Restless legs syndrome (RLS) also called Wittmaack-Ekbom's Syndrome is a fairly common condition affecting over 10 million people in the USA. It is postulated that there are many more sufferers as the disease is largely under- or misdiagnosed. It appears to be slightly more common in women, as well as in the obese, smokers and diabetics. Some ethnic groups are affected more than others and genetic studies have identified genes on three different chromosomes which increase your risk of developing the disease. This disorder also occurs secondary to a number of other conditions including iron deficiency anaemia, kidney failure, and other neurological movement disorders such as Parkinson's.
Diagnosis
RLS is a hard disease to diagnose and commonly the symptoms are attributed to many other causes such as arthritis, muscle cramps, varicose veins and deep vein thrombosis. Neurological and vascular tests are performed as are routine blood tests in order to rule out secondary causes of the disorder.
You may be a sufferer if you fit the following:
- You feel you need to move your legs due to an uncomfortable sensation
- This need is much worse during periods of inactivity such as when sitting in a chair or while lying in bed
- The sensations are partly removed when you stretch your muscles or walk around
- Sensations get worse as the day progresses especially at night.
Symptoms
The symptoms all relate to pain, tingling or a burning feeling in the legs, which makes you want to move your legs constantly. I can remember some nights trying to get to sleep and having this horrible sensation in my legs which felt as if I had ran 20km, when in fact all I had done all day was laze about. I had to move them up and down for hours before I could get any sleep. I am not alone, my mother sometimes paces the hallway with pains in her legs until she gets some sleep, well for a few hours and then she will be back up again walking the floors. This happens most nights and then the next day she is exhausted and finds it hard to cope with work and other daily activities.
Treatment
The treatment depends on a number of factors including making an accurate diagnosis and determining the severity of the disease. It is important to note that this disease is not fully treatable and there is no cure. If RLS is occurring as a result of another disorder then the other disorder should be corrected, for example iron deficiency anaemia can be controlled by iron supplementation. This should help to resolve some of the RLS symptoms. Initially dopamine agonists such as cabergoline are administered to patients in an effort to relieve their suffering and symptoms. If this does not work an alternative drug levodopa which is used to treat the movement disorder Parkinson's is given. If the patient's condition appears to be progressing with symptoms appearing much earlier in the evening it is often necessary to re-introduce a dopamine agonist which must be given several times during the day. In some cases this still will not alleviate symptoms and anti-epileptic drugs such as carbamazepine are required.
Painkillers can also be taken in low doses on a short term basis if the pain becomes particularly severe. With regards to sleeping problems and insomnia clonazepam can be taken to help reduce anxiety and relax muscles in order to give the patient a much better chance to get some sleep. In severe cases patients may need to go into hospital for overnight treatment. The drugs used for treatment come with their disadvantages though and even though they may be effective at ameliorating some of the symptoms, they have several side effects including those affecting the gastrointestinal system such as nausea and loss of appetite. Recent research has also highlighted the dangers of dopamine agonists, and their ability to damage important valves in the heart.
There is currently a vast amount of research in this area in the hope of finding a cure to ease those who are suffering from this frustrating disorder, but until then sufferers will have to make do with the current available drugs and their side effects.
