prevention
There are no specific preventive measures against primary restless leg 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 consists in the timely treatment of 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 phenomenon, and after childbirth everything shouldpass.
Restless legs syndrome reviews
Reviews about this pathology are contradictory. For some, the disease goes away on its own, for some, treatment does not help. Everything is individual. But maintaining a he althy lifestyle can help alleviate symptoms.
