Restless legs syndrome in the elderly - causes and treatment. Restless legs syndrome: causes and treatment of the disease Restless arms syndrome causes and treatment

The symptom complex, which today is called restless legs syndrome, was first described in the 17th century (1672) by the British physician Thomas Willis. Thomas Willis made history medical science as an author detailed description the anatomical structure of some arteries of the brain, which in his honor are still called the “circle of Willis.”

Subsequently, the Finnish doctor and scientist Carl Alex Ekbom again drew attention to this symptom complex in 1943. From the standpoint of modern medical science, Ekbom developed criteria for diagnosing the disease and shifted the emphasis from the motor component to the sensory component. Sensory disorders are the main symptom of the disease and, at the same time, the main complaint made by patients. Ekbom combined all observed forms of the disorder with the general term “restless legs”, and subsequently added the term syndrome. In relation to this pathology – syndrome restless legs– the term syndrome is used to designate a stable symptom complex, but is not a reflection of the specific and uniform pathogenesis of the disease. In modern medical practice Two terms used are restless legs syndrome and Ekbom syndrome.

Definition of restless legs syndrome

Today, restless legs syndrome is understood as a sensorimotor disorder, which is manifested by painful, unpleasant sensations in the legs, developing only at rest, which forces a person to move in order to eliminate or alleviate these sensations. Unpleasant sensations in the limbs most often bother the patient in the evening and at night, leading to insomnia such as difficulty falling asleep or frequent awakenings.

Classification of restless legs syndrome
depending on origin

It is customary to divide all cases of restless legs syndrome (RLS) into two large groups, depending on their origin:
1. Primary, or idiopathic.
2. Symptomatic or secondary.

Characteristics of primary restless legs syndrome

Primary restless legs syndrome first manifests itself before the age of 35, that is, at a young age. About half of all cases of primary restless legs syndrome are not associated with any medical condition. According to modern research This pathology is hereditary in nature, and is inherited in a dominant manner, and the degree of manifestation of the disease depends on the activity of the gene. Scientists believe that primary restless legs syndrome may be based on the activity of one or more genes, that is, it can be monogenic or polygenic. The genes responsible for the manifestation of this syndrome, which are located on chromosomes 12, 14 and 9, have been identified. However, it turned out to be impossible to reduce all the signs of pathology to the action of genetic factors alone, so today restless legs syndrome is classified as a multifactorial pathology, the development of which is caused by a complex interaction of genetic and environmental factors.

Secondary restless legs syndrome - characteristics
common causes

Secondary restless legs syndrome develops in middle-aged and older people, manifesting for the first time after 45 years. Secondary, or symptomatic restless legs syndrome, develops against the background of an underlying disease, which provokes this sensorimotor disorder.
Most often, secondary restless legs syndrome develops against the background of the following pathological and physiological conditions:

• iron deficiency in the body.

Pregnant women are at risk of developing secondary restless legs syndrome during the second and third trimesters, and its presence is recorded in approximately 20% of pregnant women. Usually, restless legs syndrome goes away on its own within a month after giving birth, but in rare cases it can persist and bother you for the rest of your life.

Uremia (increased concentration of urea in the blood) mainly develops in patients with renal pathology. Therefore, from 15 to 80% of patients with chronic renal failure undergoing hemodialysis also suffer from secondary restless legs syndrome.

Pathologies associated with the development of restless legs syndrome

In addition to the above conditions, secondary restless legs syndrome can develop against the background of the following pathological processes in the body:

• cryoglobulinemia;
• deficiency of vitamins B 12, B 9 (folic acid), B 6 (thiamine);
• magnesium deficiency;
• pathology of the thyroid gland;
• rheumatoid arthritis ;
• Sjögren's syndrome;
• obliterating endarteritis;
• venous insufficiency of the lower extremities;
• diseases spinal cord(traumas, myelopathy, tumors, myelitis, multiple sclerosis);
• Gettington's chorea;
• amyotrophic lateral sclerosis;
• post-polio syndrome;

Some patients with restless legs syndrome have a hereditary predisposition to the development of this pathology, which manifests itself in the form of a disease due to exposure to adverse environmental factors, such as overuse coffee, iron deficiency or polyneuropathy. Therefore, in this situation, the difference between primary and secondary restless legs syndrome is quite arbitrary.

Obesity increases the risk of developing this symptom complex by almost 50%. The risk group primarily includes young people under 20 years of age who are obese.

Restless legs syndrome in neurological patients (chorea, parkinsonism, etc.) can be explained by the coincidence of two pathologies, the consequences of taking medications, or the presence of common links in the development of diseases.

Data from general and special neurological examinations usually do not reveal any disease in people with primary restless legs syndrome, and in people with secondary restless legs syndrome, somatic or neurological pathologies are almost always detected, most often polyneuropathy.

Pathogenesis of restless legs syndrome

The pathogenesis of restless legs syndrome is associated with a violation of dopamine metabolism in the brain, as well as with pathology of the hypothalamus, red nuclei and reticular formation.

Course of primary restless legs syndrome

If a person suffers from primary restless legs syndrome, then the symptoms of this disease remain throughout life, varying in degree of intensity. Symptoms intensify with stress, heavy physical exertion, pregnancy, and the use of various products containing caffeine. The course of primary restless legs syndrome is characterized by a slow progression of symptoms throughout life, alternating with periods of latency (without worsening) or persistent remission (no signs of the disease). Moreover, remission can last for a different period of time, both short - a few days, and long - several years. About 15% of patients with primary restless legs syndrome have long periods of remission of the disease. Scientists believe that the symptoms of primary restless legs syndrome worsen slowly and are relatively mild.

Course of secondary restless legs syndrome

Secondary restless legs syndrome is characterized by various variants of the course, since it is determined by the characteristics of the underlying disease. However, most patients report a consistent tendency for symptoms to worsen as the disease progresses. Periods of remission in patients with secondary restless legs syndrome are practically not detected. Progression occurs very quickly, but only up to a certain level of intensity of discomfort. After the maximum intensity of unpleasant sensations has been reached, a plateau phase begins, which is characterized by a stable, non-progressive course of the disease.

Prevalence of restless legs syndrome

According to epidemiological studies, the prevalence of restless legs syndrome in the population of Western countries is 5-10%. In this case, people of any age are susceptible to the disease, but most often the pathology occurs in middle-aged and elderly people. Women suffer 2.5 times more often than men. It is noteworthy that residents of Asian countries practically do not suffer from restless legs syndrome, where the incidence of this pathology is only 0.1-0.7%. A number of scientists believe that 15-20% of sleep disorders are caused by this particular pathology.

