Restless legs syndrome how to treat. Restless legs syndrome: classification, causes, signs, diagnosis, treatment, prognosis

Movement disorders are characterized by a variety of clinical manifestations. One of the mysterious but fairly common problems in adults over 30 is restless leg syndrome (RLS). It is manifested by unpleasant sensations in the lower extremities, which can be dealt with with the help of massage and physical activity.

Distinguish between a primary problem and a secondary one. Since the movement disorder occurs at night, it is associated with sleep disturbances that create serious inconvenience for the patient. Diagnosis of the disease is reduced to the exclusion of other possible factors of violation of the physiological functioning of the nervous system and muscles.

Since the exact pathogenesis of the disorder is unknown, doctors today are unable to explain its nature. At the same time, it is customary to distinguish two main manifestations of the problem, the division of which is based on the origin of RLS:

1. Idiopathic restless legs syndrome is a primary process, the cause of which is unknown. Moreover, more than 50% of cases of detection of this disorder belong to this group. Family cases of the disease are also confirmed, which are diagnosed in 40–80% of patients. Presumably, this pattern is associated with genetic changes, namely, with defects in individual sections of chromosomes. Doctors tend to multifactorial disorders, that is, the need for exposure to environmental factors and the presence of a predisposition to the development of the disease.
2. Symptomatic restless legs syndrome is associated with other ailments, which are the main cause of its formation. Failures that occur both with age and under the influence of chronic processes provoke metabolic disorders, leading to tremors in the limbs. It is one of the main signs of this movement disorder. Failures of physiological innervation are formed with vegetovascular dystonia (VVD), a lack of trace elements, and renal dysfunction. Uremia presumably plays one of the key roles in the pathogenesis, which is associated with a high percentage of patients on dialysis who have a disorder of the muscles. A certain cascade of reactions provokes the occurrence of restless leg syndrome during pregnancy. All of these causes can lead to RLS.

There are two main theories explaining the nature of the clinical manifestations of the problem. The first is based on the participation of iron in the conduction of nerve impulses. Low blood ferritin levels in patients are associated with more severe symptoms and poor prognosis. This assumption is also confirmed by visual methods of brain research, such as magnetic resonance imaging and polysomnography. Autopsy in people with severe manifestations of RLS revealed a decrease in the level of iron in neuromelanin, as well as an increase in the amount of a protein that regulates the transport and metabolism of this microelement. The difficulty of using these indicators in the prognostic assessment of the condition of patients lies in the fact that their level in peripheral blood does not reflect its intracellular concentration, which is of key importance. At the same time, there are studies proving that the blood-brain barrier is a kind of reservoir of iron, which is actively used by brain neurons.

The second theory is based on dysfunction of dopaminergic receptors. The neurotransmitter that controls impulse transmission plays an important role in the proper functioning of skeletal muscles. Although the exact cascade of reactions in RLS is unknown, this assumption is one of the main ones today. It is based on a significant improvement in the condition of patients when using drugs from the group of dopaminomimetics.

Main symptoms

Although medicine does not exactly know the pathogenesis of the disease, its clinical picture only confirms the assumption of a neurological origin of the disease. Signs of RLS are directly related to impaired innervation of the muscles of the limbs. Hands are rarely involved in the process only because of the lower load and the lack of such a pronounced predisposition to stagnation. There are several main symptoms of restless leg syndrome. In this case, most often they occur in the supine position, during sleep or before it:

1. Limbs begin to hum. Patients complain of discomfort, while pain is absent. Exercise and massage help to get rid of this problem, in connection with which people try to walk around and stretch their legs. The condition is alleviated by increased blood flow activity.
2. The sensitivity of the lower extremities is impaired. There is a tingling sensation, the legs seem to become cold, itching and a desire to run.
3. Muscle tremors are a common symptom. It is manifested by twitching fingers, and sometimes the entire foot is involved in the process. The shins can also be affected, but this is less common.

More often, clinical manifestations are recorded in the late evening or at night. This makes patients irritable, distracted and reduces their performance, because it interferes with normal rest. Some people develop insomnia because it takes a long time for muscle tremors and discomfort to calm down.

Diagnosis of the disease

To date, there are no methods to identify or accurately confirm the disease. If you suspect restless legs syndrome, you will need to see a neurologist who will collect an anamnesis and conduct a thorough examination of the patient. With the secondary development of a movement disorder, hematological tests will be needed, as well as polysomnography, which allows you to record brain activity during sleep. Diagnosis includes an X-ray examination, as well as a photo of the central nervous system using magnetic resonance or computed tomography to exclude pathological changes. Based on the results of the examinations, an individual plan for dealing with the disorder is drawn up.

Treatment of RLS

Therapy of the disease depends on the etiology of its formation. If the syndrome occurs against the background of other chronic systemic problems, then it is necessary to act on the cause. When restless legs syndrome occurs primarily and is idiopathic, treatment is carried out at home, and the justification for medical support in each case is determined individually.

Preparations

When dealing with RLS, doctors try not to use potent drugs, as this can adversely affect the general condition of the patient. Herbal preparations based on valerian and motherwort are widely distributed. In severe cases, anticonvulsants and dopaminergic medications such as Levodopa are used. The effectiveness of the latter once again proves the neurological origin of the disorder. Sedatives are also actively used to restore natural sleep, which is disturbed by restless leg syndrome. When the patient's condition is aggravated by depression, appropriate medications are used.

