The official name of the disease is restless legs syndrome (RLS). It is characterized by movement disorders and sensory disturbances that cause severe inner restlessness. Patients experience an increased, unpleasant urge to move. This feeling is particularly noticeable in the legs. Arms can also be affected.
The syndrome is considered a neurological disorder and was little known until a few years ago. The German Restless Legs Association (Deutsche Restless Legs Vereinigung e.V.) estimates that several hundred thousand people are affected in Germany.
Those affected describe their symptoms in very different ways.
The following overview shows the most important symptoms:
- A strong urge to move with feelings of tingling, pulling or tearing in the legs.
- The sensations occur on one or both sides.
- The arms are rarely affected.
- Pain can be felt in the arms or legs
Symptoms usually appear in the evening and at night, as soon as the body comes to rest. The consequences are sleep disorders, daytime tiredness and exhaustion.
Complaints also occur during the day. Prolonged sitting, such as during air travel, visits to the theater or conferences, can trigger RLS symptoms.
This leads to great psychological stress. RLS patients avoid situations that require prolonged sitting. Sleepless nights cause anxiety before going to bed. The psychological stress can exacerbate the insomnia. A vicious circle.
Depending on the severity, restless legs syndrome reduces the quality of life enormously. In the worst cases, the psychological stress can lead to depression.
Many patients experience involuntary leg movements during sleep, which impair the falling asleep and deep sleep phases @ Andrey Popov /AdobeStock
Primary RLS: genes and metabolism
Around sixty percent of all patients suffer from primary (idiopathic) restless legs syndrome. Primary RLS is an independent underlying disease. Research into primary RLS is still in its infancy. Previous findings show that it is a neurological disorder.
Researchers assume a genetic predisposition as the disease often affects several family members in different generations. Those affected report their first symptoms before the age of 30. Between the ages of 50 and 60, most people see a doctor for the first time as the symptoms are noticeably troublesome.
However, scientists have not yet found any specific changes in the brain structure of RLS sufferers.
Substances containingdopamine or opioids alleviate the disease. From this, doctors conclude that the symptoms of RLS are caused by a disturbance in the dopamine metabolism. Iron metabolism is also suspected to play a role.
Secondary RLS: pre-existing conditions and special life circumstances
Forty percent of RLS patients develop secondary (symptomatic) restless legs syndrome. This means that RLS is associated with other illnesses.
Possible causes are
- Pre-existing conditions, such as kidney disease or thyroid disease, also rheumatism
- Iron deficiency
- pregnancy
- Taking certain medications, such as for depression or thyroid therapy
Secondary RLS improves or disappears as soon as the trigger is no longer present. As part of the medical history, the doctor will clarify which form of RLS you suffer from. In the case of secondary RLS, you should never stop taking medication on your own authority or discontinue treatment for another (pre-existing) condition.
Talk to the doctor treating you. He or she may prescribe a different medication.
It usually takes some time before a sufferer receives a clear diagnosis for their symptoms. The first port of call is usually the family doctor. They examine the patient thoroughly. If there is no other explanation for the symptoms, the GP will refer the patient to a neurologist.
Before a diagnosis of RLS is made, the doctor and patient usually conduct an intensive medical history interview. Observation and assessment of the patient's medical history play a key role in this.
These accompanying symptoms usually lead to the diagnosis:
- Patients complain of insomnia and daytime tiredness.
- The compulsion to move becomes stronger in the evening or at night or when resting.
- Those close to the patient complain about the patient's symptoms (sleep disturbance and tiredness).
Self-help for mild symptoms
Mild forms of restless legs syndrome can be managed by the sufferer themselves.
Here are some tips for self-help:
- Ensure sufficient, but moderate, physical exercise.
- Avoid heavy physical work.
- Try cold foot baths.
- Massage affected arms, feet and legs.
- Do squats.
- Avoid coffee and alcohol.
- Avoid heat, for example saunas.
There are self-help groups in every region. There, people can talk about their condition, encourage each other and share up-to-date information about their RLS. A self-help coordination center will tell you in which city the nearest RLS group meets.
If you are no longer able to carry out your daily duties because of your symptoms, you should definitely consult a doctor. He or she will talk to you about drug therapy.
Cold foot baths help with restless legs syndrome @ SusaZoom /AdobeStock
RLS therapy with medication for severe symptoms
If the above measures are not enough to noticeably alleviate your symptoms, you will need medication. A neurologist will work with you to select a suitable medication and determine the dosage.
The following treatment options are usually the main focus:
- The first choice is dopaminergic therapy. The patient takes L-dopa. This is an amino acid. The human body uses it to produce the messenger substances adrenaline, noradrenaline and dopamine. These substances are important neurotransmitters that influence brain metabolism. Alternatively, medicine uses dopamine agonists. Brain metabolism and neuronal activity play a role in RLS.
- The second option is treatment with opiates. As a rule, the neurologist prescribes drugs with a short-term effect. Only in particularly severe cases do they resort to medication with a long-term effect.
- The third option is treatment with anticonvulsants. This group of drugs originally comes from the treatment of epilepsy. It also alleviates the symptoms of restless legs syndrome.
RLS syndrome is a painful chronic disease that occurs frequently in families. The first phases of the disease appear before the age of 30. The symptoms only worsen at an advanced age, making treatment necessary. In addition to self-help, medicine has effective medication that can significantly improve quality of life.
A neurologist is the right person to consult for all neurological complaints. After studying medicine, a neurologist has completed 5 years of specialist training, which includes all relevant therapeutic and diagnostic treatment methods.