As can be seen from the above data, restless legs syndrome is quite common, but practically undiagnosed. This state of affairs is due to the fact that most practicing doctors do not know enough about this syndrome, and its individual symptoms are explained by neurological or psychological disorders, vascular diseases or other pathologies. Therefore, in relation to the problems of diagnosing this disease, the excellent statement of A.M. is completely suitable. Wayne "To establish a diagnosis of any disease, you must at least know about its existence."

Diagnosis of restless legs syndrome

However, diagnosing restless legs syndrome does not present any serious difficulties and is based on specially developed criteria based on the patient’s complaints.

R. Allen and colleagues in 2003 developed four universal criteria for diagnosing restless legs syndrome. It is noteworthy that these criteria are essential, that is, necessary and sufficient for making a diagnosis.

So, here are these four diagnostic criteria:
1. An irresistible desire to move the legs or other parts of the body, which is caused by the presence of unpleasant sensations in the lower extremities.
2. Unpleasant sensations intensify or begin to appear at rest.
3. During physical activity discomfort decrease or disappear.
4. Unpleasant sensations intensify in the evening and night hours.

These diagnostic criteria are simple and universal. If a person answers yes to all four questions, then they most likely suffer from restless leg syndrome. These questions can be addressed to the patient in a form convenient for him - orally or in writing.

Characteristics of diagnostic criteria for restless legs syndrome

The first and second diagnostic criteria reflect the sensorimotor manifestations of the pathological state of the body and the use of physical activity in order to relieve this sudden, irresistible urge. And the third and fourth criteria are a reflection of the signs on which the severity of discomfort in the limbs depends. Let's take a closer look at what is meant by each diagnostic criterion.

An irresistible desire to move the legs, which arises in response to extremely unpleasant sensations in the lower extremities
The main characterological symptom of restless legs syndrome is an unpleasant sensation in the legs, which is very difficult to fit into any framework. This feeling is difficult to explain to a doctor or just another person. The main descriptive sign of an unpleasant sensation is the desire to make any movements. Instinctively, some people resist this urge by trying to change positions, but in general, patients find it better and easier to move their legs to get rid of the unpleasant stress-like feeling. The pathological sensation develops in any part of the lower limb, but most often affects the legs and feet. In cases of severe disease in pathological process the arms, neck, or trunk may be involved. When the symptoms are so severe, the person cannot fall asleep, taking a variety of positions, but to no avail. It should be taken into account that the patient considers the cause of the sleep disorder to be an uncomfortable posture, and not constant motor acts.

The desire to move the limbs is often combined with other neurogenic symptoms, such as:

• “crawling” - the impression of something crawling under the skin or in the blood vessels;
• local temperature - feeling hot, rolling scalding waves;
• tingling, pinching, rubbing, piercing - sensation of bubbles under the skin or in blood vessels, electric discharges in the legs, itching, etc.

It is noteworthy that all the above-described unpleasant sensations are felt deep in the legs, under the skin, which is described by a person as something in the vessels, bones, etc. A number of patients completely deny the presence of any unpleasant sensations, focusing specifically on the desire to constantly move their legs.

Increased or onset of discomfort at rest
This means that the intensity of the discomfort is directly proportional to the amount of time spent at rest. Thus, the longer a person does not move, the stronger his discomfort, and the more irresistible the desire to move. Volitional suppression of this sensation and continued stay in a state of rest, as a rule, leads to an even greater progression of the symptom, and even to the appearance of pain. If you start moving, on the contrary, the symptoms are significantly alleviated or disappear completely.

Prolonged sitting in such people leads to an irresistible desire to walk around and stretch their legs. Therefore, the behavior of patients with restless legs syndrome often involves avoiding prolonged sitting - they instinctively stand in public transport if there are empty seats, try not to go to theaters, cinemas, drive a car or fly on an airplane. If a person with this pathology drives for a long time, then he is forced to periodically stop, get out of the car and make movements (walking, jumping, etc.) in order to eliminate the unpleasant sensations.

Reduction or disappearance of painful symptoms when moving
The symptom has a pronounced temporal aspect. That is, the unpleasant sensations recede immediately after the movement begins. Jumping, walking, shifting from foot to foot, stretching a limb - any motor action reduces the intensity of unpleasant sensations. The improvement effect continues as long as the person moves. However, no continuation of the normal state occurs after the end of the movements. That is, this symptom can be described by the following formula: there is movement - there is no unpleasant sensation, stop movement - the return of unpleasant sensations. That's why this sign is very specific, and helps to distinguish restless legs syndrome from other pathologies associated with the presence of discomfort in the lower extremities.

Increased discomfort at night or in the evening

People with restless legs syndrome have a clear circadian rhythm in the intensity of their symptoms. That is, the maximum severity of unpleasant sensations occurs in the evening and at night with a peak between 00.00 and 04.00, and relief is observed in the morning - from 06.00 to 10.00. This circadian rhythm corresponds to daily fluctuations in human body temperature. This means that the highest daily body temperature corresponds to the period of relief of symptoms, and the lowest, on the contrary, the maximum severity of discomfort. If the pathology is advanced, then the person constantly feels symptoms of the same intensity, not related to the time of day. However, the main time when people are especially tormented is the time of falling asleep, since two factors are combined here - evening and a relaxed state of rest. 15-30 minutes after a person goes to bed, he begins to be bothered by unpleasant sensations in his legs.

Periodic leg movements during sleep

It is noteworthy that after falling asleep, people with restless legs syndrome suffer periodic leg movements during sleep (PLMS) . These movements are observed in 70–92% of patients and are of a flexion-extension nature. In this case, an involuntary contraction of muscle groups occurs for a very short period of time - 0.5-3 seconds, and the interval between PDNS is 5 - 90 seconds.

Restless Legs Syndrome Severities

The severity of restless legs syndrome correlates with the frequency of PDNS, which are recorded using a special polysomnographic study.
Depending on the detected frequency of periodic leg movements during sleep, three degrees of severity of the disease are distinguished:
1. Mild severity - frequency of PDNS 5 - 20 per hour.
2. Average degree severity - frequency of PDNS 20 - 60 per hour.
3. Severe degree - the frequency of PDNS is more than 60 per hour.