If a patient has a lack of vitamins and microelements, in addition to a special diet, synthetic analogues of these substances in the form of tablets are also prescribed. Iron, magnesium and folic acid preparations contribute to the normalization of neuromuscular transmission and the mitigation of the manifestations of RLS. If the syndrome is associated with congestion, ointments are used that activate venous circulation, such as Troxerutin. Effective and drugs that help thin the blood, for example, "Aspirin", which also has an analgesic effect, as well as medicines for removing excess fluid, which include "Diakarb".

Folk remedies

Home treatments are well received for restless leg syndrome. This is due to the great importance of diets and regimens in the fight against this disorder. The following recipes are most effective in maintaining good health in patients with RLS:

1. Hawthorn infusion helps fight spasm and anxiety. You will need to pour a teaspoon of dried flowers of the plant with a glass of boiling water, leave for 2-3 hours, then take a drink 2-3 times a day.
2. Melissa also helps to cope with the manifestations of the disease. Moreover, it can be taken both in the form of an infusion, which requires only half a teaspoon per glass of boiling water, or used for foot baths at night.

Sleep hygiene is important. The bedroom needs to be well ventilated. If patients go to bed at about the same time, they feel a noticeable improvement, which implies that adherence to the regimen has a beneficial effect on the course of the disease. Walking before bed in the fresh air also helps fight muscle tremors and discomfort.

Gymnastics

Physical exercise plays a leading role in the fight against restless leg syndrome. It is important not to overload the lower limbs, as this will only aggravate the situation. Doctors recommend doing stretching-based gymnastics, as it has a beneficial effect on the functional ability of the muscles. You can do it both during the day and before bed. Yoga is a good helper in the treatment of restless leg syndrome. Various asanas allow you to keep the body in good shape, without too much load on the muscles of the lower extremities. Normal walking is also useful, for which special conditions are not required.

Forecast and prevention

The outcome of the disease depends on the cause of its occurrence and the adequacy of the therapy. In cases of idiopathic RLS, 30% of patients experience long-term remission. If other chronic diseases are identified that could provoke the disorder, the prognosis depends on the response to their treatment.

Prevention comes down to maintaining a mobile and active lifestyle, following the general rules of a healthy diet and timely diagnosis of systemic ailments that can cause movement disorders.

Possible Complications

Sleep disturbances are the main consequence of RLS. Insomnia is a common problem associated with constant restlessness and the need to move around to relieve muscle spasm. With pathologies of innervation, aggravation of congestion and limitation of the patient's further mobility is possible.

A fairly common occurrence, incomprehensible discomfort in the legs, which do not allow you to fall asleep or, conversely, wake up a person. Most people explain such sensations to themselves as banal fatigue, without going into details, but this ailment has a name - restless legs syndrome. However, first things first…

So, restless leg syndrome, what is it? This is a neurological disease that manifests itself at the time when the patient goes to bed. The main complaint of patients is that, supposedly, as soon as you go to bed, incomprehensible burning sensations and itching appear in your legs, all this causes discomfort and does not allow you to fall asleep. This is how this syndrome manifests itself.

The disease was first described in 1672 by Thomas Willis, after which the Swedish neurologist Ekb took up the study of this issue in the 1940s. That is why the disease occurs under the guise of Willis' disease and Ecomb's disease.

The disease is rare and occurs in 10-15% of the world's population. At risk are women who are about 1.5 times more likely than men to suffer from this disease. In addition, the disease is diagnosed in the elderly and middle-aged people.

The reasons

The causes of the formation of the disease are divided into two groups:

1. Of unknown origin (idiopathic).
2. Secondary (resulting from a concomitant disease or disorder).

The idiopathic nature of the development of restless leg syndrome is the most common. Moreover, this type of disease, compared with the secondary one, begins to develop much earlier. So, the patient begins to feel the first signs of the idiopathic form of the syndrome already at the age of 30.

There is evidence that indicates the relationship of the idiopathic form of the disease with a hereditary factor, however, it is impossible to assert that the disease has a 100% hereditary structure, since there is too little evidence.

As for the secondary type of the disease, in this case, the disease begins to manifest itself at a later age of about 40–45 years. The main reasons for the formation of a secondary type of disease are:

• diabetes;
• anemia;
• renal failure of a chronic nature;
• thyroid disease;
• chronic alcoholism;
• circulatory problems in the legs
• multiple sclerosis;
• spinal cord injury;
• tumor processes in the spine;
• radiculopathy;
• arthritis;
• amyloidosis;

Amyloidosis is a disease associated with disorders of protein metabolism in the body and is characterized by deposits of the amyloidoid substance.

• lack of vitamins in the body (B vitamins, folic acid, thiamine);
• uremia;
• excess weight;
• lack of dopamine in the body;

Dopamine is the hormone responsible for movement

• polyneuropathy.

Pregnancy should be singled out as a special group, since it is this condition of the female body that can cause Willis's disease. In about 20% of cases, a pregnant girl may feel discomfort associated with her legs (more often in the 2nd and 3rd trimester of pregnancy). All symptoms disappear within 1–1.5 months after childbirth.

In addition, the intake of certain drugs, neurological focus and excessive consumption of foods and drinks with excess caffeine can serve as an impetus for the development of the disease.

Symptoms

The symptoms of Ecomb's syndrome can be divided into two groups:

1. Touch.
2. Psychosomatic.

Sensory symptoms include the direct manifestations of the disease, and psychosomatic symptoms include its consequences.

So, the main sensory symptoms are:

• itching in the legs;
• feeling of "goosebumps";
• burning in the legs;
• numbness;
• pressure on the legs;
• involuntary motor manifestations (twitching, flexion or extension);
• tingling (the condition resembles when the leg or arm was lying down).

All of the above symptoms do not have a pronounced pain effect, however, their intensity causes discomfort and leads to the gradual development of psychosomatic symptoms.

