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Restless Leg Syndrome

Jennifer gets up from her desk once again to check on something-anything-to quench her urge to get up and move around. When she sits back down at her desk for an extended period of time, her legs really bother her, especially in the afternoon. She can't quite put her finger on what is wrong, she just knows that she wants to massage her legs, move them around, and get up and walk. She recalls that the restlessness was not as noticeable a few years ago when she first took the job.

At night, when Jennifer is reading in bed, she massages her legs to alleviate the gnawing sensation. She gets up and walks to the kitchen and back to help relieve the discomfort. She finally falls asleep, but for her husband, Greg, there is a long night ahead. He hopes that her night time leg twitching that he has come to expect will not be too bad tonight. He has an early morning presentation and needs an uninterrupted night of sleep. Unfortunately, Jennifer's restless leg movements wake him up a few times and he is a tired man in the morning.

Jennifer is one of millions of Americans that have symptoms of Restless Leg Syndrome.

Symptoms of Restless Leg Syndrome
Unpleasant sensation Skin Crawling Feeling
Tingling Creeping feeling in leg
Pulling sensation Leg pain
Sensation of electricty Tense feeling in legs
Itchy Tugging
Aching Burning
Nighttime twitching Gnawing

FACTS ON RLS

The symptoms start after a period of inactivity, either sitting or lying down. There is an intense desire to handle or move one's legs. The symptoms temporarily go away with walking, stretching or any type of leg movement. The symptoms are more aggressive at night, and tend to worsen with age. Women are affected twice as commonly as men. Stress, anxiety, and depression can be associated with RLS. (Table 2) RLS can be hereditary in up to half the cases, and temporary RLS can develop in the third trimester of pregnancy.

Diagnosis of Restless Leg Syndrome
  • Sensory symptoms (Table 1) that are triggered by rest, relaxation, or sleep
  • A strong and often overwhelming need or urge to move the legs
  • Sensory symptoms that are relieved with movement and the relief persists as long as the movement continues
  • Symptoms that are worse at night and are absent or negligible in the morning

Some people with RLS also have Periodic Limb Movements of Sleep (PLMS). While sleeping, the legs twitch or jerk due to involuntary flexing and extension of the legs. This can interfere with good sleep and cause insomnia and excessive daytime drowsiness.

Researchers believe that RLS is caused by an imbalance of the brain chemical dopamine. There also appears to be relationship with poor uptake of iron in brain cells, leading to brain iron deficiency. Treatment consists of seeing a physician to confirm the diagnosis and to rule out any other disorders that may be causing the symptoms, such as Venous Reflux Disease. Warm baths, stretching, and massage can help relieve some of the symptoms. Minimizing caffeine and alcohol, as well as mild exercise, maintaining regular sleeping pattern, and cessation of smoking may help as well.

VENOUS REFLUX DISEASE

But many of these symptoms can be caused by another disorder, one that is easily treatable with a high success rate: Venous Reflux Disease. Venous reflux disease, the disorder that is responsible for varicose veins, is much more common than RLS. It is estimated that 40% of women over the age of 40 have venous reflux disease. Unlike RLS, venous reflux disease is curable.

Jennifer saw her physician, who noticed that Jennifer's ankles were slightly swollen. She also remembered that Jennifer developed varicose veins during her last pregnancy. Realizing that some of Jennifer's symptoms could also be caused by venous reflux disease, she sent Jennifer to Dr Louis Prevosti at VEINatlanta for an evaluation. Once there, Jennifer received a venous duplex ultrasound which confirmed that the valves in her leg veins were not working properly. Dr Prevosti noticed blue reticular veins behind both knees. Dr. Prevosti ordered medical grade prescription compression stockings and received approval from her insurance carrier to perform a venous ablation procedure for each leg. Within a few weeks, she had the procedures completed in the office, with no interruption in her daily schedule. In addition, sclerotherapy was used to treat the unsightly blue reticular veins. When her treatment was complete, Jennifer's symptoms were greatly improved, and her legs looked better too!

Before and After Photos

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