Sleep disturbances in people with restless legs syndrome

People suffering from restless legs syndrome have a reduced quality of life. This fact is explained by the fact that such patients suffer from insomnia. Lying in bed for a long time, changing positions, moving the legs - all this prevents a person from falling asleep. The varying depth of sleep disturbances is an integrative (cumulative) indicator of the severity of this syndrome. That is, the more severe the form of restless legs syndrome, the more pronounced various sleep disorders are.

PDNS are the cause of changes in sleep structure, imbalance of its phases and constant awakenings. After waking up, a person, as a rule, can no longer fall asleep. To improve their well-being and reduce the intensity of symptoms, patients begin to walk around the apartment. Such forced night "walks" are called night walker symptom . By 4.00 am the severity of unpleasant sensations decreases, and the person falls asleep for a short period of time. Naturally, after such an inadequate night's rest, people have difficulty waking up, and feel tired, inattentive, forgetful, etc. all day.

Differences between restless legs syndrome and other diseases
with similar symptoms

Restless legs syndrome must be distinguished from other diseases whose symptoms are similar. The distinctive signs of various diseases are presented in the table.

Disease	Symptoms similar to such as in the syndrome restless legs	Signs uncharacteristic of the syndrome restless legs
Peripheral neuropathy	Unpleasant sensations in the legs, "goosebumps"	They do not have a clear circadian rhythm, there are no PDNS, reduction in the intensity of unpleasant symptoms does not depend on physical activity
Akathisia	Anxiety, desire move, discomfort at rest	They do not have a clear circadian rhythm, there are no unpleasant sensations in the legs (burning, crawling, etc.), relatives do not suffer from the syndrome restless legs
Vascular pathology	Paresthesia ("goosebumps")	Increased discomfort in the legs when moving, the presence of a pronounced vascular pattern on the skin of the legs
Night cramps (crumpy)	Develop at rest stopped by movements legs (stretching), have a clear daily schedule rhythm	They begin suddenly and do not get worse with rest. there is no irresistible desire to move, any voluntary movement does not stop seizures, occur in one limb

Principles of treatment for secondary restless legs syndrome

Treatment of restless legs syndrome should be carried out depending on whether the pathology is primary or secondary.

If we are talking about secondary restless legs syndrome, then the underlying disease should be identified and adequate therapy for the latter should be started. It is recommended, first of all, to study the concentrations of vitamins and microelements - iron, folic acid and magnesium, and if a deficiency is detected, to correct the deficiency state. Very often, restless legs syndrome is associated with iron deficiency . In this case, treatment is carried out with iron preparations in the form of tablets or intravenous and intramuscular injections under the control of ferritin levels in the blood serum. Treatment with iron supplements should be continued until the ferritin concentration reaches 50 mcg/l.

The use of the following medications may increase the symptoms of restless legs syndrome:

• neuroleptics;
• lithium preparations;
• adrenomimetics;
• calcium antagonists;
• adrenergic blockers.

Therefore, if you have restless legs syndrome, it is recommended, if possible, to exclude any drugs from the above groups, or to select a replacement.

Principles of treatment for primary restless legs syndrome

If a person suffers from primary restless legs syndrome, then only symptomatic therapy can be carried out, which is aimed at alleviating or eliminating the patient’s discomfort. There are drug and non-drug methods of treating primary restless legs syndrome.

Non-drug methods include moderate physical activity during the day, the correct sequence of actions when falling asleep, and walking in the evenings. Showering before bed and proper nutrition will also help relieve the intensity of symptoms. Proper nutrition patient with restless legs syndrome means avoiding caffeine in any products (coffee, chocolate, Coca-Cola, etc.) and limiting alcoholic drinks. It is recommended to quit smoking and follow a daily routine. A hot foot bath or foot massage will effectively help combat painful symptoms. You can also use physiotherapy - transcutaneous electrical stimulation, vibration massage, darsonvalization of the legs, reflexology and magnetic therapy.

The use of medications for the treatment of restless legs syndrome is resorted to only in cases of ineffectiveness of non-drug methods and a serious deterioration in the quality of life. The following groups of drugs are used: benzodiazepines, dopaminergic drugs, anticonvulsants and opiates. All these medications affect the central nervous system, so treatment should only be carried out under the supervision of a physician.

So, we looked at the main manifestations, diagnosis, differences from other diseases and principles of treatment for such a fairly common ailment as restless legs syndrome. Without a doubt, the effectiveness of treatment is determined, first of all, by the most accurate diagnosis of the pathology. Unfortunately, today no more than 30% of cases of this symptom complex are correctly diagnosed. Therefore, if you notice any signs of the disease, consult a doctor and describe all your sensations in as much detail as possible. In doing so, focus on the main signs of restless legs syndrome, since when early detection pathology, it is possible to begin adequate treatment, which will lead to stable remission.

Before use, you should consult a specialist.

Restless legs syndrome affects people of all ages, but more often than others it occurs in middle-aged and retired people, as well as pregnant women in the second and third trimester. Research has found that up to 10% of the world's population suffers from RLS of varying severity.

Kinds

There are two types of disease:

1. Primary (idiopathic).
2. Symptomatic.

Idiopathic restless legs syndrome — the most common type of pathology. It is characterized by early manifestation (in childhood). There are family cases of the problem. According to various sources, the frequency of such cases can reach 30-90%. Genetics have discovered a connection between the formation of pathology and disturbances in the structure of certain chromosomes. Scientists have come to the conclusion that the idiopathic form is a pathology that occurs under the influence of many negative factors in the presence genetic predisposition.

The symptomatic form manifests itself no earlier than in adulthood (after 45 years) and is a consequence of concomitant pathologies of the body - metabolic disorders, diseases of the nervous system and blood vessels of the lower extremities. , but after childbirth the symptoms disappear.

Causes of restless legs syndrome

To prescribe competent and successful treatment, it is important to establish the right reason development of pathology:

• Genetics. In the idiopathic form without concomitant pathologies of the nervous system and other diseases of the body, the cause is always poor heredity. Primary restless legs syndrome, when properly diagnosed, is detected quite early - before the age of 30.
• Associated pathologies. The cause of RLS may lie in dysfunction of the nervous system, which reduces dopamine metabolism in the central nervous system. Factors that cause such disorders include kidney failure, diabetes, and brain injury. The syndrome can also develop in diseases such as multiple sclerosis, Parkinson's disease, pathologies cardiovascular systems s. Once these causes of RLS are established, there is no point in fighting the symptoms; proper therapy for the underlying disease is needed.
• Pregnancy. According to statistics, symptoms of restless legs syndrome occur during pregnancy in 15-20% of cases. The reason for this is the provoking factors that accompany pregnancy - hormonal changes in the body, increased load on the lower limbs due to weight gain, neurological disorders due to increased nervousness and worries about the unborn baby.
• Bad habits. Both primary and secondary forms of RLS can occur with alcohol abuse, smoking, and drinking in excess of drinks with a high caffeine content (energy drinks, coffee, strong black tea). Any bad habits affect the entire body as a whole, and to a large extent this effect also affects the functioning of the nervous system.
• Medications. A side effect after taking a number of medications can be the development of RLS. Such drugs primarily include those that contain caffeine (analgesics), as well as antidepressants, antipsychotics, antiallergic drugs, and antiemetics.

