You may want to check out the restless leg syndrome web site. There are
sections for patients and for providers.
www.rls.org
Renee
Leslie Nicholson wrote:
>
> At 23:05 19/07/99 +0530, you wrote:
> >>>>
>
> Dear friends,
> I have two lady patients,both in 50s who are having nocturnal
> pains in both legs,of such a severity that they are not able to sleep in night.hence they
> spent most of time walking in night.During day time they are having no pain at all.
> Both are hypertensive ,on atenolol,not diabetics
> osteoporosis,with low serum calcium levels.X-rays show moderate osetophytosis
> and OA changes as per their age.ESR is about 35-45.
> All the known analgesics,NSAIDS,even opium derivatives ,tranquilizers,sedatives.and even tegritol along with Vit.E and height dose of
> Vit.B1B6B12 ,ginkobiloba etc all drugs have been tried without any relief.Localy
> Moist heat,and message with analgesic gels and than compression by compression bandage have not been of any use either.
> MRI have shown disc prolapse,hence Lumbar traction,and stabilization with corset
> and Interferential therapy ,TENS have also been tried without any benefit or the relief.
> One of the lady feels that she feels current like jerking of both limbs in night.
> SLR test is -ve flexion extension and ROM are normal.Hence MRI finding of disc may be only incidental,as we have seen many asymptomatic disc,in past.
> I seek the help of house in diagnosis and treatment of this condition.
> Thanks
>
> Dr Sood,
> If neurological testing is negative (including Babinski and clonus), the patients have been cleared of serious pathology & are not diabetic there are some other possibilities / treatments. Stimulants (coffee, alcohol etc) are to be avoided in the evening. Check the ladies for iron deficiency and if necessary prescribe same. Antidepressant medication can cause these symptoms also. I know there was a recent trial which found that in some sufferers, medication used to control the symptoms of Parkinson's Disease also controlled their "restless legs". From a physiotherapeutic point of view, I would be interested to see a complete turnaround from all these ineffective passive forms of therapy (corset, traction, interferrential, tens) to a trial of active management. These ladies are hypertensive and osteoporotic. They do not suffer during the day. What about a weight bearing progressive exercise program? Can't hurt - may help not only the restless legs but muscle tone, cardiovascu!
lar
> endurance, feeling of well being and that feeling of tiredness at the end of the day which may aid sleep.
> Best wishes to the ladies,
> Leslie
> Leslie Nicholson
> Lecturer in Musculoskeletal Physiotherapy / Sports Physiotherapy
> School of Physiotherapy,
> Faculty of Health Sciences,
> University of Sydney,
> PO Box 170,
> Lidcombe 2141
> NSW, Australia,
> phone: 9351-19369
> Fax: 9351-9278
> E mail; [log in to unmask]
> WWW: http://www.cchs.su.edu.au/Academic/BIO/biomech/smrg/nicholson/leslie.html
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