What is Restless Legs Syndrome?
Restless legs syndrome is an irritating and uncomfortable neurological disorder that causes feelings in the legs that suffers have described using words such as: tingling, numbness, pain and needles, tiredness, itching, uneasiness, pain, cramping, aching, burning, creeping, crawling, and simply indescribable. Although most cases of restless leg syndrome happen in healthy people, there is an increased chance of the syndrome occurring in people who have diabetes or chronic alcoholism, or who are pregnant. Cases of restless leg syndrome caused by pregnancy usually clear up after delivery of the baby.
Causes of restless legs syndrome
Some recognized causes include iron deficiency, neurological lesions, pregnancy, diabetes, and uremia. Other possible causes of restless leg syndrome may be included or exacerbated by medications such as antidepressants, lithium, and dopamine antagonists, H? blockers. Caffeine has been recognized as exacerbating the symptoms of restless leg syndrome.
Risk factors of restless leg syndrome:
- Diet – caffeine(coffee, tea, coca, and a large number of soft drinks) has been shown to increase subjects’ proneness to develop RLS at lower levels of blood glucose. Alcohol is also recognized as a dietary trigger for restless leg syndrome.
- Smoking – affects the blood flow and oxygenation of already stressed muscles.
- Hormones- low levels of serotonin possibly due to the interaction with dopamine can trigger restless leg syndrome.
- Health issues – chronic fatigue syndrome and fibromyalgia sufferers seem at increased risk of having restless leg syndrome.
- Nutrient – low levels of iron, magnesium, folic acid and vitamin E may be found to be low in people with RLS.
Symptoms of restless leg syndrome
Restless leg syndrome is characterized by a tetrad of:
- Disagreeable leg sensations that usually occur before sleep onset.
- Irresistible urge to move the limbs
- Partial or complete relief from discomfort on leg movement
- Return of the symptoms on cessation of leg movements.
The most disabling complaint is the irresistible and profound urge to move the limbs. Patient describes a building of the sensation to a point where they must give in and move their legs. Restless leg syndrome has been describes as arising from rest, and the symptoms are present only at rest and just before the patient sleeps. The symptoms sometime interfere with sleep onset and may cause insomnia and prolonged awakenings, leading to significantly reduce total sleep time. The sensory complaints are often very difficult to describe and are left to subjective interpretation by the patients, who may use multiple terms to describe the discomfort (e.g. creepy crawly, ache, burning, creeping, crawling, and pulling).
Restless leg syndrome is considered to be a clinical disorder that is principally diagnosed by history. Examination may provide opportunities to rule out masking disorders, while sleep testing is best used when other sleep disorders are suspected.
The four diagnostic features: URGE
The diagnosis of restless legs syndrome is a clinical diagnosis. There are no specific tests to order, no pathognomic findings on exam or in the laboratory. Diagnosis depends on the patient’s history of symptoms. As developed by the international RLS study group, there are four diagnostic features must be present to make a definite diagnosis of RLS. These can be remembered under the acronym URGE. They are following
- Urge to move the legs. (An urge to move the legs that is usually accompanied or caused by unpleasant sensations in the legs)
- Rest induced(The worsening of the symptoms at rest)
- Gets better with activity(The relief of symptoms with activity)
- Evening and night worse (A variation of symptoms with time of day such that symptoms are worse or only occur in the evening and/or night.)
Treatment of restless legs syndrome
Treatment of restless leg syndrome is aimed at controlling the often-debilitating sensations. The first approach is to look for factors that might be contributing to the symptoms. When restless leg syndrome linked to iron deficiency anemia, doctors prescribe iron supplements. Life style changes, such as following a balanced diet that contains iron and eliminating or cutting down on caffeine, alcohol, and cigarette smoking, may also help. For mild cases, exercising, stretching or massaging your legs, applying heat or ice packs, or taking a hot bath may bring relief. If these treatments don’t work, medication from one of several drugs classes may be prescribed. The medication do not cure restless leg syndrome; they manage the symptoms and are needed on a permanent basis.
Dopamine agents, benzodiazepine, opioids, and anticonvulsants.
Homeopathic treatment of restless leg syndrome – Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat restless leg syndrome but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned; several well-proved remedies are available for restless leg syndrome treatment that can be selected on the basis of cause, location, sensation, modalities and extension of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Few important remedies for the homeopathic treatment of restless leg syndrome are given below:
Arsenic Album, Causticum, Rhus Tox, Tarantula, Zincum Met, Belladonna, Ruta, Carbo Veg, Lycopodium, Kali Carb, Natrum Mur, Sepia, Phosphorous, Nitric Acid, Platina, Sulphur, Psorinum and many other medicines.
- Donald Webb; Medical Meanderings 2006; 18-19.
- Alon Y. Avidan, Phyllis C. Zee; Handbook of sleep medicine; 2006; 112
- Wayne A. Hening, Mark J. Buchfuhrer B. Lee; Clinical Management of Restless Legs Syndrome; 19-20.
- Lawrence Epstein, Steven Mardon; The Harvard Medical School Guide to Night’s Sleep 2006; 148,150