To Your Good Health: Several treatments calm restless legs

Q: During my one-hour drive from work to home, I heard a doctor on the radio talk about restless-leg syndrome.

Can you expand on it for me? What is the treatment?

A: Restless-leg syndrome involves abnormal feelings in the legs that come on when a person is sitting but more often when the person lies down for sleep.

People describe the feeling in many ways: creeping, crawling, burning or aching. Along with these sensations, an affected person has an irrepressible urge to get up and move around. Doing so quiets the sensations. All this can happen after the person falls asleep.

For most, a cause isn't found. Some sufferers have an iron deficiency; others, a deficiency of the brain chemical dopamine.

Whatever the cause, 30 to 60 minutes of daily exercise lessens symptoms and often prevents nighttime awakenings.

Stopping smoking and cutting back on alcohol and caffeine also improve the picture. Warm baths before bedtime and massaging the leg muscles can block restless legs from occurring.

If none of these gets rid of the problem, then medicine is worth considering.

People who suffer from the syndrome would do well to contact the Restless Leg Foundation. Call 1-877-463-6757 or visit www.rls.org .

Q: My sister sees her doctor every month and always comes home with a diagnosis of strep throat. The doctor gives her a prescription for antibiotics each time. Is it possible that a person has strep throat monthly?

She never looks sick to me. And what are all these antibiotics doing to her?

A: Anything is possible, but a monthly strep throat is distinctly unusual.

At most, 10 percent of adult throat infections are due to the strep germ. Fifty percent are viral infections, and antibiotics are not called for in a viral illness. In 30 percent of adults with a sore throat, no cause is found. Antibiotics are not helpful in such cases, either.

The best way to determine whether a sore throat is a strep throat is by taking a throat culture.

The second-best way is a rapid strep antigen test. It's done right in the doctor's office and takes about 10 to 15 minutes.

Q: Ever hear of taking blood by using a blood-pressure cuff as a tourniquet? My doctor's nurse does it all the time.

Does the cuff possibly mess up blood tests?

A: I'm sure that the nurse isn't pumping up the blood-pressure cuff so high that she's damaging red blood cells or shutting off circulation in the arteries.

USPharmacist.com > Restless Legs Syndrome: A Common ...

2009;34(1):24-29.&Nbsp;

Restless legs syndrome (RLS) is a common sensorimotor disorder of the central nervous system. It is characterized by an irresistible urge or need to move the limbs that occurs as a result of uncomfortable limb sensations. Although RLS usually starts in the legs, it can spread to other parts of the body, such as the arms or torso. RLS sufferers often describe the disorder as feeling like water flowing inside the legs, "bugs in the bones," or electricity in the legs. These symptoms may be present all day, but usually worsen during periods of inactivity and in the evening. People with RLS usually must move their limbs for complete or partial relief of the uncomfortable sensations. At night, RLS often is associated with periodic limb movements (PLMs), which can cause sleep problems and also make it difficult to perform sedentary activities such as sitting comfortably in a car or on an airplane for extended periods. 

The cause of RLS remains unclear, but research suggests that impaired dopamine activity in the brain due to iron insufficiency may induce RLS in people with a genetic predisposition. RLS can be classified as primary or as secondary due to another medical condition, such as end-stage renal disease (ESRD) or pregnancy. Dopamine agonists like ropirinole and pramipexole are first-line therapy for RLS with daily symptoms. Alternative therapies are available for refractory cases or persistent symptoms. This article explores the prevalence, etiology, and diagnosis of RLS, as well as available treatments. 

Prevalence

Epidemiologic studies report that 7.2% to 11% of the general population in Europe and North America suffers from some form of RLS. Despite its high prevalence, this syndrome remains underdiagnosed and troubling for many patients. 

Etiology

The etiology of RLS is not fully understood. Studies have demonstrated that it is not a structural neurodegenerative problem, but rather involves the dopamine system, iron homeo stasis, or genetics. The following discussion sums up current thought on each of these three potential causes. 

Dopamine System: It is generally accepted that RLS follows an autosomal-dominant mode of inheritance that requires only one affected parent to pass the trait to the offspring. More genetics studies are needed to shed light on the genotype of RLS sufferers.