restless legs specialists& Info about the syndromeWho does not know it, the tingling in the legs during long train rides or meetings in the office? As if the legs had turned into an anthill. This sensation allows a vague idea of how agonizing the Restless Legs Syndrome has an effect on those affected.
The following sections provide detailed information about the Disease RLS and its treatment options. You will also learn how you can actively combat the disease and thus improve your quality of life.
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Restless Legs Syndrome cases in Germany
1.330 cases in 2019
1.372 cases in 2022 ( prognosis )
What is restless legs syndrome? A strong inner restlessness due to movement disorders and insensations, which results in an increased urge to move. It is a neurological disorder. Symptoms: Primary symptoms are: Urge to move with tingling, pulling or tearing in the legs, pain in the arms and legs. They usually occur in the evening and at night, and exercise relieves the symptoms. Causes: Heredity and metabolism cause a primary disease. Rarely, the disease occurs secondarily as a result of a previous disease, such as kidney, thyroid, but also rheumatism. Also pregnancy. Medication can be the cause. DiagnosisIf the general practitioner does not find an explanation for the symptoms, the patient is usually referred to a neurologist. Through an intensive anamnesis interview the diagnosis is developed. Treatment: In case of pronounced symptoms, a drug therapy is carried out. Opiates and anticonvulsants (epilepsy medications) may also be prescribed.
Restless Legs Syndrome: briefly explained
The official name of the disease is Restless legs syndrome or restless legs syndrome (ICD code: G25.81) for RLS. Characteristic are movement disorders and insensations, which can cause a strong inner restlessness. Patients experience a increased unpleasant urge to move. Mostly in the legs this sensation is noticed, but also the arms can be affected.
© Piotr Marcinski
The syndrome is considered to be neurological disease and was little known in medical circles until a few years ago. The German Restless Legs Association e.V. is amed to affect several hundred thousand people in Germany.
Symptoms: what happens in RLS
– A strong urge to move with feelings of Tingling, Pull or Tearing in the legs. – Sensations occur on one or both sides of the body. – Rarely, the arms are also affected. Pain noticeable in arms or legs – symptoms usually appear in the evening and at night, as soon as the body is at rest comes. Exercise alleviates the symptoms.
The Consequences are sleep disturbances, daytime tiredness and fatigue states. Complaints also occur during the day. Sitting for long periods of time, such as air travel, theater visits or congresses, can trigger RLS symptoms.
Insomnia and physical restlessness in RLS © Sergey / Fotolia
This circumstance leads to a large psychological stress. RLS patients avoid situations that require prolonged sitting. Sleepless nights trigger 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 for some patients. In the worst case, the psychological stress leads to depression.
Causes of restless legs
Primary RLS: Genes and metabolism
About sixty percent of all patients suffer from primary (idiopathic) Restless Legs Syndrome as independent underlying disease. Research into primary RLS is still in its infancy. Evidence to date shows that it is a neurological condition.
The researchers ame that this is caused by genetic disposition of the disease, as it often affects several family members in different generations. Patients report first symptoms of restless legs syndrome symptoms before the 30. Year of life. Between the 50. and 60. Most patients report to their doctor for the first time before they reach the age of 18, because the symptoms cause them noticeable stress.
In contrast to Alzheimer's patients, scientists have not yet found any specific changes in the brain structure in RLS sufferers.
Substances containing dopamine or opioids alleviate the disease. From this, doctors conclude that the symptoms of RLS are caused by a Dysfunction in dopamine metabolism are emerging. Iron metabolism is also suspected to play a role.
Secondary RLS: pre-existing conditions and special life circumstances
Forty percent of RLS patients develop a Secondary (symptomatic) Restless Legs Syndrome. Possible causes are:
– Pre-existing conditions, such as kidney disease or thyroid disease, including rheumatism – Iron deficiency – Pregnancy – Taking certain medications, such as for depression or for thyroid therapy
Secondary RLS improves or disappears as soon as the Trigger is eliminated. As part of the medical history, the doctor will clarify which form of RLS you are suffering from. In the case of secondary RLS, you should never stop taking medication or discontinue therapy for another (pre-) illness on your own authority.
Talk to the treating physician. He can prescribe you another remedy.
The path to a diagnosis of RLS
It usually takes some time before a sufferer receives a clear diagnosis for their symptoms. The first point of contact is usually the family doctor. This examines the patient comprehensively. If there is no other explanation for the symptoms, the family doctor refers the patient to a specialist Neurologists.
The Diagnosis RLS is usually followed by a very intensive Medical history discussion developed between doctor and patient. Observation and evaluation of the patient's medical history play an important role in this process. Diagnosis is usually led by these accompanying symptoms:
– Patients complain of insomnia and daytime fatigue. – Especially in the evening or at night, or at rest, the compulsion to move becomes stronger.
Therapy options and self-help
Self-help for mild symptoms: Light exercise and cooling
Mild forms of Restless Legs Syndrome can be managed by the sufferers themselves. Here are some tips for self-help:
– Ensure adequate, but moderate, physical activity. – Avoid heavy physical work. – Try cold foot baths. – Massage affected arms, feet and legs. – Do squats. – Give up coffee and alcohol. – Avoid heat, for example the sauna.
In every region there are Self-help groups. 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.
Self-help reaches its limits when insomnia and daytime fatigue exhaust you to such an extent that you are only able to perform your daily duties to a limited extent. In these cases, doctors advise drug therapy.
RLS therapy with medication for pronounced symptoms
If the above-mentioned measures are not sufficient to noticeably alleviate your symptoms, drug therapy is required. A neurologist will work with you to select a suitable remedy and determine the dosage.
The first choice is dopaminergic therapy. The patient takes L-dopa. This is an amino acid. The human body produces Messenger substances adrenaline, noradrenaline and dopamine here. These substances are important Neurotransmitter and thus at the Brain metabolism involved. Alternatively, medicine uses dopamine agonists.
Brain metabolism and neuronal activity play a role in RLS. © ktsdesign
The second possibility is a treatment with Opiates. As a rule, the neurologist prescribes short-acting drugs. Only in particularly severe cases will he or she resort to medication with a long-term effect.
The third option is therapy with Anticonvulsants. This group of medications originated in the treatment of epilepsy. It also alleviates the symptoms of restless legs syndrome. Also prescribed for migraine prophylaxis.
The RLS syndrome is a painful chronic disease that runs in families. First phases of the disease appear before the age of 30. Year of life. Only at an advanced age do the symptoms worsen, so that treatment becomes necessary. In addition to self-help, medicine has effective drugs that significantly improve the quality of life.