The psychosomatics of restless legs syndrome manifests itself in the form of a depressive state in a person, against the background of regular lack of sleep. Perhaps aggravating the picture with frequent stress at work or in other places.

Restless legs syndrome manifests itself most clearly in the first half of the night. At the earliest stage, immediately after putting a person to sleep, after 15–30 minutes, he begins to feel attacks of this disease. The time interval from 12 am to 4 am is the most dangerous, in terms of the manifestation of the syndrome. From 4 a.m. to 10 a.m., the likelihood of the manifestation of the disease remains, but its intensity is much lower than in the first half of the night.

The discomfort caused by this disease does not allow a person to fully fall asleep, he is forced to knead his lower limbs, stretch them, change his sleeping position and even get up to “stretch” his legs.

The peculiarity of the disease lies in the fact that during exercises that relieve symptoms, the disease recedes, but as soon as the patient stops manipulating the legs, the sensations return.

Willis disease gradually begins to manifest itself not only in the supine position. There is evidence when the patient felt symptoms while walking.

Localization of unpleasant sensations is as follows:

1. About 50/% - lower leg.
2. About 30% are feet.
3. About 20% are thighs.

The most common place is the lower leg, less often the foot. There have been reports of symptoms of the syndrome on the hips, and even the torso with the arms.

Despite the age restrictions that have been described above, there is some evidence that this disease can also develop in children. In this situation, the symptoms of the disease in a child are no different from adults.

Diagnostics

The absence of visible reasons for the formation of the syndrome, the basis of diagnostic measures is the collection of data on the patient's condition as a result of a survey by the doctor. The study of the anamnesis allows the specialist to draw a conclusion about the presence or absence of this disease.

In addition, since the secondary type of the disease is associated with the presence of any disorders or abnormalities in the body, the patient's complaints about discomfort in the lower extremities are an indicator for diagnosing the body in order to detect such abnormalities. Such activities include:

• general blood analysis;
• analysis of blood sugar levels;
• Analysis of urine;
• analysis of the level of iron in the blood;
• electroneuromyography (ENMG);

Electroneuromyography - a study aimed at establishing the state of nerve conductors in the human body

• polysomnography (study of the patient's sleep);
• Ultrasound of the lower extremities.

One of the main tasks of a neurologist is not just to determine the presence of a problem, but also to be able to differentiate the disease from such ailments as anxiety disorder, akathisia, fibromyalgia, arthritis, vascular diseases, etc.

Treatment

Treatment for restless leg syndrome depends on the nature of the condition.

It is possible to cure and completely get rid of this disease. Usually therapy is as follows:

1. Medical treatment.
2. Treatment with folk remedies.

Treatment of the primary syndrome

How to treat the idiopathic form of the disease? As a rule, when there is no pronounced cause, the basis of treatment is the elimination of symptoms and alleviation of the patient's condition.

• refusal to drink alcohol (maximum restriction of its intake) and smoking;
• compliance with sleep and wakefulness (going to bed and waking up should be done at about the same time);
• contrast foot baths before bedtime will be an excellent prevention of Ekobma's disease.

In addition, for the treatment of the idiopathic form of the disease, the doctor prescribes a drug - mirapex.

Mirapex is designed specifically for the treatment of restless legs syndrome, in addition, it can be used for other diseases, such as Parkinson's disease.

The use of this drug during pregnancy is not discussed, since studies on pregnant women have not been conducted.

Treatment of the secondary syndrome

What to do if the cause of the disease is any internal or external disturbances? First of all, it is necessary to eliminate the cause that causes this syndrome. This will require either a change in lifestyle, or the doctor will prescribe medications to support the body.

What pills can be prescribed:

• benzodiazepines - sleeping pills (cause dependence with long-term use);
• dopamine receptor agonists - designed to produce dopamine in the body;
• vitamin complex (depending on which vitamin is required by the body);
• opioids - with severe sleep disorders;
• anticonvulsants - a symptomatic medicine to eliminate convulsive manifestations;
• drugs to treat depression.

ethnoscience

Treatment of this disease is carried out not only by medical methods, but also by folk remedies. So, for treatment at home, the following recommendations apply:

How else can you help your body during exacerbations:

• regular walks before going to bed in the fresh air;
• you can use a pillow as a roller, which must be placed between the legs before going to bed;
• the preferred sleeping position is on the side;
• during an attack, you need to rub your legs well with your hands.

Some tips for replacing drug therapy

Sex

Regular release of endorphins will improve the patient's quality of life, relaxation after intercourse will reduce the intensity of discomfort from Ekobm's disease or completely eliminate them for a while.

Massage

The relaxing effect of massage has long been well known to everyone. It is desirable that this be a relaxing foot massage, since a strong intense load on the legs can play a negative role in the fight against the disease.

Regular stretching

Stretching, oddly enough, has a positive effect on the body and soothes restless legs, and doing it on a regular basis will help in the fight against the disease.

Forecast

The prognosis for this disease is quite favorable, with proper and proper treatment and compliance with all the recommendations voiced by the doctor, the symptoms completely disappear and no longer bother the person.

It is worth remembering that the drugs that are practiced in the treatment of Willis' disease can be addictive, so you need to periodically replace them with others.

So, restless legs syndrome is an unpleasant disease that reduces the quality of sleep of a healthy person and causes depression. You should not run this ailment, but it is better to consult a specialist if its primary symptoms occur. Take care of your sleep and do not let any illness disturb it.

