Dr Martin Scurr has been treating patients for more than 30 years and is one of the country's leading GPs. Here he offers advice to a patient suffering from restless legs syndrome.
I have suffered with restless legs syndrome for several years. Every doctor I've consulted tells me that there is no cure, but can this possibly be correct? I spend several hours almost every nightwalking about unable to lie still in bed, which of course causes extreme tiredness during daytime hours. I would be so grateful for your advice.
Dr Scurr says... This is a miserable affliction and, sadly, not all doctors recognise the true extent of the distress it can cause. Restless legs syndrome affects 5 to 10 per cent of the population and is more common in women, usually starting in middle age.
The symptoms you know all too well: a burning, itching irritability and aching sensation - particularly when the legs are at rest, at night when lying down, or when you're trying to get off to sleep. The only way to relieve this is to keep moving constantly.
In most cases I've seen, there's no identifiable cause, although in a few it occurs as a complication of another health condition.
This can include iron deficiency anaemia (such as that caused by heavy periods around the time of the menopause), kidney failure, diabetes and coeliac disease, to name a few.
But in all of these, restless legs is a secondary state of affairs, so it's the main problem that needs to be treated, not the restless legs.
It's a condition that can vary hugely in severity. Some patients have it mildly, while others can be severely troubled with no let-up at all. And when it's this bad, the sleep disruption has a knock-on effect on daytime activities, resulting in a toll on your ability to work and your personal life.
Although the exact cause is unknown, it is thought the condition is associated with an imbalance of chemicals in the brain, such as dopamine, which is related to movement.
Until recently, many patients have been given tranquillisers or sleeping pills to try to suppress the symptoms, but this does not work. Now it is thought the treatments most likely to work are medicines called dopamine agonists, which mimic the effects of the chemical dopamine. For my patients, I favour pramipexole.
While dopamine agonists are the same medicines used in the treat-ment of Parkinson's disease, let me reassure you that restless legs are not a form of Parkinson's, and nor do they lead to it.
But the benefit of dopamine agonists lasts only as long as the pills are continued.
Unfortunately, this means your doctors have all been correct - there is no cure, only effective control. But please be reassured that there are no dangers taking this treatment long-term.
It is worth adopting a few lifestyle changes which may also help ease your distress. Moderate daily exercise helps some people, as may a sensible balanced diet. Massage may also suppress the symptoms and help you get that much-needed sleep.
But, most important, make sure your doctor has ruled out the possibility of the other conditions I mentioned earlier. This will involve a careful examination of your history and symptoms - possibly even blood tests. The diagnosis of restless legs syndrome can be made only when there is no other, remediable cause detected