Venous disease and restless leg syndrome

Venous disease was proposed as a cause of restless leg syndrome (RLS) by Dr Karl Ekbom in 1944, but has since remained largely unexplored.

RLS is a poorly understood disorder in which patients experience a compelling desire to move the legs. RLS is accompanied by unpleasant sensations in the legs, described by patients as crawling, creeping, pulling or aching.

Some patients experience only mild occasional symptoms, others struggle with disabling episodes on a nightly basis.

Symptoms of RRLS are worse during periods of decreases activity.

The cause of RLS remains elusive. There are no physical findings, no conclusive blood assays. The diagnosis can only be made on clinical history.

Treatment focuses on nightly management of symptoms rather than on a cure.

RLS is divided into primary (idiopathic) and secondary.

Primary RLS is felt to be the most common form and thought to be a sensori-motor abnormality.

Secondary RLS occurs in such disparate conditions as back pain, iron deficiency, renal failure, pregnancy, neuropathy and venous disease.

In 1995 a groundbreaking study by Dr A H Kanter suggested that sclerotherapy in patients with varicose veins and RLS is 98% effective in initial relief of RLS.

More recent studies have found Endovenous Laser Ablation for venous insufficiency alleviation RLS symptoms in patients with venous disease and moderate to severe RLS.

In conclusion patients with RLS and varicose veins should be considered for phlebological evaluation and possible treatment before being consigned to chronic drug therapy.

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