Physiotherapy for Restless Leg Syndrome

Introduction

Restless Leg Syndrome (RLS) manifests as an irresistible urge to move one's leg. It is also known as Willis-Ekbom disease. The term RLS was introduced by Karl-Axel Ekbom who encountered a number of outpatients complaining of peculiar and tormenting paraesthesias deep in their lower legs which he had never heard of before.  It is considered a condition of the nervous system that leads to a movement disorder that causes discomfort during sleep or relaxation. Mostly idiopathic in nature, Restless Leg Syndrome (RLS) has been managed over the years with medical / drug interventions. Recent research interventions aimed towards the management of RLS include exercise training, transcutaneous spinal direct current stimulation (tsDCS), pneumatic compression devices (PCDs), light therapy, repetitive transcranial magnetic stimulation (rTMS), or acupuncture for the treatment of primary RLS, exercise training for the treatment of uremic RLS, and endovenous laser ablation (ELA) for the treatment of RLS with superficial venous insufficiency (SVI).

Causes of Restless Leg Syndrome

RLS is mostly idiopathic. This means that in most cases, the cause is unknown. It often runs in families and specific gene variants have been associated with the RLS condition. Low levels of iron in the brain also may be responsible for RLS and may be related to a dysfunction in a part of your brain that controls movement. Other conditions that could be linked to the cause of Restless leg syndrome are:

• Chronic diseases.
• Medications.
• Pregnancy.
• Lifestyles like lack of sleep or other sleep disorders like apnea. Also, intake of alcohol, tobacco, and caffeine use.

Symptoms of Restless Leg Syndrome

People who have Restless leg syndrome usually experience the following:

• Irresistible urge to move the legs.

• Uncomfortable sensations in the leg inform of aching, throbbing, pulling, itching, crawling, or creeping.

These symptoms can further lead to one experiencing the following:

• Mood Changes.
• Sleep disorders.
• Concentration issues.
• Impaired memory.
• Decreased activities of daily living or productivity.
• Depression and anxiety.

Diagnosis of Restless Leg Syndrome

Restless Leg Syndrome doesn't have a single test for its diagnosis. A diagnosis is usually made based on your symptoms, medical history and family history, a physical examination, and test results.

Management of Restless Leg Syndrome

There is no cure for Restless Leg Syndrome. Symptoms are managed and the underlying medical condition like lack of iron, chronic diseases etc that leads to Restless leg syndrome can bring relief when treated. Alternative ways like a hot bath, taking a walk, use of heat pads also provide relief. Some Medications are used to relieve the symptoms as well and they include:

• Dopaminergic drugs, which act on the neurotransmitter dopamine in your brain. The FDA has approved pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro) for moderate to severe RLS.
• The Parkinson's disease drug carbidopa/levodopa (Sinemet) occasionally is prescribed
• Benzodiazepines, a type of sedative, may help with sleep, but they can cause daytime drowsiness.
• Narcotic pain relievers
• Anticonvulsant or anti-seizure drugs such as carbamazepine (Tegretol), gabapentin (Neurontin), gabapentin enacarbil (Horizant), and pregabalin (Lyrica).

Physiotherapy Management of Restless Leg Syndrome

Recent research has proved that physiotherapy is effective in relieving symptoms of RLS.

Effective results are obtained through various specific exercise programs like:

• Traction straight leg raise.
• Reflexology,
• Electrical stimulation,
• Stretching exercises, and
• Workout plans like strength training, and aerobic exercises.
• Near Infrared therapy.

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