Restless legs syndrome (RLS) is a condition characterized by unpleasant, painful sensations in the lower extremities, which appear mainly at rest (usually in the evening and at night) and force the patient to make movements that relieve them, which leads to sleep disturbance.
Medical statistics state that worldwide, from 10 to 25% of the entire adult population have some form of RLS. RLS occurs in all age groups, but is more common in middle and old age. Sometimes remissions may occur, during which the symptoms weaken significantly or disappear altogether. However, symptoms usually reappear after some time and get worse over time. RLS accounts for approximately 15% of cases of chronic insomnia.
Causes
In most cases, RLS occurs in the absence of any other neurological or physical disease. RLS can be primary (ideopathic) or secondary (associated with various pathological conditions).
Medical conditions that may cause secondary RLS.
- Pregnancy
- Peripheral neuropathy
- Iron deficiency
- Radiculopathy
- Kidney failure
- Parkinson's disease
- Spinal cord injuries
- Diabetes
- Postgastrectomy syndrome
- Rheumatoid arthritis
- Abuse of strong drinks, coffee, tea and smoking.
It should be noted that not all patients with these conditions experience RLS. Sometimes there are familial cases when the disease is observed in several generations.
Restless legs syndrome - what is it?
Restless legs syndrome or Ekbom syndrome is a large group of diseases hiding behind typical clinical manifestations - nagging pain in the legs, a feeling of heat in the feet, aching sensations in the calves, intermittent swelling of the legs, and so on.
These sensations can be so intense that patients cannot sleep, seeking relief from suffering in night walks. The reasons for the development of this kind of condition can be different and the list of them is quite impressive: from hereditary metabolic disorders and intervertebral hernia, to chronic venous insufficiency and atherosclerosis of the arteries of the legs. Sometimes it is difficult not only for the patient, but also for the doctor to figure out what’s what. However, the problem of “restless legs”, no matter what causes it, has to be solved and, unfortunately, in some cases the matter does not end with general recommendations and strengthening procedures.
Symptoms
First of all, RLS is characterized by the appearance of unpleasant sensations in the lower extremities . This is most often not pain, but itching, trembling, burning, stretching, a feeling of internal tension, fullness, tingling and twitching in the depths of the legs, thighs, and feet. These sensations occur in waves, every 5-30 seconds. They usually occur at rest: while sitting or lying down, and especially when falling asleep. To alleviate their condition, patients are forced to stretch and bend their limbs, shake, rub and massage them, toss and turn in bed, get up and walk around the room, or shift from foot to foot. During movement, the unpleasant sensations weaken or pass, but as soon as the patient lies down, and sometimes just stops, they intensify again.
RLS symptoms are circadian in nature, i.e. have a clear circadian rhythm , appearing or intensifying in the evening or night hours: between 18 pm and 4 am. Before dawn, symptoms weaken and may disappear altogether in the first half of the day. In severe cases, the characteristic circadian rhythm disappears and symptoms become permanent. They can occur not only in a supine position, but also in a sitting position and can make visiting a movie or theater, or a long trip in public transport unbearable.
The consequence of unpleasant sensations in the legs and the need to constantly move them is sleep disturbance - insomnia . Patients cannot fall asleep for a long time and often wake up at night. The consequence of insomnia is drowsiness and fatigue during the daytime.
Periodic movements of the limbs aggravate sleep disturbances in RLS . During sleep, patients experience involuntary rhythmic short-term twitching of the lower extremities every 5-40 seconds. In mild forms, these movements occur within 1-2 hours after falling asleep, in severe forms they can continue throughout the night.
In idiopathic RLS, clinical manifestations persist throughout life, and in most cases there is a tendency for symptoms to slowly increase, although long-term remissions are possible. Severe restless legs syndrome and, as a consequence, poor health, drowsiness, decreased attentiveness, asthenia significantly reduce a person’s quality of life, making him nervous, irritable, and tired.