Doctors note that in Lately Restless legs syndrome is becoming an increasingly common pathology among all segments of the population. The reason lies in the very way of life of people - increased stress, constant pressure, work associated with both prolonged sitting and increased physical activity.

If you notice symptoms of RLS, you need to take immediate action. The pathology will not go away on its own; it requires identification of provoking factors, their elimination and further treatment of the disease.

Symptoms of RLS

Restless legs syndrome is characterized by the following symptoms:

• The occurrence of painful sensations in the lower extremities, expressed in the form of itching in the legs, twitching of nerve endings, pain. Patients cannot accurately describe the pain factor: someone complains of aching pain, for others it appears spontaneously in different parts of the legs. The sensations are smooth, they are not concentrated at one point all the time and change localization, flowing from one place to another.
• RLS is characterized by the manifestation of symptoms only when the legs are at rest, most often when the patient falls asleep. Due to the constant desire to change the position of the body, the brain cannot go into sleep mode and turn off the nervous system, so chronic insomnia occurs. Such symptoms (selective in time of onset) are called circadian - occurring with a certain rhythm. In the morning and daytime hours the symptoms do not bother the patient, he can take a little nap, but he still does not have enough full sleep.
• Unpleasant sensations disappear with the movement of the lower extremities, hence the name of the pathology. To get rid of the irritating factor, patients begin to jerk their legs, change their position; with obsessive pain, a person can get up and start walking around the room, but as soon as he goes back to bed, the symptoms return.
• Involuntary movements of the lower extremities sometimes occur even in a state of complete sleep. If the patient manages to fall asleep and enter the slow-wave sleep phase, he may continue to unconsciously jerk his limbs. Such movements may occur only a few times, or may last throughout the night, depending on the severity of the disease.

From the above, it is clear that restless legs syndrome is expressed in one striking symptom - unpleasant sensations in the limbs in a state of complete rest. But these sensations are subjective; no doctor will give a typical picture of their manifestation. During a neurological examination of patients with RLS symptoms, physicians most often do not detect specific focal pathology, sensory impairment, or reflex distortion. This means that the pathology itself does not manifest itself in any way at the time of examination, which makes it difficult to diagnose.

Diagnosis of the disease

It is worth noting that, despite its prevalence, the diagnosis of “restless legs syndrome” (the causes and treatment are described in the article) is not given to every patient with characteristic symptoms. The problem is the difficulty of diagnosing the disease. Correct conclusion are done only in 8–10%; in other cases, patients are treated for neurological pathologies. If insomnia occurs due to discomfort in the legs before going to bed, it is important to contact a highly qualified specialist - a somnologist. Somnology studies specifically sleep disorders, so the doctor will be able not only to determine the root cause of insomnia, but will also prescribe related examinations from other specialists, which is not always done, for example, by a neurologist.

It is important to collect a family history before making a diagnosis. If a factor of chronic insomnia is identified among close relatives of the patient, there is a high probability of an idiopathic form of the disease caused by a hereditary predisposition. In this case, a geneticist will be involved in making a diagnosis.

Women with characteristic symptoms take a pregnancy test, since hormonal changes in the body are often the cause of the problem.

Patients are prescribed blood tests to detect a lack of minerals and vitamins, diabetes mellitus, and iron deficiency anemia. The doctor may also order tests to detect spinal cord tumors, problems with the heart, kidneys and lungs, and thyroid function.

After the results are obtained, special examinations are carried out:

• An electroencephalogram can detect neurological disorders. Eg, convulsive syndrome often confused with RLS;
• electroneuromyography provides the ability to assess the quality of conduction of nerve endings;
• Polysomnography helps to identify pathology in its uncharacteristic course, detects movements of the limbs in any phase of sleep, and not only when the patient falls asleep and when he is simply at rest. The same technique allows you to determine the severity of the disease. No more than 20 movements within an hour indicate mild form pathology, over 60 - about its severe course.

To make an accurate diagnosis, your doctor may prescribe special dopaminergic medications. If, after taking a course of such drugs, the patient reports the disappearance of symptoms, it means that it was restless leg syndrome that was bothering him. This diagnostic is based on the study of RLS and the establishment of a direct connection between this pathology and the number of dopamine receptors involved in the transmission of nerve impulses.

Drug treatment

Therapy is highly individual for each patient, but general principles There are still some ways to treat restless legs syndrome:

• Dopaminergic medications. The main effect of this group of drugs is aimed at the peripheral nervous system. Levodopa is most often prescribed as a drug for the treatment of Willis disease. Taking the medication is sometimes accompanied by muscle spasms, nausea, and dizziness.
• Benzodeazepines - Diazepam, Mirapex and others. Medicines whose main effect is a hypnotic and sedative effect. The drugs do not treat restless legs syndrome itself, but they help to significantly improve the quality of sleep and reduce anxiety. Medicines are highly addictive; even after curing the disease, patients cannot sleep normally all night without taking the drug. Other side effects include daytime sleepiness and decreased concentration and alertness.
• Vitamins - multivitamin complexes containing folic acid, magnesium, iron, vitamins C, E, group B are recommended for patients with mild forms of pathology, pregnant women and the elderly, since discomfort in the lower extremities is sometimes provoked by a banal lack of nutrients in the body.
• Anticonvulsants are prescribed individually for severe cases of the disease, when basic therapy does not produce a positive result.

Only the attending physician can prescribe drug treatment! Uncontrolled reception drugs can lead to depletion of the nervous and cardiovascular systems, mental disorders, disorders of psychomotor functions.

