Diagnosis
This is usually provided by the experienced family doctor or the neurologist (specialist in neurology). It is not uncommon for several years to elapse before a diagnosis is made, as leg restlessness is often seen as a symptom of “physical restlessness”, as it can occur, for example, in depression or other psychosomatic disorders. The therapy of RLS (Restless legs) is primarily carried out with medication.
The patient and doctor first clarify the severity of the symptoms and then determine a treatment plan. If, for example, there are more nocturnal (unconscious) twitches and thus sleep disorders, it may be sufficient to treat the sleep disorder. For moderate leg restlessness, the first choice is L-dopa (e.g. Restex).
This drug, which is also used in the treatment of Parkinson’s disease, is a chemical precursor to the actual messenger substance “dopamine“. In the body, L-dopa is, so to speak, “converted” to dopamine and then takes over the tasks of this messenger substance. It can often relieve the symptoms within a very short time and over 80% of patients react very positively.
Overall, the use of L-Dopa, especially over a longer period of time, is not without problems, as it can cause numerous side effects. (see the topic L-DopaDopamine [in brief]). In cases of severe leg restlessness, a different class of drugs is used today.These are the so-called “dopamine agonists”.
In its original form, dopamine as a messenger substance attaches itself to a receptor and causes a reaction there. This can be compared to a key and a lock. Actually, only dopamine “fits” into this receptor lock.
The “dopamine agonists” are drugs that can also trigger a reaction at the dopamine receptors. They act a bit like a fake key or a lock pick. Typical agonists, i.e.
substances that act at the receptor like dopamine, are e.g. cabergoline (trade name e.g. Cabaseril) or pramipexole (trade name e.g. Sifrol).
Similar to L-Dopa, there may be a rapid improvement, but considerable side effects must be expected. If the above-mentioned therapeutic approaches are unsuccessful and the strongest and most intense urge to move continues and this may even be accompanied by pain, an attempt can be made with the so-called “opioids“. Opioids are commonly used drugs in pain medicine and should only be used to a very limited extent, as they have a high addictive potential and tolerance can develop relatively quickly.
This means that in order to achieve a certain effect, one needs constantly larger doses of such a substance. It is therefore necessary to weigh up the benefits and risks carefully. There are some non-drug approaches that can complement RLS therapy (Restless legs syndrome).
Here, for example, the so-called sleep hygiene (see also topic sleep disorder) is of great importance. Other approaches vary from patient to patient and can therefore only be understood as therapeutic stimulation. In any case, any kind of “passive” artificial relaxation (e.g. progressive muscle relaxation, autogenic training, etc.)
is not recommended, since it can lead to an aggravation of the symptoms. Attending a self-help group can, as with many other diseases, also be very helpful.
- Hot or cold bath or shower
- Light movement (no excessive effort)
- GymnasticsStretching Exercises
- Thai Chi
- Massages
