Many patients describe symptoms of ‘restless leg syndrome’ which can cover a wide variety of complaints from aching in the leg, to sensations of irritation and a feeling of being compelled to move the legs around.
In some cases patients describe a sensation similar to an insect crawling on the skin, or of being aware of the blood flow in the leg.
It is difficult to be certain in many cases what the cause of all of the symptoms is. Some doctors think that in certain cases the symptoms are caused by a neurological condition that is related to the way the brain processes a chemical called dopamine – in severe cases patients may be prescribed drugs such as gabapentin or levodopa. True restless leg syndrome is called Willis – Ekbom disease by neurologists.
In other cases the symptoms can’t be explained, or can be caused by simpler problems such as varicose veins or venous reflux (where the valves in the veins don’t work and blood flows the ‘wrong way’ down a vein’). There are also other associations such as with low iron levels, diabetes or thyroid disease.
Unfortunately there is no definitive blood test or scan for restless legs syndrome which can definitively diagnose the disorder. The diagnosis is made on purely clinical grounds based on an assessment of the patient’s symptoms and after excluding other conditions which may be causing the symptoms.
Clearly it is very important for a doctor to be sure about the cause of a symptom before putting a patient on a long term medication – all medicines have risks and side effects and in particular medicines designed to work on nervous pathways in the brain.
Ultrasound Scanning of the legs for signs of venous reflux can rule out this particular diagnosis as one of the causes of restless leg type symptoms – quite often a patient will have venous reflux without being aware of any external evidence of varicose veins. Ultrasound is quick ,easy, painless and completely safe way of diagnosing or excluding venous reflux as a cause of restless legs. In many patients, treating the vein reflux by closing the leaking vein with the Endovenous laser can improve or completely resolve the symptoms of aching and discomfort that patients complain of.
Image Source M Yashna
