Restless Leg Syndrome

By February 15, 2017News

Restless Leg Syndrome (RLS) is a poorly understood disorder that compels a person to move their legs and is often accompanied by intense, unpleasant sensations in their legs. RLS affects 5-15% of Americans. Women are twice as likely to be affected. In 30% of patients the sensations are painful. Symptoms of RLS are worse in the evening and when relaxed or during decreased activity, especially while lying down. Patients are most often completely symptom free in the morning. Symptoms are strongest at bedtime and patients often cannot fall asleep until early in the morning. Patients with severe RLS experience nightly attacks that lead to chronic sleep deprivation and psychological and cognitive defects.
There are no classic physical findings, laboratory studies or standard radiology studies to diagnose RLS. The diagnosis is made by clinical history. RLS is divided into primary (idiopathic) and secondary causes. Primary is thought to be related to central nervous system abnormalities while secondary may be caused by back pain, iron deficiency, renal failure, pregnancy, neuropathy and venous disease.
A recent study in the Journal of Phlebology of screened 89 patients who complained of restlessness in their legs. Patients were divided into operative and non-operative groups. Patients continued medications for sleep and symptom relief in both groups. Patients in the operative group underwent ablation (closure) of the incompetent saphenous vein and perforator vessels. Patients were followed for 6 weeks. At the final evaluation, the non-operative group actually was found to worsening of symptoms. In the operative group patients were found to have an average of an 80% decrease in severity of symptoms. Of these patients 79% improved to “mild” symptoms, 95% improved to “mild” or “moderate” disease and 31% experienced complete relief of symptoms.
In our practice we have seen great success in relieving symptoms of RLS after successful veonus ablation. We believe that RLS patients should be properly evaluated for venous insufficiency before initiation or continuation of drug therapy. Any patient found to have venous insufficiency should be referred for evaluation for possible vein ablation.