The day was exhausting. Finally stretching out in bed and sleeping – the thing you’ve been looking forward to for quite some time. But instead of relaxation, frustration awaits. The legs don’t want to rest, burn and tingle. Almost every tenth German knows this situation. Restless legs syndrome (RLS) is one of the most common neurological disorders. Learn here how RLS develops, what effects it has on the body and psyche, and what therapy can help.
What is restless legs syndrome?
Although the symptoms of the widespread restless legs syndrome were first described in the 17th century, it is often not recognized or only recognized late. Yet the complaints are typical: they occur mainly when the affected person comes to rest and wants to relax, so preferably in the evening after lying down. The legs tingle, burn, pull, tear, twitch and hurt. It is also characteristic that the insensations always improve by standing up and moving around. It is estimated that about 8 million Germans are affected; women more often than men, older people more often and more severely than younger people.
Aggravating circumstances for restless legs
Affected people often feel that they are not taken seriously – for healthy people, it is hard to imagine that tingling in the legs that improves with movement can be very distressing. In addition, the symptoms also occur with other diseases, so that even the doctor is often late in making the correct diagnosis. Among the most common misdiagnoses is polyneuropathy, a disease of the peripheral nervous system that often occurs with diabetes. But venous diseases, Parkinson’s disease or Lyme disease are also wrongly suspected as culprits. And not infrequently, the complaints are assessed as psychosomatic. So it is hardly surprising that depression can occur as a late consequence – which in turn gives rise to further misdiagnosis.
What exactly is the manifestation of RLS?
There is a whole range of symptoms that lead to the diagnosis of the clinical picture. The main complaint is the burning, tingling, and pulling sensation at rest, which tends to be felt deep in the muscles and bones, starts in usually both legs at the bottom (rarely the arms) and moves upward, and is accompanied by an urge to move. The latter forces the sufferer to constantly move or massage the legs. Many have to stand up and “walk around”. Symptoms usually improve immediately with exercise. However, as the duration of the disease increases, this movement must last longer and be stronger in order to achieve the desired effect. In addition, muscle twitching and spontaneous movements of the extremities occur both during sleep and while awake. Particularly in the evening and at night the affected person suffers from the symptoms, later increasingly during the day. In the long run, the constant lack of sleep leads to concentration and sleep disorders, states of exhaustion and slowing down, a tendency to aggression and depression, and even cardiac arrhythmias.
How does restless legs syndrome develop?
About 40 percent of cases are thought to be inherited (primary form), as they are clustered in some families. The secondary form, on the other hand, is caused by other triggers. These include iron and folic acid deficiencies, hormonal imbalances (especially due to thyroid disorders), and kidney failure. Many women also suffer from RLS in the last trimester of pregnancy. Secondary forms are also believed to have certain genetic traits that cause one person to have RLS but not another. The exact mechanism of the disease is still only suspected. Scientists assume that disorders of the “dopaminergic system” are present. Dopamine is a messenger substance on nerves in the brain that attaches itself to receptors intended for it and triggers reactions there. If these “stimulus receptors” are altered, overreactions or increased arousal can occur.
What helps against RLS?
The diagnosis is made exclusively through the symptoms of discomfort – the neurological examinations are unremarkable. No cure is yet possible, which means treatment is limited only to symptom relief and therapy for any underlying disease. Options include regular physical exercise such as:
- Cycling
- Swimming and endurance sports
- Brush massages and cold or alternating showers of the legs.
- Relaxation methods and stress relief
Alternative medicine procedures such as spinal chiropractic, homeopathy, neural therapy or magnetic therapy can also help. Some patients report that abstaining from caffeine in the afternoon and alcohol relieves discomfort. Medications include enzymes, vitamin B, L-dopa, and in severe cases, sedatives.