Treatment at home

Treatment for restless legs syndrome can begin before your appointment. drug therapy folk remedies, which can temporarily relieve symptoms and relieve sleepless nights:

• Soothing decoctions and tinctures of motherwort, valerian, lemon balm, linden. These folk remedies, in moderate quantities, can help relieve tension, relieve fatigue, eliminate spasms and cramps of the lower extremities, and improve the quality of sleep. Decoctions are taken before bed, half a glass, and tinctures - 20-25 drops.
• Laurel oil helps relax the muscles of the limbs, relieves spasms, and has a warming effect. Shredded bay leaves should be placed in a dark glass container and filled vegetable oil. The container is placed in a cool, dark place for 5 days. The oil is rubbed into the feet with light massage movements before going to bed.
• Lemon juice and vinegar. Rubbing vinegar or lemon juice on your feet before bed will help relieve discomfort. This must be done carefully so as not to burn the skin.
• Foot baths with hot water will help relieve restless legs syndrome and soothe muscles, especially if work involves long stay on your feet during the day. You can add a decoction of chamomile, calendula, nettle, and sage to the bath. The water temperature should be tolerable for your feet, not too hot. The duration of the procedure is 10-15 minutes before bedtime.

The above folk remedies provide a temporary effect when the symptoms of the disease often worsen due to increased fatigue and tension in the legs, but for full treatment illness requires medical attention.

If restless legs syndrome is mild, simple steps before bed will help you get rid of the discomfort. preventive actions:

• Establishing a specific night sleep routine. If a person finds that discomfort occurs late in the evening before going to bed, you can try changing your daily schedule so that you can sleep longer in the morning. A comfortable pillow, the right orthopedic mattress, the exclusion of external irritating sounds, and a cool room contribute to good sleep.
• . Hiking in the evening, swimming and yoga help restore strength and calm the nerves.
• Quitting bad habits and caffeine consumption. If you suffer from RLS, you will have to exclude from your diet not only coffee and black tea, but also any other products containing caffeine, such as energy drinks, chocolate, cola. Alcohol and nicotine also increase symptoms.

Restless legs syndrome (RLS) is a sensorimotor neurological disorder manifested by increased motor activity of the lower extremities, mainly at rest. Usually, characteristic symptoms have a pronounced circadian rhythm with onset or intensification in the evening and at night. The most common complaints of patients are disturbance and deterioration in the quality of sleep, affective and anxiety disorders, deterioration in the quality of life associated with health status and decreased performance. This disease is common among all age groups, but the number of patients increases with age. Thus, in old age it affects 9-20% of people. At least a third of RLS cases first appear between 20 and 30 years of age. In women, this disease occurs 1.5 times more often than in men, and this disproportion increases due to the fact that women more often seek medical care. Sometimes it is quite difficult for clinicians to diagnose RLS or determine the extent and severity of this disease, as well as evaluate the advantages and disadvantages of treatment. It should be noted that for general practitioners, these problems are more acute than for narrow specialists.

According to statistics, 5-10% of the adult population suffers from restless legs syndrome. At the same time, a third of those suffering from the disease are bothered about once a week, and two thirds – from two times or more. Most often, this disease is found in adults in middle and old age, and women suffer from restless legs syndrome 1.5 times more often than men.

Restless legs syndrome, depending on the cause, can be primary or secondary. However, it has not yet been possible to find out the exact reason for the development of primary RLS, but it is assumed that it lies in proper operation some brain structures. Primary RLS occurs in close relatives. It usually appears in the first 30 years of life and is thought to be associated with defects of chromosomes 9, 12 and 14.

Secondary RLS occurs during pregnancy (usually in the second and third trimesters), with iron deficiency in the body and with end-stage renal failure. There are also known cases of the development of restless legs syndrome in diabetes mellitus, amyloidosis, rheumatoid arthritis, thyroid diseases, alcoholism, radiculopathy, multiple sclerosis, as well as deficiency of vitamin B12, thiamine, folic acid, magnesium. In this case, most often the disease develops after 45 years. Also, sometimes restless legs syndrome develops in those suffering from Parkinson's disease, Huntington's chorea, and Tourette's syndrome.

Unpleasant sensations in the legs may occur when various diseases. But if they appear at rest, disappear with movement, intensify in the evening or at night, without appearing during the day, are accompanied by leg movements and problems with sleep, be sure to consult a neurologist with suspicion of Eckboth syndrome.

Who is susceptible to the syndrome?

And although this disease is often confused with other diseases, for example, varicose veins of the legs, there are still groups of people who fall into the so-called risk group. Often, restless legs syndrome makes itself felt in parallel with the development of other diseases, such as kidney failure or diabetes.

People with a lack of iron and folic acid in the blood also suffer. Symptoms of such anxiety often occur in pregnant women in the second and third semesters of pregnancy, but after childbirth, most often, all discomfort quickly disappears.

Also, obese people are more susceptible to the syndrome, especially at a young age.

Oddly enough, the desire to constantly go somewhere, most often, does not arise among those who are real life moves a lot, but, on the contrary, those who lead a sedentary lifestyle.

However, in most cases, the disease is not at all associated with any additional diseases; in such cases, patients develop serious metabolic disorders. Unfortunately, what is the reason for such failures – doctors are still not able to answer this question.

Causes and consequences of RLS

Not so long ago, doctors called the cause of restless legs syndrome disturbances in the functioning of nerve endings and blood vessels. But recent studies have shown that the disease is a mental disorder. This is due to a failure of chemical processes in the parts of the brain responsible for the motor processes of the limbs. This made it possible to distinguish Ekbom syndrome into a separate section of diseases.

Observations of patients suffering from symptoms of the disease have shown that it generally begins as a concomitant to more serious problems of the body.

In addition to brain disorders, it can accompany a lack of vitamins and minerals, and it can also be caused by:

• Anemia, due to iron deficiency, indicated by low hemoglobin levels
• Damage to nerve endings in the background diabetes mellitus(neuropathy)
• Deficiency of B vitamins, magnesium and calcium
• Taking or refusing sedatives, vasodilators and antidepressants
• Kidney diseases
• Spinal cord nerve damage
• Arthritis of various etiologies
• Lyme disease
• Parkinson's disease
• Smoking, alcohol and caffeine abuse
• Stress and nervous disorders
• Hereditary predisposition
• Pregnancy

The disease develops very slowly. On early stages it may not cause special concern. Timely diagnosis and treatment can easily cope with it. But the apparent innocence of the symptoms misleads most sufferers of restless legs syndrome. People don't contact medical institutions, until this leads to severe sleep disturbance and stress, and sometimes to mental disorders, which are no longer so easy to get rid of.

Symptoms of restless legs syndrome

The main symptoms of restless legs syndrome are sensory disturbances, which are expressed in paresthesia and movement disorders.

