Steps to relaxing your restless legs
QI SUFFER terribly from restless legs and have for many years. It is getting progressively worse and sometimes is almost unbearable. I take sedatives every night to help me sleep. Can the condition be cured?
ARESTLESS legs syndrome is a difficult condition to treat as the underlying cause is not fully understood. Sufferers usually have an irresistible desire to move, twitch or jerk their legs, particularly at night, and describe an unpleasant crawling or creeping sensation in the feet, calves and thighs.
When someone has had a condition for a long time, it can seem that all avenues have been explored for treatment, but it can be worth re-exploring and trying things again.
It is not usually a curable condition, although there are certainly case studies where it has resolved or at least temporarily abated. Some cases are associated with iron deficiency, in which case iron supplements will help: it is important to look at a blood test for ferritin – a protein that binds to iron helping us store it – not just levels of iron itself.
Reducing caffeine, alcohol and smoking are all thought to help. Other non-drug treatments that can alleviate daytime symptoms include walking and stretching exercises or heat therapy with heat pads.
Drug options for people with difficult daily symptoms include Parkinson’s disease drugs such as ropinirole, as well as nervepain analgesics like gabapentin or pregabalin.
These are all NHSapproved medications for restless legs syndrome. It also approves the use of a drug known as rotigotine for restless legs where there are very bad daytime symptoms, as it can be used in patch form and lasts a long time.
If treatment is not successful, then seeing a specialist is appropriate. This would usually be a consultant in sleep medicine or a neurologist.
QMY SON, who is in his mid-20s, has had hearing problems for a number of years and now has tinnitus. It is getting worse and is causing him severe distress. He has tried a number of ways to ease the symptoms, such as exercise, relaxation music, lying in a darkened room with no sound at all and reducing caffeine and alcohol – none of which has helped. We are now getting desperate. Is there anything we have not tried that might help?
ATINNITUS is a severely distressing problem. Rather than simply being ‘just’ a buzzing or ringing in the ears, the constant perception of noises when there is none can be troubling and infuriating, and can hugely affect quality of life.
Exercise and relaxation – in particular, mindfulness meditation – are very important to deal with the psychological burden of the condition. For some, treatment for depression and insomnia can also be crucial.
The next step is to look at sound enrichment. This is not a cure but reduces the impact of the constant noise in quiet situations so is particularly useful for sleep, work and concentration.
The idea is simply to find a noise that is enough to counteract the tinnitus noise and sufferers do this by trialling different sounds. Sensible options to try would be white noise from, say, an oscillating fan, a mistuned radio or background TV noise; there are podcasts and online playlists you can use as sound-generators.
If the sound being used is kept at a low volume, the tinnitus can still be heard but its intrusiveness reduces.
This works by a process of habituation: one gets used to the tinnitus in the long term and this reduces its impact. Higher sound volumes can be used to completely mask the tinnitus, but the risk is that the tinnitus will then be perceived to be very loud when no background sound is on.
After sound enrichment, referral for tinnitus retraining therapy is the next step. This is a two-part process of sound therapy and counselling. Additionally, a support group can be a hugely valuable adjunct to any treatment as understanding and acknowledgment from fellow sufferers is comforting and therapeutic.
The British Tinnitus Association can be contacted on 0800 018 0527 or tinnitus.org.uk.