Monday, Sep 23, 2019
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Restless leg syndrome

Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation. It happens mostly in the evening or nighttime hours when you’re sitting or lying down. Moving eases the unpleasant feeling temporarily. The condition can begin at any age and generally worsens as you get older. It can disrupt sleep which interferes with the activities you have to do the next day.

People typically describe RLS as abnormal, unpleasant sensations in their legs or feet. They usually happen on both sides of the body. The sensation may feel like crawling, creeping, throbbing, aching, itching or electric shock or sometimes the sensations are difficult to explain.

The chief symptom is an urge to move the legs.

Sensations that begin after rest: The sensation typically begins after you’ve been lying down or sitting for a while such as in a car.

Relief with movement: The sensation lessens with movement, such as stretching, jiggling your legs, pacing or walking.

Worsening of symptoms in the evening and night: Symptoms occur mainly at night.

Often, there’s no known cause for RLS. Researchers suspect the condition may be caused by an imbalance of the brain chemical dopamine, which sends messages to control muscle movement. Sometimes RLS runs in families, especially if the condition starts before age 40. Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms. Some women get RLS for the first time during pregnancy, especially during their last trimester. However, signs and symptoms usually disappear after delivery.

Risk factors

RLS can develop at any age, even during childhood. The disorder is more common with increasing age and more common in women than in men.

Restless legs syndrome usually isn’t related to a serious underlying medical problem, however, it can accompany other conditions, such as peripheral neuropathy, iron deficiency, kidney failure, and spinal cord conditions.

Peripheral neuropathy: This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism.

Iron deficiency: Even without anemia, iron deficiency can cause or worsen RLS.

Kidney failure: If you have kidney failure, you may also have iron deficiency, often with anemia.

Spinal cord conditions: Lesions on the spinal cord have been linked to RLS/WED (Willis-Ekbom Disease). Having had anesthesia to the spinal cord, such as a spinal block, also increases the risk of developing RLS/WED.

When to see a doctor

RLS can interfere with your sleep, cause daytime drowsiness, and affect your quality of life. Talk with your doctor if you think you may have RLS.

Sometimes making simple lifestyle changes can help the symptoms of RLS. Try baths and massages. Soaking in a warm bath and massaging your legs can relax your muscles. Apply warm or cool packs. Use of heat or cold, or alternating use of the two, may lessen your limb sensations. Establish good sleep hygiene. Fatigue tends to worsen symptoms of RLS, so it’s important that you practice good sleep hygiene. Ideally, have a cool, quiet, comfortable sleeping environment; go to bed and rise at the same time daily; and get adequate sleep, seven to eight hours per night. Exercise. Getting moderate, regular exercise may relieve symptoms of RLS, but overdoing it or working out too late in the day may intensify symptoms. Avoid caffeine and caffeinated products, such as chocolate and caffeinated beverages like coffee, tea and soft drinks, for a few weeks. Sometimes cutting back on caffeine may help restless legs.

Medication therapy

Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs. These include medications that increase the levels of the chemical messenger dopamine in the brain.

Drugs affecting calcium channels: Certain medications, such as gabapentin (Neurontin), pregabalin (Lyrica) and others can also be used and work for some people with RLS. Strong pain medications can also help with RLS.

Muscle relaxants and sleep medications: These drugs help you sleep better at night, but they don’t eliminate the leg sensations, and they may cause daytime drowsiness. The doctor may have to try a number of medications before finding the right medication that may work best for you.

Complications

Although RLS doesn’t lead to other serious conditions, symptoms can range from barely bothersome to incapacitating. Many people with RLS find it difficult to fall or stay asleep. Lack of sleep may lead to excessive daytime drowsiness. Severe RLS can poorly impact the quality of life and can result in depression.

 • For more information or to see a podiatrist, visit Bahamas Foot Centre Rosetta Street, telephone 325-2996; or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820; or email foothealth242@hotmail.com; or visit www.apma.org.

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