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What is restless leg syndrome?

Restless leg syndrome is a common cause of painful legs. The leg pain of restless leg syndrome typically eases with motion of the legs and becomes more noticeable at rest. Restless leg syndrome also features worsening of symptoms during the early evening or later at night. The characteristic nighttime worsening of symptoms in persons with restless legs syndrome frequency leads to insomnia.  

Restless leg syndrome usually begins slowly. Over time, the legs become more affected. Less frequently, restless leg syndrome can affect the arms.

What causes restless leg syndrome?

The cause of restless leg syndrome is unknown in most patients. However, restless leg syndrome has been associated with pregnancy, obesity, smoking, iron deficiency and anemia, nerve disease, polyneuropathy (which can be associated with hypothyroidism, heavy metal toxicity, toxins, and many other conditions), other hormone disease, such as diabetes, and kidney failure (which can be associated with vitamin and mineral deficiency). Some drugs and medications have been associated with restless leg syndrome including caffeine, alcohol, H2-histamine blockers (such as Zantac and Tagamet) and certain antidepressants (such as Elavil).  

Occasionally, restless legs run in families. Recent studies have shown that restless leg syndrome appears to become more common with age.
What is treatment for restless leg syndrome?

Treatment of restless leg syndrome is first directed toward any underlying illness, if known. For example, a search for iron deficiency by blood testing to reveal underlying iron deficiency anemia. Reduction or elimination of caffeine and alcohol can be very helpful. Stopping smoking can also diminish symptoms. Getting better sleep and exercise can help some persons affected by restless legs.

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Post edited at 4:52 am on June 17, 2007 by sarah mae

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My best friend Anna comes today and the Remedy Drive concert is tonight!
Goodbye Livewire. It's been fun.

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Lyme disease is a tick-borne illness that causes signs and symptoms ranging from rash and flu-like fever and body aches to more serious ones including joint swelling, weakness, fatigue and temporary paralysis. Lyme disease is caused by the bacterium Borrelia burgdorferi. Deer ticks, which feed on the blood of animals and humans, can harbor and spread the disease when feeding on a host.

You're more likely to get Lyme disease if you live or spend time in the grassy and heavily wooded areas where ticks carrying the disease breed. In the United States, this includes the Northwest, North Central and Northeastern states. Even in such areas, not all deer ticks are infected with the bacteria that cause Lyme disease, and only a small percentage of people or pets bitten by deer ticks actually become sick.

Still, it's important to take common-sense precautions in areas where Lyme disease is prevalent. If treated with appropriate antibiotics in the early stages of the disease, you will most likely recover completely. However, some people have recurring or lingering symptoms long after the infection has cleared. Untreated, Lyme disease can lead to arthritis and other serious health problems.

Lyme disease signs and symptoms vary widely because Lyme disease can affect various parts of the body. Not everyone with the disease will have all of the signs and symptoms. But in general, Lyme disease can cause:

•Rash. A small, red bump may appear within a few days to a month, often at the site of the tick bite — often in your groin, belt area or behind your knee. It may be warm to the touch and mildly tender. Over the next few days, the redness expands, forming a rash that may be as small as a dime or as large as 12 inches across. It often resembles a bull's-eye, with a red ring surrounding a clear area and a red center. The rash, called erythema migrans, is one of the hallmarks of Lyme disease, affecting about 70 percent to 80 percent of infected people. If you're allergic to tick saliva, redness may develop at the site of a tick bite. The redness usually fades within a week. This is not the same as erythema migrans, which tends to expand and get redder over time.
•Flu-like symptoms. A fever, chills, fatigue, body aches and a headache may accompany the rash.
•Migratory joint pain. If the infection is not treated, you may develop bouts of severe joint pain and swelling several weeks to months after you're infected. Your knees are especially likely to be affected, but the pain can shift from one joint to another.
•Neurological problems. In some cases, inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs, and impaired muscle movement may occur weeks, months or even years after an untreated infection. Memory loss, difficulty concentrating, and changes in mood or sleep habits also can be symptoms of late-stage Lyme disease.
•Less common signs and symptoms. Some people may experience heart problems — such as an irregular heartbeat — several weeks after infection, but this rarely lasts more than a few days or weeks. Eye inflammation, hepatitis and severe fatigue are possible as well.
•Skin problems. In Europe, people with advanced Lyme disease may develop skin nodules and patches of thinning skin on their hands, elbows or knees.