The disorders affect both legs, and the movements of the limbs are most often asymmetrical.

Sensory disturbances occur when a person is sitting or lying down. Symptoms are at their peak between 12 and 4 am. To a lesser extent, symptoms appear between 6 and 10 am.

Complaints that patients may make:

• Tingling feeling in the legs.
• Feeling of numbness in the lower extremities.
• Feeling of pressure on the legs.
• Itchy skin of the lower extremities.
• Feeling of goosebumps running down your legs.

These symptoms are not accompanied by severe pain, but are very annoying to the person and cause serious physical discomfort. Some patients report a dull, tingling or mild but sharp pain.

Unpleasant sensations are localized mainly in the lower leg, less often affecting the feet. As the pathology progresses, the hips, arms, perineal area and even the torso are involved in the process.

In the initial stages of the development of RLS, a person begins to experience discomfort 15-30 minutes after he goes to bed. In the future, unpleasant sensations begin to bother you almost immediately after the cessation of physical activity, and then during the daytime hours, when the legs are at rest. It is very difficult for such people to drive a car, fly, visit the theater and cinema, etc.

In general, a clear symptom of restless legs syndrome is that the unpleasant sensations bother a person only during the period when he is not moving. To eliminate the discomfort, he is forced to move them: shake, rock, bend and unbend. Sometimes patients get up and mark time, massage their legs, and walk around the room at night. However, after they go to bed, the discomfort returns. When a person suffers from RLS for a long time, he determines for himself a specific ritual of movements that bring him maximum relief.

At night, people experience excessive motor activity in their legs. The movements are stereotypical and constantly repeated. A person bends either thumb legs, or all toes, can move the foot. In severe cases of the syndrome, people bend their legs at the hip and knee joints. Each episode of motor activity does not take more than 5 seconds. Then there is a break of 30 seconds. Such episodes are repeated over several minutes or several hours.

If the pathology is mild, then the person himself may not even know about such a disorder. It can only be diagnosed during polysomnography. When RLS is severe, the patient wakes up several times a night and cannot fall asleep for a long time.

Such pathological behavior during sleep cannot go unnoticed. During the daytime, a person feels tired and weak. His mental functions deteriorate, his attention suffers, which affects his performance. Therefore, restless legs syndrome can be considered a risk factor for the development of depression, neurasthenia, increased irritability and mental instability.

As a rule, with primary restless leg syndrome, pathological symptoms persist throughout life, but their intensity varies. Stronger than man The disease begins to worry during emotional shock, after consuming caffeine-containing drinks, after playing sports.

The vast majority of people indicate that the pathological symptoms, although slowly, are still progressing. Sometimes there are periods of calm, which are followed by periods of exacerbation. Long-term remissions, which last for several years, occur in approximately 15% of patients.

If a person has secondary restless legs syndrome, its course is determined by the underlying pathology. However, remissions are rare.

Diagnostics

During polysomnography, periodic movements in the limbs are recorded.

Precisely because the main signs of restless legs syndrome are associated with subjective sensations, which are expressed to the patient in the form of complaints, the diagnosis of this disease is based solely on clinical signs.

Additional research methods in this case are carried out to search possible reason diseases. After all, some pathological conditions can occur unnoticed by the patient, manifesting only as restless leg syndrome (for example, iron deficiency in the body or the initial stage of a spinal cord tumor). Therefore, such patients are given general analysis blood test, blood sugar test, general urine test, determine the level of ferritin in plasma (reflects the saturation of the body with iron), do electroneuromyography (shows the condition of the nerve conductors). This is not the entire list of possible examinations, but only those that are carried out for almost every patient with similar complaints. List additional methods research is determined individually.

One of the research methods that indirectly confirms the presence of restless legs syndrome is polysomnography. This is a computer study of the human sleep phase. In this case, a number of parameters are recorded: electrocardiogram, electromyogram, leg movements, chest and abdominal walls, video recording of the sleep itself, and so on. During polysomnography, periodic movements in the limbs are recorded that accompany restless legs syndrome. Depending on their number, the severity of the syndrome is conditionally determined:

• mild course - up to 20 movements per hour;
• moderate severity - from 20 to 60 movements per hour;
• severe course - more than 60 movements per hour.

Restless legs syndrome: comprehensive therapy

To alleviate the patient's condition, it is necessary to use the following treatment:

1. Sleeping pills (with the addition of tranquilizers). If the case of illness is mild, then it is quite possible to achieve visible effect possible if the doctor prescribes Clonazepam, Temazepam, Triosalam, Zolpidem, but only in small quantities (the lowest indicator). These drugs have only one huge disadvantage - addiction.
2. Dopamine. Medicines that give dopaminergic effects allow you to get almost instant results. The most effective drug is Sinemet, its effect is almost instantaneous, even when using a minimal dose. Relief occurs after half an hour and lasts more than three hours. If the symptoms of the disease do not appear regularly, then it must be taken from time to time - when necessary. If the pill has been taken, and the symptoms return at night, another dose is allowed - right in the middle of the night. You can also take Sinemet as a preventive measure, for example, if you need to be without active movement: ride in a car or fly on an airplane. Unfortunately, this drug has side effects - the “reinforcement effect” - over time, the symptoms will become more and more pronounced, and the body, having gotten used to the medicine, will stop responding to it. In this case, as a complication, the symptoms will intensify during the day or morning. To avoid this, you need to take Sinemet in small doses, as recommended by your doctor, and not increase the amount of the drug individually. Sometimes this medicine may cause complications such as upset stomach, nausea and vomiting, and severe headache. If suddenly addiction to Sinamet occurs, it is necessary to switch to another dopaminergic drug. Permax (Pergolide) has proven itself well. Some experts note that it is even more effective than Sinamet, and besides, this medicine there are no such side effects, like the first drug. Of course, Permax is not harmless; it can cause constipation, runny nose, hypotension, and in very rare cases, hallucinations. But there is no “addictive effect”. Parlodel (Bromocriptine) has worked well for RLS. There are positive aspects when restless legs syndrome is treated with Mirapex, but the effectiveness of the drug has not yet been fully studied.
3. Anticonvulsants. Another aspect of complex treatment that cannot be avoided. In the treatment of RLS, Gabpentin and Carbamazepine (containing Nerontin and Tagretol) have shown their effectiveness. It is strictly necessary to follow the dosage prescribed by the doctor.
4. Opiates. If Willis disease is severe, then there is every reason to prescribe opiates. Basically, these are Codeine, Propoxyphene, Oxycodone, Pentazocine or Methadone - in various dosages. Side effects of these drugs: nausea, dizziness, confusion. It is strictly necessary to adhere to the dose prescribed by the doctor, then there is a chance to survive for many years with a small amount of opiates without acute dependence on them. If you do not follow the dosage, you can make it even worse for yourself, since opium addiction will also be added to the RLS.
5. Other medications. It also happens that doctors prescribe medications containing beta-blockers - these are non-narcotic analgesics, which are similar in composition to antidepressants. But often drugs that belong to this category of drugs intensify the symptoms of the disease, so they are not suitable for treatment for all patients. These medications are prescribed only when other medications do not help at all.

