In the full career of a Physical Therapist, one may see thousands of physical afflictions. Most diagnosis' have standard treatment protocols that help the patient progress to the next level of care. Unfortunately, some disorders lack immediate satisfaction in terms of diagnosis and treatment. In fact, some movement disorders, especially those linked with neurological conditions, make it difficult to offer a solution since it's possible your patient will have this disorder/ condition for life.
Restless Legs Syndrome (RLS)is a neurological condition that is characterized by the irresistible and constant urge to move the legs. Delayed sleep onset, multiple awakenings, and a reduction in sleep efficiency all contribute to significant sleep disturbance in these patients. RLS can be idiopathic and begin at any age, or secondary to conditions such as, iron deficiency, renal failure, neuropathy, and normal pregnancy.RLS can also cause difficulty in falling or staying asleep which can be one of the chief complaints of the syndrome. These are jerks that occur every 20 to 30 seconds on and off throughout the night. This can cause partial awakenings that disrupt sleep.RLS is part of the Periodic Limb Movement Disorder family, which affects people only during sleep. The condition is characterized by behavior ranging from shallow, continual movement of the ankle or toes to wild and strenuous kicking and flailing of the legs and arms (movement of the legs is more typical than movement of the arms in cases of PLMD). Furthermore, abdominal, oral, and nasal movement sometimes accompanies PLMD.Currently, there are no lab tests available to confirm or deny the existence of restless legs syndrome symptoms in a patient. So, how is it to be diagnosed? By ensuring the five essential diagnostic criteria are present.
These five features must be present for a diagnosis of restless legs syndrome:
- There is an urge to move the legs, usually accompanied by or caused by uncomfortable and unpleasant sensations in the legs.
- The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
- The urge to move or the legs and any accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
- The urge to move the legs and any accompanying or unpleasant sensations are worse in the evening than during the day or only occur in the evening.
- The urge to move the legs and any accompanying unpleasant sensations are not solely accounted for by another condition, such as leg cramps, positional discomfort, leg swelling, or arthritis.
- Tell others about your condition. Sharing information about RLS will help your family members, friends and co-workers better understand when they see you pacing the halls, standing at the back of the theater, or walking to the water cooler many times throughout the day.
- Don't resist your need for movement. If you attempt to suppress the urge to move, you may find that your symptoms only get worse. Get out of bed. Find an activity that's distracting. Stop frequently when traveling.
- Keep a sleep diary. Keep track of the medications and strategies that help or hinder your battle with RLS, and share this information with your doctor.
- Adapt your work space for standing. You may be more comfortable if you elevate your desktop or book stand to a height that will allow you to stand while you work or read.
- Stretch and massage. Begin and end your day with stretching exercises or gentle massage.
- Seek help. Support groups bring together family members and people with RLS. By participating in a group, your insights not only can help you but also may help someone else.