Synonyms for restless legs syndrome: Willis or Ekbom's disease. This is a disease in which discomfort occurs in the lower extremities. They appear mainly at night, often leading to awakening and even chronic insomnia. A person constantly wants to move his legs, he feels itching and burning.

Classification of pathology

The criterion for the main classification of restless legs syndrome is the cause of occurrence. Depending on this factor, Ekbom's disease is divided into the following types:

• primary syndrome. Occurs as an independent disease. Diagnosed in 50% of patients with restless legs. It accompanies the patient all his life, proceeds in the form of exacerbations and remissions.
• secondary syndrome. It acts as a complication of other diseases: neurological or somatic. Disappears after elimination of the root cause. It accounts for 50% of cases of Ekbom's syndrome. This disease affects about 16% of pregnant women.

Reasons for development

The primary (idiopathic) form of Ekbom's syndrome is characterized by an earlier onset of symptoms. The disease is typical for young people under 30 years old. Doctors even note family cases of the disease. The secondary type of Ekbom's syndrome is more common in people over 40–45 years of age. It is associated with pathological changes that occur in the body - metabolic disorders, damage to the vessels of the lower extremities or nerves.

primary form

Idiopathic Ekbom syndrome occurs suddenly. The exact reason for its development has not yet been established. Doctors identify only risk factors for restless legs syndrome (RLS):

• dysfunction of the central nervous system;
• stress, fatigue, depression and other psychological circumstances;
• hereditary predisposition (is the cause in 20-70% of cases).

Secondary

The pathogenesis of secondary Ekbom's disease is also not fully understood. Its causes are established using statistics: what diseases the patients had at the time the problem was discovered. These pathologies include:

• diabetes;
• iron deficiency;
• severe renal failure;
• thyroid disease;
• kidney disease;
• circulatory disorders;
• abuse of alcohol, caffeine, smoking;
• deficiency in the body of magnesium, vitamins of group B;
• arthritis;
• taking certain medications.

How Restless Leg Syndrome Manifests

The main symptom of tired legs is sensitive (sensory) disorders. They are represented by paresthesias and involuntary motor activity. Symptoms occur predominantly in the lower extremities, are bilateral in nature, occur in any position: sitting, lying, standing. The severity of symptoms is maximum between 0-4 a.m. and 6-10 a.m. in the morning. Other symptoms of Ekbom's disease:

• tingling;
• numbness;
• sensation of squeezing the legs;
• the illusion of "running goosebumps";
• a feeling that something is scratching in the legs.

Specificity of symptoms

In most patients, sensory disturbances begin to appear in the legs, less often in the feet. In the future, the disease develops as follows:

• As Ekbom's syndrome progresses, paresthesias begin to spread to the thighs, then to the arms and perineum. In some cases, sensory disturbances appear in the trunk area.
• At an early stage, the duration of discomfort is about 15–30 minutes. They are counted from the moment when the patient went to bed. In the future, discomfort may occur earlier, even during the day.
• During physical activity, the discomfort disappears. To get rid of unpleasant sensations, the patient is forced to move his legs: bend / unbend, shake, turn, massage them, walk on the spot. When the patient goes to bed, the symptoms reappear. Over time, a person develops his own “ritual”, which helps to get rid of discomfort for the longest possible time.

Diagnostic methods

Confirmation of the diagnosis in RLS is done by a neurologist. The diagnostic process is not difficult, but requires a thorough examination. The patient needs to undergo the following examinations:

• Blood analysis. It is necessary to determine the level of magnesium, iron and folic acid.
• Electroneuromyography. With the help of special equipment, a study of nerves is carried out to diagnose their electrical excitability.
• Polysomnography. This is a diagnosis of human motor activity during sleep.

Restless legs syndrome treatment

In secondary Ekbom's disease, attention is paid to the treatment of the underlying disease. When the ferritin level falls below 45 mcg / ml, iron preparations are prescribed. If other deficiency states are identified, they are also corrected. Idiopathic restless leg syndrome has no etiotropic therapy. Treatment is aimed at relieving the symptoms of the disease. The main methods of therapy:

• Non-drug treatment. It is used if restless legs syndrome does not cause severe discomfort to a person.
• Medical treatment. They switch to it at the next stage of therapy if the discomfort in the legs has increased.
• Physiotherapy. It is used at the stage of drug treatment as an additional method.
• Folk remedies. They can be used even at the stage of non-drug treatment in order to alleviate the symptoms of Ekbom's disease.

Medical therapy

Medications are prescribed when restless legs syndrome significantly impairs a person's quality of life, causing persistent sleep disturbance, and non-drug methods do not work. In mild cases, they are limited to taking sedatives. In more severe cases, choose from the following drugs:

Physiotherapy

Significant relief from restless legs syndrome is given by physiotherapy courses. The procedures are carried out in addition to medical treatment. The main methods of physiotherapy:

• magnetotherapy;
• vibration massage;
• reflexology;
• lymphopress;
• mud applications;
• darsonvalization of the legs.

Other non-drug methods

Non-drug methods include normalizing the regimen, walking before bed, moderate exercise, avoiding alcohol, eating caffeine-free foods, warm foot baths at night. Recommendations for home treatment of RLS:

• Sleep ritual. You need to go to bed and wake up at the same time.
• Physical exercises. During the day and before going to bed, you need to do therapeutic exercises. Pilates, stretching, yoga will help eliminate discomfort in the legs. Active sports will only exacerbate the symptoms. Football, basketball, volleyball, jumping are contraindicated in Willis disease.
• Contrasting foot bath. It is necessary to alternately rearrange the feet in hot and cold water.
• Hobbies. It is worth finding a hobby for yourself that will help distract you from unpleasant symptoms, such as drawing, reading or knitting.
• Regular foot massage. They need to be rubbed before going to bed, which will help make it easier to fall asleep.