Causes

In the United States, Lyme disease is caused by the bacterium Borrelia burgdorferi, which is carried primarily by deer ticks. The ticks are brown and often no bigger than the head of the pin, which can make them nearly impossible to spot.

Ticks feed on blood, latching onto a host and feeding until they're swollen to many times their normal size. During feeding, ticks that carry disease-producing bacteria can transmit the bacteria to a healthy host. Or they may pick up bacteria themselves if the host is infected. In areas where Lyme disease is common, as many as 50 percent of deer ticks may carry Borrelia burgdorferi.

Deer ticks prefer the blood of mice, small birds and deer, but aren't averse to dining on humans, cats, dogs and horses. They live in low bushes and tall grasses of wooded areas, waiting for warmblooded animals to pass by and are most active in the summer.

To contract Lyme disease, you must be bitten by an infected deer tick. The bacteria enter your skin through the bite and eventually make their way into your bloodstream. Before bacteria can be transmitted, a deer tick must take a blood meal and that can take between 36 and 48 hours of feeding. Only ticks that are attached to your skin and are feeding can transmit the bacteria. An attached tick that has a swollen appearance may indicate that enough time has elapsed to transmit bacteria. Removing the tick as soon as possible may prevent infection.

Treatment

Oral antibiotics — usually doxycycline for adults and children older than 8, or amoxicillin or cefuroxime axetil for adults, younger children and pregnant or breast-feeding women — are the standard treatment for early-stage Lyme disease. These drugs often clear the infection and prevent complications. A 14- to 21-day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective. In some cases, longer treatment has been linked to serious complications.

If the disease has progressed, your doctor may recommend treatment with an intravenous antibiotic for 14 to 28 days. This is usually effective, although it may take some time to recover. Intravenous antibiotics can cause various side effects, including a lower white blood cell count, gallstones and mild to severe diarrhea.

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Post edited at 9:59 pm on June 17, 2007 by sarah mae

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My best friend Anna comes today and the Remedy Drive concert is tonight!
Goodbye Livewire. It's been fun.

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You hurt all over, and you frequently feel exhausted. Even after numerous tests, your doctor can't find anything specifically wrong with you. If this sounds familiar, you may have fibromyalgia.

Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on your body where slight pressure causes pain.

Signs and symptoms of fibromyalgia can vary, depending on the weather, stress, physical activity or even the time of day. Common signs and symptoms include:

•Widespread pain. Fibromyalgia is characterized by pain in specific areas of your body when pressure is applied, including the back of your head, upper back and neck, upper chest, elbows, hips and knees. The pain generally persists for months at a time and is often accompanied by stiffness.
•Fatigue and sleep disturbances. People with fibromyalgia often wake up tired and unrefreshed even though they seem to get plenty of sleep. Some studies suggest that this sleep problem is the result of a sleep disorder called alpha wave interrupted sleep pattern, a condition in which deep sleep is frequently interrupted by bursts of brain activity similar to wakefulness. So people with fibromyalgia miss the deep restorative stage of sleep. Nighttime muscle spasms in your legs and restless legs syndrome also may be associated with fibromyalgia.
•Irritable bowel syndrome (IBS). The constipation, diarrhea, abdominal pain and bloating associated with IBS are common in people with fibromyalgia.
•Headaches and facial pain. Many people who have fibromyalgia also have headaches and facial pain that may be related to tenderness or stiffness in their neck and shoulders. Temporomandibular joint (TMJ) dysfunction, which affects the jaw joints and surrounding muscles, also is common in people with fibromyalgia.
•Heightened sensitivity. It's common for people with fibromyalgia to report being sensitive to odors, noises, bright lights and touch.

Other common signs and symptoms include:

•Depression
•Numbness or tingling sensations in the hands and feet (paresthesia)
•Difficulty concentrating
•Mood changes
•Chest pain
•Dry eyes, skin and mouth
•Painful menstrual periods
•Dizziness
•Anxiety

Causes

Doctors don't know what causes fibromyalgia. Current thinking centers around a theory called "central sensitization." This theory states that people with fibromyalgia have a lower threshold for pain because of increased sensitivity in the brain to pain signals. Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain's pain receptors (neurons) — which receive signals from the neurotransmitters — seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals. In this way, pressure on a spot on the body that wouldn't hurt someone without fibromyalgia can be very painful to someone who has the condition. But what initiates this process of central sensitization isn't known.