It is very important to understand that if you have restless legs syndrome, then you are sick, and the disease must be treated. You shouldn’t leave everything to chance and hope for “maybe.” Only timely assistance from highly qualified specialists can, if not cure, then significantly reduce your attacks.

Restless legs syndrome: treatment at home

Non-drug treatment can also bring noticeable relief. It is necessary to strictly follow the rules recommended by doctors:

1. Physical activity on the legs, especially before bed. But this does not mean that you need to sit in the gym for days or do weightlifting, since the load should be moderate. Yoga or Pilates are great, as are regular stretching exercises. It is worth noting that even the patients themselves stated that exercise stress, which was given to the legs at the beginning of the disease, stopped the symptoms, and the disease simply receded. But if you let everything take its course, restless legs syndrome will soon develop, and stress will not bring relief, but new pain and symptoms.
2. Voluntary massage and rubbing of the legs.
3. Contrast foot baths: alternating cold and hot water.
4. Mental training: Concentration will not only train the brain, but will also help cope with neuropsychiatric stress. Start drawing, weaving beads, debating, or playing strategy videos.
5. Physiotherapeutic procedures do not benefit everyone, but sometimes magnetic therapy, mud, paraffin and lymphatic press work wonders. All this is purely individual.
6. Avoid coffee, tea and chocolate, as well as any caffeine-containing products.
7. Maintaining a daily routine: you need to go to bed at the same time. It is better to fall asleep and wake up late, then during the day you will not want to sleep. Make your sleeping conditions as comfortable as possible.
8. Do not use medications that cause RLS.

Additional techniques

As a complement to drug therapy and correct lifestyle in the treatment of Ekbom syndrome, physiotherapeutic procedures are used, which include:

• Vibromassage.
• Magnetotherapy is the use of magnetic fields that have anti-inflammatory, analgesic and decongestant effects.
• Mud applications are a method using therapeutic mud. When used, blood circulation improves, the movement of red blood cells improves, and metabolism is normalized.
• Lymphopress – creating pressure on the lymphatic system for the purpose of normalization metabolic processes in the body and increase the tone of the veins of the lower extremities.
• Reflexology is a method in which special needles are inserted into specific points on the body.
• Darsonvalization of the legs - using a special device, a high-frequency, rapidly decaying current is applied to a certain part of the body.

Prevention

• Quitting bad habits (smoking, alcohol).
• Compliance healthy image life:
  • regular walks in the fresh air;
  • physical education classes;
  • maintaining a day and night routine ( night sleep at least 8 hours).
• Balanced and rational diet: eating foods high in fiber (vegetables, fruits, greens), avoiding canned, fried, spicy, hot foods.
• Timely consultation with a doctor if health problems arise.
• Control of arterial (blood) pressure.
• Conflict resolution at home and at work.
• Refusal or limitation of coffee and strong tea consumption.
• Avoid drinking caffeinated drinks (Coca-Cola).
• Limiting the consumption of chocolate, cheese, and red fish (the tyramine it contains increases the manifestations of restless leg syndrome).

Movement disorders have a variety of clinical manifestations. One of the mysterious but quite common problems in adults over 30 is restless legs syndrome (RLS). It manifests itself as unpleasant sensations in the lower extremities, which can be managed with massage and physical activity.

There are both primary and secondary problems. Since the movement disorder occurs at night, it is associated with sleep disturbances, which create serious inconvenience for the patient. Diagnosis of the disease comes down to excluding other possible factors that disrupt 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 between two main manifestations of the problem, the division of which is based on the origin of the RLS:

1. Idiopathic restless legs syndrome is a primary process, the cause of which is unknown. Moreover, more than 50% of precedents for identifying this disorder belong specifically to this group. Familial cases of the disease have also been 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 are inclined to believe that the disorder is multifactorial, 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 reason for its formation. Failures that occur both with age and under the influence chronic processes, provoke metabolic disorders, leading to tremors of the limbs. It is one of the main signs of this movement disorder. Failures in physiological innervation are formed when vegetative-vascular dystonia(VSD), lack of microelements, renal dysfunction. Uremia presumably plays a key role in the pathogenesis, which is associated with a high percentage of patients on dialysis who are diagnosed with muscle dysfunction. A certain cascade of reactions provokes the occurrence of restless legs syndrome during pregnancy. All these reasons can lead to RLS.

There are two main theories that explain 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 concentrations of ferritin in the blood of patients are associated with greater severity of symptoms and poor prognosis. This assumption is confirmed by visual methods brain studies such as magnetic resonance imaging and polysomnography. An autopsy of 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 patients is 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 iron reservoir that 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 currently one of the main ones. 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 know exactly the pathogenesis of the disease, its clinical picture only confirms the assumption of the 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 absence of such a pronounced predisposition to stagnation. There are several main symptoms of restless legs syndrome. However, most often they occur in a supine position, during or before sleep:

1. The limbs begin to buzz. Patients complain of discomfort, while painful sensations are missing. Exercises and massage help get rid of this problem, so people try to walk around and stretch their legs. The condition is alleviated by increasing the activity of blood flow.
2. The sensitivity of the lower extremities is impaired. A tingling sensation appears, the legs seem to become cold, there is an itching sensation and a desire to run.
3. Muscle tremors are a common symptom. It manifests itself as twitching fingers, and sometimes the entire foot is involved in the process. The lower legs may 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 detect or accurately confirm the disease. If you suspect restless legs syndrome, you will need to see a neurologist who will take 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. Diagnostics includes x-ray examination, as well as photos 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 to combat the disorder is drawn up.

Treatment for RLS

Therapy for 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 influence the cause. When restless legs syndrome occurs primarily and is idiopathic, treatment is carried out at home, and the justification for drug support in each case is determined individually.