Aching pain in the legs at rest
As you know, the leg anatomically consists of the thigh, lower leg and foot. Any of the three parts can hurt, and there are cases when a person cannot say with certainty where exactly the pain syndrome is localized.
Causes of discomfort in the legs at night
Pain in the legs at rest, when a person is in a horizontal position, periodically worries not only older people, but also children. This symptom is directly related to lifestyle.
There are several reasons that cause pain:
- too intense physical exercise during sports, or related to work;
- "sedentary work;
- problems with excess weight;
- period of bearing a child.
There are conditions that serve as a catalyst for the appearance of pain in the legs. This:
- various diseases of the spine, joints or bone marrow, mechanical damage to the discs and pinched nerves
, osteochondrosis, lumbosacral radiculitis,
hernia of the lumbar spine
and others; - rheumatism, rheumatoid arthritis and other autoimmune diseases;
- varicose veins, other vascular diseases;
- chronic and systemic diseases, such as diabetes, neuropathy, causing disruption of the psychophysiological functions of the body;
- physical leg injuries;
- deficiency of minerals and vitamins, magnesium, calcium, vitamin D3;
- Ecomb's syndrome.
Recently, there has been a sharp increase in patient complaints of restless legs syndrome. This unpleasant sensation appears in a calm state, usually before bed. RLS is characterized by the fact that it is not a disease, but it causes a lot of inconvenience. When lying down, a tingling sensation occurs in the lower extremities, accompanied by an irresistible desire to get out of bed and walk. In an upright position of the body the sensation disappears, but in bed it returns again. In most cases, patients manage to fall asleep, but during sleep they are bothered by chaotic twitching of the legs, which prevents them from properly resting and recovering.
This syndrome occurs due to fatigue that accumulates in the limbs throughout the day. This explains the need for constant movement, while experts do not find specific pathologies in people with this disease. Ecomb syndrome does not pose a threat to life, but it seriously worsens the quality of life.
Older people are more susceptible to pain that occurs at night than others. This is facilitated by old injuries, arthrosis, arthritis, vascular diseases, and ultimately the sensations become so unbearable that patients have to seek help.
In young children, the discomfort usually does not cause pain, but does impair sleep. There can also be many reasons: from congenital joint dysplasia to a banal deficiency of microelements. Teenagers suffer from restless leg syndrome due to rapid growth, when bones develop ahead of muscle tissue, which is greatly stretched.
What cases require medical attention?
If there is redness or swelling in the areas where the pain is localized, or if the pain is accompanied by cramps, you should never postpone a visit to the doctor. Diagnosis and intervention by specialists is necessary when:
- Reduced or absent sensitivity of the limbs.
- There is a change in skin color.
- The pain does not subside and is not relieved by painkillers.
- Pain sensations are present in other parts of the body.
As a rule, minor pain goes away within a few days, but if there is no improvement, medical attention is needed. To begin with, you can seek advice from your local physician, and he, in turn, will give a referral to a surgeon or traumatologist.
How is the treatment carried out?
Doctors often hear the same question from patients: what to do if their legs hurt at night, while at rest? The first step is to find the cause of the pain, so self-medication is not recommended - a specialist has much more extensive experience and will better understand the symptoms of each specific case.
In the initial stages, mild sedatives such as valerian root, motherwort or Novopassit will help with RLS. This will help relieve tension in your limbs. In more serious cases, anticonvulsants and tranquilizers will be required, which are dispensed strictly according to a doctor's prescription.
In cases of pinched nerve endings due to arthrosis and osteochondrosis, the doctor will most likely prescribe medications for inflammation orally and externally. It should be borne in mind that non-steroidal drugs in tablets can be irritating to the stomach. When taking them, you should drink a sufficient amount of liquid necessary for the solubility of the medicine.
Varicose veins can be a common cause of leg pain. The best way to relieve symptoms is to lie down. The legs should be located above the level of the heart. During the working day, if there is a heavy load on the limbs, you should use compression stockings.
