. Wednesday, December 3, 2008
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They describe their legs are tingling . . . writing with worms––crawling with ants. Or as one sufferer puts it, “a drives-you-nuts kind of thing” Something that gives your limbs an uncomfortable urge to get up and move while the rest of your body is begging for sleep.

Doctors agree that this condition, known as restless legs syndrome, causes some unusual, and extremely uncomfortable, sensations. In fact, it makes doctors uncomfortable, too. That’s because they don’t know what causes it. They aren’t sure how to treat it. They even have trouble describing it.

Just ask Doughlas K. Ousterhout, D.D.S., M.D., a plastic and reconstructive surgeon in San Francisco who has had restless legs syndrome since he was a teenager. “You really can’t describe what it feels like,” says Dr. Ousterhout. “Your legs ache. You want to get up and walk or get up on your toes and get your legs going up and down that will help, but when you stop moving, it comes right back, of course.” Sometimes it comes back for just a few minutes, he adds. Sometimes it lasts for hours.

Mild or Maddening

In a way, restless legs syndrome resembles an itch deep inside one or both legs. An itch that often begins in the evening when you’re sitting or lying down. An itch that may be mildly annoying during the day but distressingly disturbing at night, when you’re trying to sleep. The only solution is to “scratch” the itch, says Lawrence Z. Stern, M.D., professor of neurology at the University of Arizona health Sciences Center and medical consultant for the Muscular Dystrophy Association. Most of the time, just getting your legs moving will help.

The severity of restless legs syndrome, and the frequency of attacks, varies widely, Dr. Stern says. Some people experience it every night––their legs can sometimes jerk or kick involuntarily. For others––and Dr. Ousterhout one––it occurs occasionally. In most cases, “It’s something people will complain about if their doctor asks them, but it’s not the reason they actually go to the doctor,” Dr. Stern says. For others, of course, just reading a book, watching a movie or sitting at the dinner table can be torture: They just have to walk around. In fact, some people stay up all night because their restless legs won’t cal down.

Taking Out the Kick

Eventually your restless legs may take you to the doctor’s office for a checkup. When you go, here’s what your doctor will probably find: nothing. This is because most people with restless legs have nothing detectably wrong. Oh, your doctor may test your blood and, if he’s a neurologist, your nervous system. But most people with restless legs have nothing wrong with them that seems to account for their problem––nothing, that is, except an itch too deep to scratch.

Fortunately, there are some things you can do to calm your restless legs.

Hit the track. Regularly exercising your legs, whether by walking, running or doing in-place toe lifts, is probably the best way to ease your restless legs, Dr. Stern says. Dr. Ousterhout agrees. “When I was in high school, I used to go running at night,” he remembers. “It was about all I could do that would make it feel better.”

Knead your knee. Or whichever part of your big is giving you grief. While rubbing your legs isn’t a cure for restless legs, Dr. Stern says, some people say that it helps.

Take a jolt. Don’t be alarmed if your doctor sends you home with a rented black box and instructions to plug yourself in. Some researchers believe that TENS treatments––TENS stands for transcutaneous electrical nerve stimulation––can significantly relieve the symptoms of restless legs. With TENS, electrodes are placed on the skin over the affected parts of your legs. Small amounts of electricity then are directed into the underlying muscles and nerves. Essentially, your legs become too distracted by the electricity to continue being restless.

A Mystery with Clues

Although the cause of restless legs syndrome remains unknown, it is not a medical mystery without some clues, Dr. Stern says. Doctors do know, for example, that restless legs gets worse at night and with advancing age. Pregnant women are prone to it. So are people with kidney problems and rheumatoid arthritis. Restless legs syndrome has also been linked to iron deficiency, diabetes and Parkinson’s disease. In fact, a common drug used to treat Parkinson’s called levodopa (Sinemet) seems to work for restless legs in one study, 26 people who took levodoopa for two years said their symptoms were much relieved. Other prescription drugs such as clonazepam (Klonopin), carbamazepine (Tegretol), primidone (Mysoline) and bromocriptine (Parlodel) can help.

But many doctors believe the potential side effects of drug therapy may outweigh the benefits of treating this relatively harmless condition, Dr. Stern says. Unless your problem is really severe, your doctor will most likely want to try other therapies before prescribing any medications.

Until more is learned about this malady, it’s important for people to know that their restless legs syndrome, while mysterious, isn’t imaginary, says Dr. Stern. “I think people often are grateful to learn that restless legs is a recognized clinical entity and that they’re not going crazy.”


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