Drugs

When fighting RLS, doctors try not to use potent drugs, as this can negatively affect the patient’s general condition. Widespread drugs plant origin based on valerian and motherwort. 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 disrupted by restless legs syndrome. When the patient's condition is aggravated by depression, appropriate medications are used.

If a patient has a deficiency 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 supplements help normalize neuromuscular transmission and mitigate the manifestations of RLS. If the syndrome is associated with congestion, ointments that activate venous circulation, such as Troxerutin, are used. Drugs that help thin the blood are also effective, for example, Aspirin, which also has an analgesic effect, as well as medications for removing excess fluid, which include Diacarb.

Folk remedies

Home treatment has good reviews for restless legs syndrome. It's connected with great value diets and regimens to combat this disorder. The most effective in maintaining good health in patients with RLS are the following recipes:

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

It is important to maintain sleep hygiene. The bedroom needs to be well ventilated. If patients go to rest at approximately the same time, they feel a noticeable improvement, which means that adherence to the regime has a beneficial effect on the course of the disease. A walk in the fresh air before bed also helps combat muscle tremors and discomfort.

Gymnastics

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 gymnastics based on stretching, as it has a beneficial effect on the functional ability of the muscles. You can do it both during the day and before bed. A good helper Yoga is a treatment for restless legs syndrome. Various asanas allow you to keep your body in good shape without putting too much strain on the muscles of the lower extremities. Regular walking is also useful, for which no special conditions are required.

Prognosis 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 that may have caused the disorder, the prognosis depends on the response to their treatment.

Prevention comes down to maintaining a mobile and active lifestyle, following general rules healthy eating And timely diagnosis systemic illnesses that can cause movement disorders.

Possible complications

The main consequence of RLS is sleep disturbances. Insomnia - common problem related to constant worry and the need to move around to relieve muscle spasms. With innervation pathologies, congestion may worsen and the patient’s further mobility may be limited.

The so-called restless legs syndrome is a pathology in which a person who has it has discomfort in the lower extremities. Because of this, he has an irresistible desire to move them, which leads to a temporary elimination of discomfort. According to medical statistics, restless legs are diagnosed in 2–10% of the human population. Such a wide range is due to the fact that patients most often do not turn to specialists for help with their problem, despite the fact that they do not know what to do with their illness.
However, when a person often has pain in his legs at night, his quality of life can noticeably decrease. If the unpleasant sensations are strong enough, then it becomes very difficult for him to sleep. For the reason that the disease is prone progress, as a result, the patient may get insomnia. Statistics show that about 15% of people with insomnia suffer from it precisely because they have relevant pain in the legs constantly or sometimes at night.

RLS manifests itself (symptoms)

RLS is a disease whose symptoms are individual for each person. Some people's legs twist at night, others simply start to hurt when they go to bed, others tell doctors that if they relax their limbs, they seem to start burning, etc. The only thing they agree on is that relevant the sensations are very unpleasant, they cause serious discomfort due to which their quality of sleep deteriorates.
If we talk about the general clinical picture, then a disease such as restless legs syndrome has the following symptoms:

• unpleasant sensations (burning, scraping, stabbing or other nature) in the depths of the legs;
• discomfort in the legs usually occurs when the muscles of the lower extremities are relaxed;
• performing actions with your feet leads to temporary relief;
• The legs are pulled the most at night, while in the morning there is almost no discomfort in the legs or no discomfort at all.

In some patients, this condition is observed not only when their body is in a lying position, but also when they are in a sitting position. Often in such cases the pulling effect is less pronounced, but also causes significant suffering to the person.

Causes (etymology) RLS

First, the causes are always determined, and treatment is prescribed only when the attending physician has accurately identified the etymology of the disease. The fact is that when a person’s legs burn at night, this may be due to a lack of a certain microelement in his body. Only a doctor can determine this. Actually, it is for this reason that treatment of the disease with folk remedies almost never leads to the desired result. However, some, believing that their remedy can help, continue to perform meaningless rituals. This is especially true when a child falls ill. Mothers and grandmothers who are not savvy in medical matters, for example, rub the feet of children who have complained of discomfort in the lower extremities with alcohol. Therefore, it is strongly recommended not to perform the treatment at home, but instead seek the advice of a doctor.
Most often, such an ailment as restless legs syndrome has the following causes:

• deficiency of one or more microelements in the body (for example, iron);
• diabetes ;
• blood vessel defects;
• alcoholism;
• arthritis, etc.

The list of reasons is quite extensive, and there is no drug that is guaranteed to help. But some, if they don’t use traditional medicine, then use some kind of pharmacological remedy, for example, they themselves prescribe treatment with mirapex. Perhaps in some cases it will help relieve the symptom, but will not get rid of the cause. And in the end, a person will have to always use this medication, spending a lot of money and depleting his health.

How is RLS therapy performed?

A disease like Restless legs syndrome involves treating, first of all, the primary ailment. If a person has a deficiency of vitamin B and / or iron, then he is prescribed relevant substances, if the patient has problems with blood vessels, then are being undertaken therapeutic measures aimed at correcting the condition of the arteries, etc.
To get rid of restless legs syndrome, in combination with the main treatment, the patient must follow some of the doctor’s recommendations, such as:

• normalization of diet;
• avoiding drinking caffeine-containing drinks in the afternoon;
• refusal or reduction of alcohol consumption;
• increasing physical activity;
• taking a hot bath before bed, etc.

Correcting the condition may take quite a while long lasting time, and therefore, if discomfort in the lower extremities causes severe suffering to the patient, he is temporarily prescribed sedatives. First, they try herbal substances, but if they do not help, then they prescribe opioids or benzozepines. They alleviate the patient's condition, but such treatment for restless legs syndrome can only be prescribed by a specialist, since these substances belong to the class of narcotics.
And to reinforce this, it should be said: only a neurologist knows what to do with restless legs syndrome. Only he is guaranteed to be able to identify the causes of the pathology and prescribe the correct therapy.

List of used literature:

• Neurology. Handbook of a practicing physician. D. R. Shtulman, O. S. Levin. M. "Medpress", 2008.
• Averyanov Yu. N., Podchufarova E. V. Restless legs syndrome // Neurological Journal, 1997. No. 3. P. 12-16. Levin O. S. Restless legs syndrome // Diagnosis and treatment of extrapyramidal disorders / ed. V. N. Shtok. M., 2000 pp. 124-138.
• Steiner J. C. Clonidine helps restless legs syndrome // Neurology, 1987. V. 37(Suppl. 1). P. 278.