My painful restless legs are stopping me from relaxing & nothing seems to work – I’m desperate for help

WE are often drawn to supplements to “fix our health”.

But, unless we are deficient in certain nutrients, then lifestyle changes are more likely to bring about noticeable changes.

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Most of us should get all the nutrients we need from eating a balanced diet.

But we sometimes need a little extra help.

For example, vegetarians and especially vegans should consider supplementing with vitamin B12, and possibly calcium, iron and zinc.

Irritable bowel syndrome patients might find a probiotic is helpful to alleviate symptoms, and people with sleep issues may want to try magnesium.

The only supplement the NHS recommends for all adults is vitamin D, which our bodies create in response to sufficient sunlight.

The advice is to take it between October and April, but some people are advised to take it all year round, including people who have dark skin and those who are not often outdoors, for example, if they are in a care home.

Here’s a selection of what readers have asked this week.

Q) AS soon as I relax in bed, I get a crawling sensation under my skin in my legs.

Lately, it seems to be getting worse, affecting my arms. I am an 82-year-old lady and have suffered from restless legs syndrome for many years.

My GP first prescribed pramipexole, which didn’t help, then ropinirole, which doesn’t work on its own, so I have to take co-codamol.

I worry I will have to take these for the rest of my life. My doctor won’t increase the ropinirole because of the side-effects.

I’ve been told there is nothing else that can be done. I have tried exercising, a warm bath, a massage, but nothing helps.

A) Restless legs syndrome (RLS) is a neurological disorder characterised by an irresistible urge to move the limbs accompanied by uncomfortable sensations.

While it most commonly affects only the legs, the arms are occasionally affected, too. Symptoms tend to be worse at night and this often affects sleep.

It’s not understood why people get it and there’s no known cure unless it’s linked to an underlying, reversible condition.

Iron deficiency or low iron levels can cause it, so it’s worth your GP checking these if they haven’t already.

It can also be caused by certain medications, including some anti-nausea drugs, antidepressants, antipsychotics and antihistamines – so again, if you take any other meds, it’s worth checking if there could be a link.

Ropinirole used to be recommended as a first-line treatment, but the guidelines have changed and now gabapentin (and similar drugs) are advised.

Some people are unable to take this due to potential interactions. Some people have side-effects, especially older adults.

So your GP might have opted away from this, but it is worth asking them. You can always download the NICE guidelines yourself or attach the link in an e-consult request for them to consider.

Just search “NICE” and “restless legs syndrome” and you’ll reach the right webpage.

It may also help if you reduce caffeine and alcohol, don’t smoke, sleep well and be physically active.

To relieve an attack, relaxation, stretching, walking or massage can help.

RLS-UK (rls-uk.org) has useful advice and resources.

Q) FOR about a year, I have been dealing with a frozen shoulder.

My doctor said it was pointless having an X-ray, but I have had corticosteroid injections, which did nothing to ease the pain.

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I am a 63-year-old type 2 diabetic, and I have also been having physiotherapy, which has noticeably improved my range of movement.

My physiotherapist is not entirely convinced that it IS a frozen shoulder, though, and has suggested it could potentially be a form of arthritis or another condition.

He has written to my doctor recommending that X-rays be carried out.

I have started experiencing upper back pain, too. I am unsure whether this is connected. How do I approach my doctor on this?

A) Frozen shoulder (adhesive capsulitis) is a condition that causes pain, stiffness and reduced range of movement of the shoulder joint.

The symptoms are caused by the formation of adhesive or scar tissue in the joint.

Studies indicate that people with diabetes may be two to four times more likely to develop frozen shoulder. Diagnosis is clinical, meaning it is based on the symptoms and examination findings rather than X-rays or scans.

The main diagnostic test is whether you can do passive external rotation of the shoulder. This means that the doctor supports the patient’s arm in a bent position (imagine holding a kettle) and tries to move the arm to the side.

Inability to do this movement is highly suggestive of frozen shoulder.

If an X-ray is obtained, it should demonstrate a normal shoulder joint.

Most patients get physiotherapy, which can be supplemented by steroid joint injections.

It usually resolves on its own over a year or two, although some individuals may experience longer recovery times.

Physios see frozen shoulder quite frequently, so if yours is experienced and believes that other causes should be considered, then your GP is likely to take that advice.

Rotator cuff injuries, bursitis, osteoarthritis and shoulder impingement are examples of conditions that can be mistaken for frozen shoulder due to overlapping symptoms.

Q) I AM a 63-year-old female who has always been healthy and active until having a mobility issue with my right leg for the last 13 years. It has led to foot drop.

It is easy to trip and fall. It was suggested I must have had a one-off viral attack which damaged an area of my spinal cord.

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I am so angry and frustrated.

This has taken a huge toll on me mentally, and my body has responded by going into overdrive.

I am overwhelmed with tiredness, but cannot sleep, and have no appetite. I am unable to relax.

My body has become my enemy. Please could you advise, before I collapse?

A) It sounds like the “fight or flight” part of your nervous system may be in overdrive and also that you have a lot of negative thoughts and emotions surrounding what has happened to your body.

This statement, “my body has become my enemy”, is a clue that you are most likely to benefit from cognitive behavioural therapy (CBT), which is available on the NHS.

CBT could help you rebuild the relationship with your body.

Please don’t delay – self-refer on the NHS talking therapies webpage, or explore insurance or private options if these are available to you.

Regarding the foot drop, in addition to physio and orthotics (which help prevent tripping and dragging of the toes), you should ask about whether electrical nerve stimulation would be an option for you.

A device sends small electrical impulses to stimulate nerves that lift the foot and is sometimes used if the foot drop is caused by damage to the brain or spinal cord (eg from stroke or MS – multiple sclerosis).

Research is ongoing into using stem cells or nerve growth factors to regenerate damaged nerves that cause foot drop.

See if any trials are recruiting by asking your specialist team, exploring the NIHR Be Part of Research webpage, or by visiting nhs.uk/tests-and-treatments/clinical-trials.

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