Let me introduce you to "restless legs syndrome"

There is a disease that causes people to experience unbearable discomfort in their lower limbs, especially in the deep part of their calves, when they sleep at night. This discomfort can only be temporarily relieved by movement or massage. Under its torture, patients can only keep moving their lower limbs or walking on the ground, which leads to serious sleep disorders. Although the disease is not life-threatening, it seriously affects the quality of life of patients. This disease is " restless legs syndrome " (RLS).

Medically, this disease is still in the research stage. It is currently believed to be a central nervous system disease, and the specific cause is still unclear. It is mainly divided into primary and secondary. It is currently believed that "primary restless legs syndrome" may be related to genetics and dopamine dysfunction, and patients often have a family history; "secondary restless legs syndrome" can be seen in iron deficiency anemia, pregnant women or parturients, nephrotic syndrome, rheumatic diseases, diabetes, Parkinson's disease, motor sensory neuropathy, and multiple sclerosis patients. Literature reports that the prevalence of this disease abroad is 1% to 10% of the total population, and in my country it is about 1.2% to 5%. It can occur at any age and is common in middle-aged and elderly people. Due to the public's lack of understanding of "restless legs syndrome", it is often attributed to insomnia, painful muscle spasms, arthritis, and psychological disorders in the elderly, etc., which makes doctors underestimate the prevalence of this disease.

1 Symptoms

The main clinical symptom of "restless legs syndrome" is a spontaneous and unbearable painful feeling in the lower limbs. The most common is the gastrocnemius muscle, which may occasionally occur in the thigh or upper limbs, usually on both sides at the same time. There is an urgent and strong feeling of wanting to move , which can partially or completely relieve the symptoms after activity, and may lead to excessive activity. When patients visit the doctor, they often complain: deep tearing sensation in the calf during rest, like ants crawling in the bones , excruciating pain, numbness, and itching. No matter how they lie down, they are uncomfortable, so they want to get down and walk around. Generally, the symptoms are most significant when lying in bed at night and reach a peak after midnight. Patients keep kicking their legs, beating their joints or massaging their legs. In severe cases, they have to get up and walk constantly to get relief . Sometimes patients will also have stereotyped and repetitive flexion movements of their legs during sleep, which will wake them up . Severe insomnia will also cause lack of energy, drowsiness, and decreased work ability during the day. This torture day and night will seriously affect the functions of the body in all aspects in the long run, and may cause loss of appetite, weight loss, slow reaction, and decreased exercise ability.

2. Check

The diagnosis of restless legs syndrome is mainly based on clinical symptoms, but auxiliary examinations can exclude some secondary causes. The International Restless Legs Syndrome Study Group (IRLSSG) has established the minimum diagnostic criteria for this disease.

1. Abnormal sensations: Due to indescribable discomfort in the limbs, there is a strong desire to move the limbs, mainly the lower limbs. These abnormal sensations often occur deep in the limbs, rather than on the surface such as the skin.

2. Motor symptoms: The patient cannot fall asleep and keeps moving his limbs to relieve abnormal sensations. The main symptoms are walking back and forth, shaking or flexing and stretching the lower limbs, or tossing and turning in bed.

3. Symptoms worsen during rest and can be temporarily relieved by activity.

4. Symptoms worsen at night and reach a peak late at night.

5. A very unpleasant physical sensation in the gastrocnemius muscle, often accompanied by temporary pain and itching in the leg.

6. Symptoms cannot be explained by medical or psychiatric disorders.

7. Other sleep disorders may exist.

3 Treatment methods Rehabilitation therapy

Patients with mild to moderate restless legs syndrome generally do not need drug treatment. They can maintain good living habits and receive rehabilitation treatment to relieve symptoms and control the progression of the disease.

1. Thermal therapy: such as infrared, wax therapy, hot pack, ultraviolet light, etc.

2. Low-frequency electrotherapy or medium-frequency electrotherapy: Electric current is often used in combination with ion introduction therapy, which has obvious analgesic and blood circulation promoting effects.

3. Exercise therapy: Commonly used are medical gymnastics, jogging, brisk walking, swimming, etc., and active resistance exercise can also be performed using equipment. At the same time, massage, passive joint movement, etc. can be performed under the guidance of a therapist.

4. Psychotherapy: Help patients regulate mood swings, sleep well, and prevent and treat depression.

Drug treatment

Severe patients can cooperate with drug treatment after the cause is removed. Dopaminergic drugs are the first choice. In addition, anti-epileptic drugs have a certain effect on some patients, especially when dopaminergic drugs are ineffective, ineffective, or the side effects are intolerable. They can be used or used in combination. For patients with secondary restless legs syndrome, the first thing to do is to treat the primary disease. As the cause is eliminated, the patient's symptoms may also disappear. For some severe and refractory patients who are ineffective with dopaminergic receptor agonists, opioids can be used. In addition, in daily life, we should try to avoid tobacco, alcohol, and stimulating foods containing caffeine. Developing a healthy sleep and work schedule, taking a hot bath before bed, limb massage, and moderate exercise can also help relieve symptoms.

The popular science content of this platform has been funded by the China Association for Science and Technology's Science Popularization Department's 2022 National Science Literacy Action Project "National Society Science Popularization Capacity Improvement Project-Rehabilitation Science Popularization Service Capacity Improvement Action Plan"