Folk remedies and homeopathy

You should not self-medicate, especially if you are not sure of your diagnosis. Regarding alternative medicine, it is also worth consulting with a doctor.

Effective folk remedies:

• Golden mustache tincture. She needs to rub her limbs daily before going to bed.
• Infusion of hawthorn. Has a calming effect. About 1 st. l. pour hawthorn berries with a glass of boiling water, let stand until cool. Use the infusion daily before bedtime.
• Relaxing tea. Rinse 10 rose hips, add 1 tbsp. l. from a mixture of oregano, mint, valerian roots. Pour 400 ml of boiling water, leave for 40 minutes. Drink the resulting tea every day 2 hours before bedtime.

Video

Restless legs syndrome is one of the most uncomfortable neurological sensorimotor disorders. As a result of this disease, it often develops. Tellingly, restless legs disease can affect both children and adults, the elderly, that is, all age categories. But most of all, the pathology occurs in women over 60 years of age. The disease is quite difficult to diagnose, since it has few distinguishing features from other pathologies, so the correct diagnosis is made only in 8% of cases, which is very small.

Disease classification

As already indicated, the disease is more typical for older people. But restless leg syndrome in children is also common. Children can suffer from this problem for quite a long time. Restless legs syndrome during pregnancy is also possible, which leads to severe psychological disorders and prolonged insomnia. Ultimately, this problem greatly complicates the healthy bearing of the fetus. So, consider the main types of this syndrome:

1. Restless legs in a child. When children begin to hurt their legs, parents and even doctors often attribute this to one of the side effects of the intensive growth of the body. But very often the reason is completely different. So, recent clinical studies have confirmed the fear that sometimes the main signs of restless legs in childhood arise due to the lack of attention of parents to the child, which leads to a psychological disorder. Another reason why restless legs syndrome occurs at night in a child is his hyperactivity during the day. And although scientists until today cannot with full certainty indicate the exact reasons why symptoms of restless legs occur in children, this phenomenon is becoming more frequent, and it is impossible to eliminate the problem without treatment.
2. Restless legs in pregnancy. This phenomenon is quite common - it occurs in 15-30% of patients. As a rule, the problem arises in the third trimester and disappears by the second month of motherhood. At the same time, it is recommended to still find out the cause of this phenomenon, since sometimes the main symptoms occur against the background of advanced iron deficiency anemia and other problems in the body. So, if restless legs begin to cause discomfort during pregnancy - what to do? First of all, you need to go for an examination and make sure that the problem is not caused by something serious. Indeed, sometimes it is a harbinger of certain pathological factors that can even be transmitted to the child hereditarily.
3. Idiopathic or primary restless leg syndrome. The disease has an autosomal dominant hereditary nature and manifests itself in patients under 30 years of age. The symptoms of the disease are similar to those of secondary restless leg syndrome. The difference is that the idiopathic syndrome is not accompanied by other neurological or somatic problems.

Causes of this disorder

If we talk about a secondary disorder, then it occurs more often in older people in the presence of various comorbidities. For example, the following diseases can cause this problem:

• Iron-deficiency anemia;
• Parkinson's disease;
• type 2 diabetes mellitus, in which it is already necessary to inject insulin;
• uremia;
• chronic lack of cyanocobalamin and folic acid;
• heart failure;
• removal of the stomach and related complications;
• kidney failure;
• hormonal disorders;
• discogenic radiculopathy;
• Sjögren's syndrome;
• hypothyroidism, thyrotoxicosis, hyperthyroidism and other diseases associated with thyroid dysfunction;
• porphyrin disease;
• rheumatoid arthritis;
• obstructive pulmonary disease;
• varicose veins in advanced form up to venous insufficiency;
• other diseases of the circulatory system;
• cryoglobulinemia;
• severe pathologies of the spinal cord, etc.

One of the significant factors that can increase the likelihood of this syndrome is pregnancy. But if this is the only reason why the legs became restless, after childbirth the problem is eliminated. Other causes of restless legs should also be noted:

• chronic alcoholism;
• amyloidosis;
• porphyric polyneuropathy.

Restless Leg Symptoms

Before considering how to get rid of restless legs syndrome, you need to understand what its symptoms are. They differ significantly, depending on the time frame. So, the exacerbation of symptoms is usually observed from midnight to 4 o'clock in the morning.

If a patient has chronic and prolonged restless legs syndrome, he suffers from the following symptoms:

• severe pain in the lower extremities;
• pain is accompanied by severe tingling, a feeling of fullness, burning, tightness, pain in the legs, itching and other complications;
• the main exacerbations occur, as a rule, at night;
• the most common location of pain is the calf muscles and ankle joint;
• even if you are at rest, the signs of pain will only progress;
• there are neuropathic rhythmic movements in the legs;
• if you start moving, the pain and discomfort in the legs partially decreases.

If left untreated, restless legs can eventually lead to a very severe form of insomnia, as severe pain will prevent the patient from falling asleep. He will have to periodically move his limbs to reduce pain, and this interferes with sleep.

If, as a result, the patient manages to fall asleep, after a while the symptoms resume, and he wakes up again. Then falling asleep again becomes even more of a problem.

Diagnostics

Before treating restless legs syndrome, an accurate diagnosis is established. The disease has a neurological nature, which means that it is necessary to perform a whole range of examinations and analyzes in order to establish its causes and form.

