please guide me my mother ( age 42 years )have Rest Less Leg syndrom since 8 months with loss of muscle power more in right leg she is on following medication since 6 month 1.pregabalin 75 mg plus methylcobalamin 750 mg HS 2. tablet toscal gem with calcium ,vit D3, and minerals symptoms 1 irregistable urge to move the legs 2 the urge is partially or totally relieved by movements 3) the urge to move legs is worse in the evening or at night than during the day or occurs only in the evening or at night 4 severe heel pain on both the legs with calf muscles pain 5 Symptoms cause significant distress or impairment in social, occupational, educational, academic. behavioral or other areas of functioning 6 Sleep disturbances and Daytime fatigue please give me the appropriate guidance for reliving the symptoms.


Well in this case we need to look for trigger points spl in calf muscle . What is the built of the person normal or obese. Vitamin b12 is ofcourse major factor. . Stretching exercises will help a lot in relieving pain.and for long term management strengthening exercises for leg eg calf raises and hans and quads ex.

built is Norma mam

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You said loss of muscle power?? If there is loss of muscle power,, then your diagnosis of RLS is wrong You should tell us which muscles are weak and how much is the power How are the DTR,s

problem in the extension amn flexion of right leg in the supine position she is unable to pull her own leg.

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For restless leg syndrome Start with Pramipexole o.125 mg 1-1-1 for 1week,and then increased to 0.25 mg 1-1-1 And continued for2 weeks and check the response .and then give follow up. If no response,we have to increase the dose. I hope she will improve

look for underlying causes like Iron deficiency/chronic Renal failure/ parkinsonism/ Peripheral neuropathy like in diabetes or vit B12 deficiency/ electrolyte imbalance just to name a few causes. Look for any drug causes like Antipsychotics/ SSRI/ antiemetics Treat these conditions if present . Avoid coffee / tea Symtomatic treatment for leg movements- Pramipexole for moderate to severe cases (Alternate is Ropinirole/ Rotigotine/ levodopa)with BZDs . In mild cases only BZD can be effective. If still symptom persist add Gabapentin Aerobic exercises if possible

RESTLESS LEG SYNDROME - USUALLY ITS A UNCOMFORTABLE SENSATION IN LOWER LIMBS. SENSATION LIKE ITCHY; PINS AND NEEDLES or CREPY AND CRAWLY IN THE LIMBS. TREATMENT- NON DRUG - leg massage Hot baths or heating pads Good sleep habits Drug - mostly Dopaminergic drug which act on neurotransmitter oin the brain Mirapex or Pramipex is the drug of choice ..

1st line drug is pramipexole,start with o.125 mg 1-1-1 for a week and the increase to 0.25 mg1-1-1 for another week and further increment according to the response. Most of the pts will respond to small doses

for heel pain rule out for calcaneal heel spur

what is S.ferritin level

not checked

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Add Tab Pramipex 0.75 mg bd I agree with Dr Nitin Kumar Gupta

did she attain menopause? can post menopausal effect. regarding physiotherapy treatment she can b benefitted with relaxation exercises, aerobic exercise like cycling , walking. closed kinematic chain exs and interferential therapy for the pain.

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