Restless legs syndrome is characterized by pain in the legs, pain which becomes more severe while resting and lose its intensity when the person moves his feet. Symptoms are worse in the evening or at night so that people with restless legs syndrome generally suffer from insomnia. Restless legs syndrome installs gradually and leads to pronounced impairment of lower limbs. This syndrome affects the hands rarely.
Causes of restless legs syndrome:
- Iron deficiency
- Nerve disorders
- Kidney disease (associated with deficiencies of vitamins and minerals)
- Some medicines
Symptoms vary from person to person. Symptoms may be uncomfortable or irritating, annoying or debilitating. Although the disease is not life threatening, may have a negative effect on everyday life. Symptoms may include:
- Urgent need to move legs
- Uncomfortable sensation in legs
- Sleep disorders and difficulty in falling asleep
- Periodic, involuntary, spasmodic movements of the lower limbs occurring during the night.
RLS etiology is unknown. However, studies showed that it could be related to a disturbed balance of a chemical in the brain, a substance called dopamine. Dopamine is secreted naturally and is involved in coordinated movements. The dopamine blood level lowers in the evening and can thus be explained why RLS symptoms get worse in the evening and at night. Another cause of RLS is the iron deficiency, which occurs in the production of dopamine. There are two types of RLS: primary and secondary.
Primary RLS occurs naturally. It can occur at any age, though usually occurs in young adults with mild, minimal symptoms. However, symptoms may become more frequent and severe, causing sleep disturbances. This happens later in life, after age 50 years.
There are data suggesting familial cases of RLS. One study showed that people who develop the syndrome before 45 years, come from families where at least 50% of family members had this disease. However, if the disease occurs after 45 years, only 45% of relatives were affected.
It occurs as a complication of other conditions such as:
- Iron deficiency anemia
- Chronic renal failure
- Chronic alcoholism.
Some medications can also worsen the symptoms as antidepressants, antipsychotics, antihypertensives or those for heart disease, allergic or cold treatments and tranquilizers.
Many forms of restless legs syndrome are mild and require no treatment. These forms can be improved by some simple life changes. However, in case of severe symptoms, it is recommended therapy – medical and lifestyle modification. If the patient is diagnosed with RLS, we recommend establishing with your doctor the possible therapeutic options.
There are several lifestyle changes that can improve symptoms RLS, for example:
- Avoid stimulating substances as tobacco, alcohol, coffee
- Quit smoking
- Exercise regularly (but not around the hours of sleep)
- Establish a regular sleep schedule by waking up and going to bed at the same hours, avoid stimulants, such as caffeine.
- Avoid drugs that may trigger or exacerbate the symptoms, and if you think that you take a medicine that may cause the RLS symptoms , we recommend you to continue the normal administration of the drug but to establish a meeting with your doctor as soon as possible.
Other methods to improve symptoms RLS include:
- Stretching and massaging legs
- Performing a warm bath in the evening
- Reading or watching TV in order to distract you
If you experience severe symptoms that do not respond to lifestyle changes, we recommend a combination between drug therapy and the life style mentioned before. Dopamine agonists are the most common types of medication for this disease. These drugs are used to treat Parkinson’s disease. However, patients with RLS are not at increased risk of developing Parkinson’s disease. These agonists increase the dopamine level, the main cause of RLS.
Ripinirole and pramipexole are two types of dopaminergic agonists, frequently used in the RLS treatment. Like any other type of medication, they can have side effects. In case of patients who need medication, it is recommended the doctor’s opinion in establishing a balance between benefits and side-effects. If the symptoms don’t respond to dopaminergic agonists, other substances like carbamazepin, gabapentin, benzodiazepins and strong can be used. Although those chemicals are not legal in the United Kingdom, some specialists use them in RLS forms that don’t respond to other forms of treatment.