The main approaches to diagnosis include the following:

• conducting a biochemical blood test;
• complete neurological and somatic examination at the doctor's appointment;
• analysis of all the symptoms of the patient, assessment of the family history of patients and other data that will help in making a diagnosis;
• conducting electroneuromyography;
• carrying out a quantitative analysis of the content of ferritin in the blood plasma and comparing the results;
• polysomnographic study, etc.

The studies themselves will not necessarily give the full picture. It is mandatory to visit a therapist, as well as an endocrinologist for a more accurate diagnosis. And only after that you can begin the treatment of restless leg syndrome.

Therapeutic treatment

As soon as a full diagnosis of the patient's condition has been carried out and the main cause of pain and discomfort of the lower extremities has been identified, an appropriate treatment regimen is chosen. For example, it may include a set of measures to restore the natural level of certain substances (for example, cyanocobalamin) in the blood, trace elements, vitamins, etc. The attending physician determines the most successful treatment regimen and prescribes it to the patient.

Medical treatment may include the use of the following drugs:

1. Sleeping pills and tranquilizers (Halcyone, Restoril, Klonopin, Ambien). These drugs are used at the initial stage, when the disease manifests itself with mild symptoms.
2. Antiparkinsonian drugs. Today, Mirapex is actively used as the main remedy for restless legs. This drug accelerates the production of dopamine and its metabolism, increases the sensitivity of its receptors in the striatum. The time of complete absorption of the product takes 1-2 hours, which means that it has a very fast effect. In view of this, Mirapex is used as a symptomatic drug in the treatment of idiopathic restless legs syndrome, as well as Parkinson's disease. The drug is sold strictly after the appointment of a doctor, as it has a list of significant side effects and contraindications.
3. Opiates. If the syndrome develops further and becomes more severe, doctors may resort to the use of strong painkillers. Opioid analgesics used are Methadone, Codeine, Oxycodone, Propoxyphene, etc.
4. Anticonvulsants (Tegretol, Neurontin, etc. are used).
5. It is also possible to use ointments and creams as local remedies to combat pain and achieve complete relaxation. Doctors may prescribe Menovazin, Nise, Relax, Nikoflex, etc.

Physiotherapy

The following procedures can be used to treat the disease:

• cryotherapy;
• vibration massage;
• endodermal electrical stimulation;
• magnetotherapy;
• darsonvalization of limbs;
• acupuncture;
• lymphopress;
• applications using sea mud;
• manual acupressure, etc.

Psychotherapy

Since the disease often has a psychogenic nature, it is important to undergo a course of psychotherapy, which implies constant consultations with a psychotherapist. This is usually necessary if the diagnostics did not find any causes of this violation. So, some patients need correction of comorbid mental disorders. They are prescribed sedatives, antidepressants, as well as benzodiazepine receptor agonists, in particular Trazodone and Zolpidem.

folk therapy

Alternative treatment of restless legs syndrome also has a right to exist. There are many approaches that have proven their effectiveness more than once. For example, these may be recipes:

• Massage with additional rubbing of laurel oil into the skin. To prepare the liquid, place 39 g of crushed bay leaves in 100 ml of oil and insist. Every day, the product is rubbed into the skin of the legs before going to bed.
• The use inside the water infusion of hawthorn.
• Rubbing into the legs of a rich tincture of the golden mustache.
• Rubbing the surface of the legs with a solution of apple cider vinegar.
• The use of phytotherapeutic foot baths based on sage, nettle, oregano, valerian, etc.
• Cold and hot shower.
• The use of linden or lemon balm tea.

Physiotherapy

This is another treatment that includes the following exercises:

• Throughout the day, it is necessary that the legs experience a load. In extreme cases, you can periodically squat without a load.
• Regular flexion and extension of the legs.
• Various elements of stretching exercises, in particular, for the calf muscles.
• Long jogging or walking just before bed.
• Cycling, running on an exercise bike and other similar exercises.

Other home treatments

• a good effect is an increase in intellectual load immediately before bedtime;
• it is also recommended to independently massage your shins and calf muscles;
• feet can be alternately placed in a cold and hot bath;
• it is recommended to completely abandon bad habits;
• the doctor may prescribe a diet correction;
• before going to bed, place a small pillow between your legs.

In addition, it is important to put your own sleep hygiene in order and follow all the recommendations of your doctor.

Forecast and prevention

Due to the fact that restless legs syndrome is considered a very understudied pathology, doctors cannot guarantee that there will be no more relapses when the symptoms disappear. But patients can change their own lifestyle and start taking preventive measures to avoid recurrence of problems in the future. It is recommended to do the following:

• make dietary changes;
• reduce the use of alcoholic beverages, coffee, tea, stop smoking;
• try to expose yourself to more physical activity every day;
• massage your feet regularly using warming or cooling creams;
• use phytotherapeutic baths with sea salt and herbal decoctions;
• and yoga;
• use aromatherapy products, as well as arrange regular relaxation sessions;
• walk more often in the fresh air;
• follow all recommendations for sleep hygiene;
• avoid stress and emotional upheaval;
• occasionally use some

Restless legs syndrome (RLS) is usually defined by medical specialists as a specific sensorimotor disorder that is characterized by severe symptoms. This pathology begins to manifest itself in the evening and at night, expressed in unpleasant sensations in the lower extremities, which cause a person to make involuntary movements of the legs to obtain relief. This physical activity often leads to discomfort and sleep disturbances.

Why does this condition occur, what are its symptoms and is it possible to get rid of restless leg syndrome? You will read about this and much more below.

Causes of Restless Leg Syndrome

There can be many reasons for the formation and development of the syndrome. They are grouped into several separate blocks and correlated with the classification of a sensorimotor disorder.

