Restless legs- agonizing urge to move

Restless legs syndrome

Do you sometimes suffer from a hard-to-describe, deep-seated and uncomfortable urge to move your legs?

Does this urge to move increase when you sit down or lie down in bed?Does it get better when you move or walk?

Does it get worse in the evening or at night?

If you have answered "yes" to all the questions, it is very likely that you have "restless legs syndrome"!

What is restless legs syndrome?

What is it?

Restless legs syndrome (RLS) or "restless legs syndrome" is a neurological disorder whose cause is unknown. The symptomatology consists of an unpleasant urge to move the legs, which typically occurs when sitting down or going to rest.

The discomfort is very difficult to describe: it tingles, pulls, bites, burns or hurts deep in the legs and immediately gets better when you move your legs.

Although the legs are usually affected, the symptomatology can also refer to the arms or other parts of the body.

Other characteristics

Other diagnostic criteria are

Sleep disturbances and daytime sleepiness
Involuntary twitching of the legs while sleeping or at rest (not while falling asleep!)
Periodic leg movements during the night with movements every 20-40 seconds
Increase of symptoms during the day
Accumulation during pregnancy
Accumulation in direct relatives

Frequency

The disease is common: it is estimated that 3-10% of the population is affected. Of these, 1-2% are said to require treatment.

Women are more often affected than men. The disease may appear at a young age.

If symptoms begin before the age of 40, familial clustering is common. A genetic cause is thought to be linked to chromosome 12. If the symptoms do not begin until after the age of 50, fewer affected relatives are found.

Periodic Limb Movement Disorder

Periodic leg movement

Like restless legs syndrome, this disorder also affects the movement of arms and legs during sleep. However, the symptoms start abruptly without any internal urge.

In most cases, the legs move automatically during sleep, typically lasting between half a second to a maximum of 5 seconds. After 20-40 seconds the phenomenon repeats itself and so it goes hundreds of times in a single night.

The result: lack of recovery during sleep, no thought of a restful deep sleep.

The diagnosis is made in the sleep laboratory or with an examination of leg movement (actimetry) with appropriate sensors attached to the legs.

The therapy corresponds to the measures that have been mentioned in Restless Legs Syndrome.

Diagnosis

Clinical diagnosis

The diagnosis is made according to clinical criteria. Laboratory tests or technical examinations are necessary at most as a supplement.

The following symptoms should be present:

An urge to move the legs, usually accompanied by or caused by uncomfortable and unpleasant sensations in the legs.
The urge to move and the uncomfortable sensations begin or worsen during periods of rest or inactivity such as sitting or lying down.
The urge to move and the uncomfortable sensations are partially or completely improved by exercise such as walking or stretching, and also by mental activity such as computer games. The improvement lasts at least as long as this activity is performed.
The urge to move and the uncomfortable sensations are worse in the evening or at night than during the day, or occur exclusively in the evening or at night.

The followingadditional indications exist:

Restless legs syndrome in first-degree relatives.
Response to therapy with L-dopa
Periodic leg movements during sleep

Causes

The actual cause of the complaints is unknown. However, there are some findings:

Genetic factors certainly play a role
20% suffer from the symptoms during pregnancy
20-60% of dialysis patients have RLS
Patients with polyneuropathy (diffuse nerve damage, mostly in the legs) are also more frequently affected.
Iron deficiency aggravates the complaints

Certain medications/drugs can worsen symptoms:

Antidepressants
Neuroleptics
Antiemetics
Lithium
Caffeine
Alcohol

Misdirected

Many patients often go from doctor to doctor, and it takes a long time before the correct diagnosis is made. Since the complaints occur in the legs or muscles, orthopedists or vascular specialists are consulted in addition to the family doctor - who, of course, cannot find anything.

The right contact person is a neurologist.

Our observations

In recent years we have noticed that two groups of patients are particularly affected:

Patients with swelling and water retention of the legs. You can find more details under the keyword "lipedema". In this case, decongestive therapy procedures also have a very positive effect on RLS.
Patients with increased tension and especially changes in breathing with a decrease in CO2 level. For more details, see the topic "Hyperventilation". In this group of patients, we were able to achieve significant progress through breathing training.

Therapy

Drug therapy

Medicinal help is possible! The most effective drugs are anti-Parkinson drugs. Although this is quite clear, it is not known why this occurs.

RLS is not a preliminary stage of Parkinson's disease!

Drug therapy is effective and efficient. But it should definitely be discussed with a specialist (neurologist).

Medications (examples)

L-Dopa (e.g. Restex® - the only approved drug with this active ingredient)
Dopamine agonists (pergolide, pramipexole, ropinirole)
Sedatives (clonazepam, oxazepam, etc.)
Antiepileptic drugs (gabapentin)
Opiates (tramadol, oxycodone, etc.)

Non-drug therapy

From our perspective, therapy for RLS is by no means limited to medications. We are often surprised how quickly the symptoms improve when a multimodal therapy is consistently applied.

Especially important seem to be decongestive procedures, (e.g.) manual lymphatic drainage, apparative compression, other forms of massage, restful sleep (sleep hygiene), relaxation procedures, respiratory therapy and a change of diet with weight optimization.

In particular, respiratory therapy seems to us to be suitable for reducing the general excitability of the central and peripheral nervous system.

Restless legs- agonizing urge to move

Restless legs syndrome

What is restless legs syndrome?

What is it?

Restless legs syndrome (RLS) or "restless legs syndrome" is a neurological disorder whose cause is unknown. The symptomatology consists of an unpleasant urge to move the legs, which typically occurs when sitting down or going to rest.

Other characteristics

Frequency

Periodic Limb Movement Disorder

Periodic leg movement

Diagnosis

Clinical diagnosis

Causes

Causes

Misdirected

Our observations

Therapy

Drug therapy

Non-drug therapy

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Similar disease patterns

Teaser lipedema

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Teaser fluid storage

Tense and swollen: fluid retention syndrome

Teaser Restless legs

Urge to move at rest: Restless Legs