Leg Compression Cuffs

My wife was recently in hospital having suffered a stroke. She also has secondary cancer in her bones, including her legs. Against our wishes they used leg compression cuffs on her because it's the standard post-stroke procedure. It left my wife in agony. Now she is back home she is suffering from nightly restless leg syndrome. Has anyone had a similar experience with leg cuffs? Do you think they may have caused permanent nerve damage in her legs?

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I've never experienced a stroke, but from what I know about the use of compression devices they are used to prevent blood clots in the legs when somebody is unable to move.

The risk of this is high after a stroke and if clots should form in the legs, they can travel and cause a pulmonary embolism which is usually fatal.

I do appreciate that under the law of informed consent, strictly speaking, to apply the cuffs against your wishes was illegal. They should have explained the benefits, risks and alternatives when seeking your consent. Otherwise even if you had consented, it wouldn't have been "informed" hence still illegal.

However, I guess you're more concerned about the consequences of what was done.

Since the aim of using the cuffs was to prevent blood clots in veins, rather than arteries, if correctly applied the cuffs should not have interfered with the blood supply going TO the legs. In that case, no damage should be caused to nerves by preventing oxygen getting to them or by mechanical pressure on them. That is, if they were correctly applied.

I'm really guessing, but it seems unlikely that your poor wife's worsening RLS is related to the use of the cuffs.

I wonder if she was given painkillers whilst in hospital and if so, what they were. If painkillers were given over a relative period of time, then stopped, the RLS could be due to withdrawal from these.

I also wonder how your wife's RLS was treated before her stroke and if any changes have been made. In addition, since her stroke has she been prescribed any new medications she didn't previously take?

The latter may be exacerbating her RLS.

[Hidden in reply to Hidden]

Thank you for your response. I've read that compression cuffs are supposed to help RLS but, as you say, that requires them to be used correctly. Other than aspirin she is not on any new medication but has been taking a calcium channel blocker for some time, which I believe will make her RLS worse. We're trying leg massages and Tonic Water (for the quinine) because the side effects of the dopamine agonists sound horrendous - apart from which, she is already on way too many drugs!

[Hidden in reply to Hidden]

Hi

In cases where RLS is at least partly due to venous insufficiency, then compression may help with RLS symptoms. In idiopathic RLS or RLS due to other conditions however, it won't be much help.

Aspirin shouldn't make any difference to RLS, but calcium channel blockers can.

If she's on a lot of medications, then there may be others she's taking that could be making her RLS worse.

Hopefully she has been tested for iron deficiency recently. This is a major causative factor in RLS.

Dopamine agonists are not the first choice of RLS medication these days, alpha 2 delta ligands are and these don't have the same risks as dopamine agonists.

However, both types of medication have side effects, it's just a matter of whether the improvement gained from them is greater than the side effects.