Basic classification:

• Idiopathic type. This form of the syndrome refers to the primary one, is not accompanied by additional negative symptoms (there are no neurological and somatic diseases) and has a direct hereditary nature, manifesting itself at the age of 1 to 30 years. Statistics show that restless legs syndrome of this type occurs in 50 percent of all patients with a confirmed diagnosis, and the proportion of patients with RLS in the family can reach 70 percent. A deep analysis of such cases revealed an autosomal dominant type of transmission of the syndrome, both polygenic and monogenic in nature;
• Child type. The syndrome in children under 12 years of age is distinguished as a separate type of sensorimotor disorder and it depends mainly on external factors, naturally, in the absence of poor heredity. The main factors are motor hyperactivity during the day, as well as a lack of attention from adults, which provokes psychological disorders. RLS of this type is conditionally referred to as the primary form of the disorder, while the symptoms of the syndrome gradually increase over the years and cannot disappear on their own;
• Symptomatic type. Restless legs syndrome is secondary and most often acts as a background for various pathologies, diseases, and other syndromes.

The three main symptomatic causes of restless legs syndrome, doctors consider:

• Pregnancy. Restless legs syndrome is detected in every fifth pregnant woman, most often in the 2nd and 3rd trimester. In the absence of additional pathologies, the manifestations of RLS disappear after delivery;
• iron deficiency. Up to half of all people with anemia suffer from restless leg syndrome;
• End stage uremia. About a third of all patients with advanced uremia develop RLS.

In addition to the above reasons, other problems, pathologies, diseases can also indirectly affect the increase in the risks of the syndrome:

• Acute lack of vitamin B12;
• Diabetes mellitus of any type;
• cryoglobulinemia;
• Polyneuropathies caused by amyloidosis, porphyric neuropathy, or prolonged alcoholism;
• Complex spinal cord injury.
• Rheumatoid arthritis;
• Heart failure and vascular disease;
• The use of a number of drugs.

Restless legs syndrome symptoms

The main clinical manifestation of RLS is increased motor activity of the legs during sleep. The prevalence of the syndrome among the Russian population averages about 10 percent, while every third patient has the main symptom more than twice a week, which significantly worsens the overall quality of life.

As medical statistics show, all age groups suffer from restless legs syndrome, but most often the most striking symptoms occur in people over 40 years old, and more often in the fair sex.

The basic disorder manifests itself in a certain interval of the daily rhythm - in the evening and at night, reaching a peak by 3-4 o'clock in the morning. Additional symptoms of the syndrome include:

• Intensive pain syndrome throughout the structure of the lower extremities;
• Unpleasant sensations are supplemented by itching, pains in the legs, burning sensation, squeezing, bursting, tingling;
• Rhythmic movements of the lower extremities of a neuropathic nature, which temporarily reduce pain and discomfort. In the absence of movement to a state of rest, pathological manifestations again increase and progress, being localized in the areas of the calf muscles and ankle;
• The formation of persistent insomnia - sleep disorders.

According to modern data, every fifth case of severe forms of insomnia in the world is directly related to the presence of restless legs syndrome in a person. The patient cannot fall asleep for a very long time, periodically wakes up in case of increasing discomfort. It is complaints of poor sleep in the vast majority of cases that lead the patient to a doctor.

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The main symptoms of restless legs syndrome are almost always supplemented by periodic movements of the limbs - rhythmic twitches of a short duration and a stereotypical structure. In most patients, they are limited to flexion of the big toes with the fanning out of the remaining fingers.

More severe cases include motor activity in the knee and hip areas. An involuntary seizure is short and rarely exceeds 5 seconds, but it occurs in series at intervals of up to one minute, and the total manifestation time can take several hours.

As a rule, neither the patient nor relatives in the case of a mild complex syndrome suspect the presence of RLS with MPC, and the patient himself goes to the doctor with complaints of sleep disorders of unknown etiology. In the case of the primary form of the syndrome, the symptoms persist throughout the patient's life, decreasing in proportion to the effectiveness of the therapy.

In the symptomatic form of RLS with signs of somatic or neurological diseases, the pathology disappears completely after the treatment of the cause that caused the syndrome is completed.

Diagnostics

Restless legs syndrome, although it is a fairly common disease, but at the same time rarely diagnosed correctly due to insufficient qualifications of doctors who tend to interpret the complaints and external symptoms of patients as manifestations of neurosis, psychological stress, diseases of blood vessels, joints, etc.

Proper diagnosis consists of a series of successive steps:

1. Studying the patient's complaints and a thorough analysis of the anamnesis;
2. Neurological and somatic examination.
3. Complex differential analysis with the exception of the secondary nature of RLS, its comparison with hypnic jerks, akathisia, cramps, meralgia, fibromyalgia, etc.;
4. Appointment of a biochemical blood test;
5. The study of the concentration of ferritin in the blood serum;
6. Carrying out electroneuromyography (for the presence or absence of polyneuropathy), as well as polysomnography with fixation of the entire sleep process on the corresponding graphs;
7. If necessary, a comprehensive additional examination with other specialized specialists to confirm or exclude concomitant diseases.

How to Treat Restless Leg Syndrome

Restless legs syndrome treatment is a complex process consisting of a number of steps. After a clear diagnosis of RLS, an appropriate individual scheme is prescribed, taking into account the current condition of the patient, the severity of the pathology, the presence of additional complications and concomitant diseases.

