Restless legs syndrome: causes and treatment. Video

Restless legs syndrome fully manifests itself in the older generation, but at least a third of cases were first noted in young women or men. It may first appear during pregnancy, after a long car trip, long-term work with a laptop on your lap, air travel, or other immobility situations.

Most often, the disease causes anxiety in the evening or at night, but over time it can begin to disturb during the day. The maximum severity of symptoms usually occurs from 0 to 4 am, the minimum – from 6 to 10 am. In severe cases, the disease becomes permanent, making it unbearable for the patient to fly on an airplane, visit a theater or cinema, or travel by transport. Often, special attention is paid to it if the following accompanying symptoms appear:

• heaviness in the legs, calves,
• spreads his leg from the inside,
• veins appear on the legs.

It is also called restless legs syndrome (RLS) or cold feet syndrome because it causes discomfort in the lower extremities that disappears with movement. Making rhythmic measured movements, walking around the room, massaging the legs, the patient relieves his condition. However, as soon as a person lies down, the unpleasant symptoms return, sometimes disturbing the whole night.

Most often, painful or disturbing sensations arise in the depths of the legs, less often in the feet, and can be asymmetric or one-sided. Over time, the disease often spreads to the thighs, knees, and even the perineal area. The syndrome leads to sleep disturbances, lethargy and absent-mindedness during the day, and sometimes to depression. In severe cases, the disease does not leave the patient even during sleep, forcing the legs to twitch, spread the fingers, even bend the joints.

The disease can develop against the background of diabetes mellitus, amyloidosis, alcoholism, deficiency of vitamin B12, thiamine, magnesium, folic acid, diseases of the thoracic or cervical spine, spinal cord.

There are several main causes of restless legs syndrome:

• heredity;
• pregnancy;
• uremia;
• iron deficiency.

Often, even experienced doctors confuse tired legs syndrome with neuroses, osteochondrosis of the spine, peripheral vascular disease, nocturnal cramps, polyneuropathy and other diseases with similar symptoms

RLS symptoms can last a lifetime, but with the right regimen and nutrition, their intensity decreases to almost zero. The disease can intensify during stress, after intense physical activity, during pregnancy, after consuming products containing caffeine.

It is important to identify and cure the cause of the disease, to make up for the vitamin deficiency.

Non-drug therapy includes:

• the abolition of drugs that enhance the manifestation of RLS (antidepressants, antipsychotics, metoclopramide, antihistamines, etc.);
• little physical activity, especially in the morning and afternoon;
• observance of the bedtime ritual, which includes a shower, a warm bath and a foot massage;
• restriction of products containing caffeine (coffee, strong tea, chocolate, coca-cola, etc.);
• smoking cessation;
• limiting alcohol;
• compliance with the daily regimen.

If non-drug measures do not have the desired effect, the doctor prescribes drug therapy. These can be herbal sedatives, placebo, or drugs: clonazepam, alprazolam, levodopa, and others. Of particular difficulty is the treatment of tired legs syndrome in pregnant women – almost any drugs for them are prohibited.

Benzodiazepines (clonazepam, alprazolam) are prescribed to improve sleep, reduce the number of awakenings. However, sensory and motor symptoms do not disappear. The danger of this group of drugs is that over time their effect decreases, drug dependence arises.

Dopaminergic drugs (for example, dopamine receptor bagonists and levodopa) eliminate not only the symptoms, but also the disease itself, these drugs are most often used. The effective dose with levodopa remains constant over the years, and may even decrease over time. However, long-term treatment often leads to an increasingly early manifestation of the syndrome, it begins to disturb the patient even during the day.

If these drugs are unsuitable, cause side effects, anticonvulsants such as gabapentin are used. In addition, opoids are good at reducing unpleasant symptoms, but due to the high risk of drug dependence, they are used in the rarest and most difficult cases.

Thanks to modern methods of treatment, it is possible to achieve, if not a complete elimination of the problem, then a significant improvement in the quality of life of patients. Some drugs have to be taken for life, others only during an exacerbation of the disease. The main thing is to consult a doctor on time, to correctly diagnose and treat this unpleasant neurological disease.