If the problem is related to stretching of muscle tissue due to training or injury, you should treat your legs with anti-inflammatory agents - these are Dolgit, Nise and others gels.
Other remedies for aching legs
The best remedy is definitely a foot massage. It will eliminate tension and improve blood circulation. Massage is the best treatment method for vascular diseases of the legs and flat feet.
Popular folk remedies include propolis compresses, as well as decoctions of raspberry leaves and various wraps.
Baths made of linden blossom, lemon balm or pine needles are also suitable. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
Flat feet and venous diseases are among the “leaders” that provoke leg pain
Flat feet often cause pain: the ligaments, muscles of the foot, and bones weaken and cannot, as before, fully perform their functions. At the initial stage of the disease, orthopedic insoles can alleviate the condition. Over time, it is no longer possible to do without drug treatment.
For varicose veins
the patient experiences severe discomfort in the evening or after standing for a long time. There is a burning sensation in the area of the feet and calves, “goosebumps”, it seems that the limbs are simply “bursting” from unpleasant sensations. Relief may not come even at night. Night leg pain in the elderly is caused by cramps; Sleep disturbance is often observed against this background. If you try to treat varicose veins on your own, you can progress the disease and lead to thrombosis - a life-threatening condition.
Additional provoking factors
In addition to the listed diseases that can cause severe pain in the legs, discomfort in the lower extremities can also arise for other reasons. Cold and dampness are the main enemies of good health. If an elderly person's feet are cold or wet, this will in most cases cause pain.
Excess weight often provokes various disorders. All experts agree that extra pounds are very dangerous in old age. Excessive activity, as well as a sedentary lifestyle, are equally undesirable for the health of a pensioner. Load on joints and muscles is necessary, but it should be reasonable and moderate: advanced age is not the best time for experiments.
Suffered sprains, dislocations, and fractures do not go away without a trace. They often remind themselves of pain, especially against the backdrop of changing weather or after overwork. Often problems with joints and muscles are the result of a hereditary predisposition. In these and other cases, if pain in the legs occurs, you just need to trust the doctor, who will draw up a treatment plan.
Features of diagnosis and therapy
Discomfort in the pelvis, knees, and feet that does not go away for a long time is a serious reason to consult a doctor. Diagnosis of the disease is carried out on the basis of detailed blood and urine tests, x-rays, ultrasound of joints and blood vessels, MRI and CT. Depending on the situation, the doctor prescribes narrowly targeted medications.
For joint diseases, therapy necessarily includes hormonal corticosteroid drugs; they have an analgesic effect. Nonsteroidal anti-inflammatory drugs stop acute processes. Chondroprotectors prevent the development of joint dystrophy. Patients are often prescribed antibiotics, vitamin-mineral complexes, and medications that normalize metabolism.
For the treatment of gout, drugs such as allopurinol, probenecid, and sulfinpyrazone are often prescribed. Diet, rest, and drinking plenty of fluids are required - following these recommendations is no less important than taking pills.
The main way to combat varicose veins is to constantly wear compression stockings or knee socks. A doctor may prescribe an ointment for leg pain in older people, but it will only provide temporary relief. In severe cases, the patient is offered surgery to remove the affected veins.
When is a doctor's help needed?
Situations when your legs hurt badly at night cannot be ignored. The development of diseases can lead to a significant deterioration in health, a long-term decrease in a person’s performance, and disability.
An urgent visit to the clinic is necessary in the following cases:
- sudden onset of pain in a limb, persisting for several days;
- a stable feeling of weakness in the leg, numbness, difficulty walking;
- the presence of external tissue changes - edema, tumors, redness.
When making an appointment with a doctor, difficulties arise with choosing a specialist. If you have pain in your legs at night, you can take a ticket to see a therapist, surgeon, traumatologist, neurologist, phlebologist or orthopedist.