Medical therapy

• With a mild form of the disease, tranquilizers and sleeping pills are enough to get rid of restless leg syndrome. Typical representatives are Klonopin, Restoril;
• In the idiopathic form of RLS and the presence of Parkinson's disease - treatment with Miralex, which stimulates the work of dopamine;
• To neutralize convulsions in moderate and severe forms of the syndrome - Neurontin, Tegretol;
• In especially severe cases and severe pain static syndrome - injections of opiates. Typical representatives are Methadone, Codeine;
• In the normal course of RLS, ointments for external use are used to neutralize the pain syndrome. Typical representatives are Nikoflex, Relax, Nise;
• Other drugs for the treatment of concomitant diseases, complications, as well as medicines for health reasons.

Physiotherapy

An effective addition to drug therapy is exercise therapy, which includes:

• Stretching exercises for the calf muscles;
• Standard squats without weights;
• Long walk or 20-minute jog
• Cycling or gym replacement;
• Walking on tiptoe with a high raising of the lower extremities;
• Flexion and extension of the lower extremities in the joints.

Physiotherapy

It includes the impact on the lower limbs by manual acupressure, electrical stimulation, acupuncture, magnetotherapy, applications based on mixtures of sea mud, lymphopress, vibromassage, cryotherapy, darsonvalization of the limbs.

Psychotherapy sessions conducted by a specialized specialist for the treatment of patients with the primary form of restless legs syndrome can also be a good addition.

Treatment at home

At home, by prior agreement with the attending physician, it is recommended to optimize the meal plan with an emphasis on a rational balanced diet, self-massage of the lower extremities, avoiding alcohol and smoking, observing proper sleep hygiene, contrasting water procedures for the legs, moderate physical and intellectual stress.

Treatment of restless legs syndrome with folk remedies

Restless legs syndrome treatment can be supplemented with classic traditional medicine recipes. They will be very effective in the case of the primary form of the disease and will be a component of therapy in the case of secondary symptomatic forms of the disease with the manifestation of RLS.

Before using any of the recipes described below, be sure to consult with your doctor and agree on the use of funds!

• Rubbing the lower extremities with tincture. An excellent remedy for restless legs syndrome is a concentrated tincture of a golden mustache, sold in a pharmacy. Pour some liquid into the palm of your hand and rub it thoroughly over all surfaces of the legs, paying particular attention to the joints. It is enough to carry out the procedure 1 time before bedtime, but daily;
• Laurel oil massage. Take 30 grams of fresh bay leaf and fill it with 100 grams of sunflower oil. Let the product brew for 1 day in a dark, cool place, after which you conduct self-massage sessions of the limbs with the addition of such “laurel oil”;
• Apple vinegar. Apple cider vinegar can help relieve pain in RLS. 10 minutes before going to bed, rub them on the shins and knees;
• Tea. As a relaxing remedy for additional therapy for restless legs syndrome, it is recommended to use herbal teas based on linden and lemon balm. This kind of packaged products are widely distributed in domestic pharmacies. Brew them instead of regular tea, drinking liquid 1 hour before going to bed;
• horseradish compresses. Take 50 grams of chopped horseradish leaves and roots, pour 0.5 liters of vodka and let it brew for 4 days. Moisten a gauze bandage liberally with this product and apply a night compress every day;

• home tincture. Take 100 milliliters of motherwort, peony, hawthorn, valerian tinctures, half the eucalyptus tincture and four times less mint tincture. Mix the liquids in a container, add 10 grams of clove leaves there and leave for 1 week in a cool and dark place. Strain and consume 20-25 grams of the above homemade tincture before bedtime;
• Before going to bed, wear warm socks made of sheep's wool on your feet.. Choose as long products as possible, optimally so that they reach the knee. With regular use, they will reduce the manifestations of RLS;
• Foot baths. Take in equal proportions 50 grams of sage, valerian, oregano and nettle, pour 1 liter of boiling water. Let it brew for 5 minutes. Pour the liquid into a container and steam your feet for 15 minutes. You need to do the procedure regularly, every evening 30-40 minutes before bedtime.

Prognosis and prevention of the disease

In the primary form of restless legs syndrome, due to genetic inheritance or acquired factors, complex therapy leads to a weakening of the symptoms of manifestations and the formation of remission stages with alternating periods of exacerbations - it will not be possible to completely get rid of RLS.

In the case of a secondary form of pathology caused by diseases and other syndromes, with the correct treatment of the underlying disease, RLS also completely disappears.

Basic preventive measures that may help reduce the risk of developing restless legs syndrome include:

• Quitting alcohol, reducing caffeine and tobacco use;
• Correction of the power system;
• Creation of prerequisites for regular moderate physical activity on the lower limbs;
• Conducting home sessions of aromatherapy, relaxation, yoga, meditation;
• Warm baths before bedtime with sea salt;
• Long (at least 1 hour) walking a few hours before going to bed;
• Reducing psycho-emotional stress - stress and depression should be avoided, if it is impossible to control the condition, a psychologist should be consulted;
• Regular intake of vitamin and mineral complexes;
• Compliance with sleep hygiene and normalization of daily rhythms of rest and wakefulness.

When and which doctor to contact?

Unfortunately, in most cases with a typical course of restless legs syndrome, the patient does not pay attention to the symptoms of the problem, attributing it to severe fatigue. In rare cases, a visit to a doctor begins after the formation of problems with the quality of sleep, when the manifestations of the syndrome lead to insomnia or systemic disturbances in the quality of night rest.

If you have RLS symptoms on a regular basis, then you should immediately contact a specialist. Usually a neurologist- it is he who will conduct the primary diagnosis, send for additional tests and instrumental studies.

If the case of restless legs syndrome is atypical, secondary, there are additional symptoms of somatic or neurological disorders, then the help of other specialists may be required - from a general practitioner to an endocrinologist.