Treating Varicose and Spider Veins Cures Restless Legs Syndrome

Are Your “Restless Legs” keeping you up at Night?

By Kimberly Moskowitz, MD

Restless legs syndrome (RLS) is a poorly understood disorder in which patients experience irresistible urges to move their legs, particularly in the evening or night.  These disconcerting urges   are relieved only by limb movement such as walking or stretching the legs.  RLS plagues at least 10-15% of the population, affecting women twice as often as men.  RLS can begin at any age, including infancy, but is most commonly diagnosed between the ages of 30 and 60.  Most patients find it  difficult to describe their symptoms; however, they often report “heebee-jeebie”, “creepy crawly”, “antsy””, or “boring” feelings in their legs.

 

Universally, symptoms are precipitated by sitting, lying down, or resting for prolonged periods of time and they generally worsen with nightfall.  Only 30% of victims report pain; however, most experience such an intense desire to move their legs, that discomfort and involuntary jerking occur if they remain still.  Because of this, patients often report difficulty falling asleep resulting in insomnia, depression, anxiety, daytime fatigue and a feeling of chronic exhaustion.  Restless legs syndrome sufferers often find ordinary activities, such as car rides or sitting in movie theaters difficult because their legs simply won’t let them sit still.

Although we have made great strides in acknowledging RLS as a legitimate medical condition, the aetiology remains elusive.  There are no conclusive blood assays, radiologic tests or sleep studies to confirm RLS.  Thus, the diagnosis can only be made by clinical history based on four criteria put forth by The International Restless Legs Syndrome Study Group and the National Institutes of Health:

(1) An irresistible urge to move the legs

(2) Temporary relief with movement

(3) Worsening of symptoms with rest or inactivity

(4) Worsening of symptoms in the evening or night

RLS is divided into primary (idiopathic) and secondary causes.   Primary disease is thought to be due to abnormal brain metabolic pathways.  There is no “cure” for primary RLS and it invariably progresses with age.  Primary disease can be treated with medications; however, these drugs have significant side effects and often fail to alleviate symptoms.  Secondary RLS is linked to a wide range of conditions such as anemia, renal failure, neuropathy, thyroid dysfunction, pregnancy, and venous insufficiency. Unlike primary disease, secondary RLS is usually curable when the underlying cause is corrected.

Venous insufficiency is thought to be the leading curable cause of RLS. Venous insufficiency occurs when veins of the lower extremities fail to return blood to the heart properly, resulting in varicose and spider veins. Although many patients with venous insufficiency have large varicose veins and/or smaller spider veins, many have no visible vein disease.  For this reasons, all patients with Restless Leg Syndrome should have their legs evaluated by a board-certified vein specialist. A thorough ultrasound exam of the legs must be performed to accurately diagnose underlying vein disease.

Studies show that simple non-surgical varicose vein treatments such as EVLT (Endovenous Laser Treatment), sclerotherapy, or foam sclerotherapy results in improvement or complete resolution of RLS in the majority of patients.  Closure of the abnormal veins, including spider veins, also improves circulatory health of the affected legs resulting in dramatic improvement in leg aching, leg fatigue, leg cramping and swelling.

Laser closure (EVLT) of varicose veins is covered by healthcare plans because it reduces the risk of some serious medical complications such as phlebitis, (inflammation of the vein), leg ulcers, deep vein thrombosis (blood clots), and possibly stroke in some patients.

In the past decade, Restless Legs syndrome has emerged from anonymity but no common pathway has been identified to explain this perplexing disorder.  We do know that many people once thought to be cursed with an incurable disease, can actually be healed by treating their varicose and spider veins with EVLT and sclerotherapy.  Simple non-surgical procedures like EVLT and sclerotherapy can remove unsightly leg veins while they also calm your restless legs and sleepless nights.


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Posted in: Restless Legs Syndrome

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