It's likely that a number of factors contribute to the development of fibromyalgia. Other theories as to the cause of fibromyalgia include:

•Sleep disturbances. Some researchers theorize that disturbed sleep patterns may be a cause rather than just a symptom of fibromyalgia.
•Injury. An injury or trauma, particularly in the upper spinal region, may trigger the development of fibromyalgia in some people. An injury may affect your central nervous system, which may trigger fibromyalgia.
•Infection. Some researchers believe that a viral or bacterial infection may trigger fibromyalgia.
•Abnormalities of the autonomic (sympathetic) nervous system. Part of your autonomic nervous system — the sympathetic, or involuntary, system — controls bodily functions that you don't consciously control, such as heart rate, blood vessel contraction, sweating, salivary flow and intestinal movements. It’s thought that sympathetic nervous system dysfunction occurs in people with fibromyalgia, particularly at night, which leads to fatigue, stiffness, dizziness and other signs and symptoms associated with the condition.
•Changes in muscle metabolism. For example, deconditioning and decreased blood flow to muscles may contribute to decreased strength and fatigue. Differences in metabolism and abnormalities in the hormonal substance that influences the activity of nerves may play a role.

Psychological stress and hormonal changes also may be possible causes of fibromyalgia.

Treatment

In general, treatment for fibromyalgia includes both medication and self-care. The emphasis is on minimizing symptoms and improving general health.

Medications

Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:

•Analgesics. Acetaminophen (Tylenol, others) may ease the pain and stiffness caused by fibromyalgia. However, its effectiveness varies. Tramadol (Ultram) is a prescription pain reliever that may be taken with or without acetaminophen. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) — such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Anaprox, Aleve) — in conjunction with other medications. NSAIDs haven't proved to be effective in managing the pain in fibromyalgia when taken by themselves.
•Antidepressants. Your doctor may prescribe antidepressant medications such as amitriptyline, nortriptyline (Pamelor) or doxepin (Sinequan) to help promote sleep. Fluoxetine (Prozac) in combination with amitriptyline has also been found effective. Sertraline (Zoloft) and paroxetine (Paxil) may help if you're experiencing depression.
•Muscle relaxants. Taking the medication cyclobenzaprine (Flexeril) at bedtime may help treat muscle pain and spasms. Muscle relaxants are generally limited to short-term use.
•Anticonvulsants. Drugs approved to treat epilepsy have shown some effectiveness in people with chronic pain. Pregabalin (Lyrica) decreased pain and fatigue and improved sleep in people with fibromyalgia in trials.
Prescription sleeping pills, such as zolpidem (Ambien), may provide short-term benefits for some people with fibromyalgia, but doctors usually advise against long-term use of these drugs. These medications tend to work for only a short time, after which your body becomes resistant to their effects. Ultimately, using sleeping pills tends to create even more sleeping problems in many people.
Benzodiazepines may help relax muscles and promote sleep, but doctors often avoid these drugs in treating fibromyalgia. Benzodiazepines can become habit-forming, and they haven't been shown to provide long-term benefits.
Doctors don't usually recommend narcotics for treating fibromyalgia because of the potential for dependence and addiction. Corticosteroids, such as prednisone, haven't been shown to be effective in treating fibromyalgia.

Cognitive behavior therapy

Cognitive behavior therapy seeks to strengthen your belief in your abilities and teaches you methods for dealing with stressful situations. Therapy is provided through individual counseling, classes, and with tapes, CDs or DVDs, and may help you manage your fibromyalgia.

Treatment programs

Programs that combine a variety of treatments may be effective in improving your symptoms, including relieving pain. These interdisciplinary programs can combine relaxation techniques, biofeedback and receiving information about chronic pain. There isn't one combination that works best for everybody. Your doctor can create a program based on what works best for you.

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For more information, check out: Fibromyalgia

Post edited at 10:16 pm on June 17, 2007 by sarah mae

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My best friend Anna comes today and the Remedy Drive concert is tonight!
Goodbye Livewire. It's been fun.