HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Painful Sensation In Lower Legs And Knees?

default
Posted on Sat, 6 Jun 2015
Question: I've had Restless Leg Syndrome for several years and have taken Pramipexole, 0.25 mg Tablets--one at 4pm and two at bed time. The 4pm tablet has been added in the last year. This tablet is a generic replacement for Mirapex.

I have discussed this matter for years with my personal physician and also met with a Neurologist.

My RLS generally begins in the early evening, but sometimes in the late afternoon or earlier if riding in a car. Sometimes involves involuntary limb movement, but generally feels like there is something in my lets that wants to escape or like a sensation with movement in my lower legs, but sometimes goes above the knees.

Once I get to sleep, it does not bother me during the evening although I may get up to use the bathroom 2 or 3 times. I am 81 yrs. and have periodically had prostate and bladder problems.

One of the recently used home remedies mentioned on the Internet is to empty a pkg. of Crystal Light into a 16.9 oz bottle of water and shake well. This remedy has helped me deal with the RLS after it is in progress.

It does not occur every evening, but most evenings. The symptoms have on occasion been a prelude to a Bowel movement which of course is confusing

Probably needless to say, but it makes it difficult for me to sit still--I have to get up and walk around.

Your consideration of this problem is greatly appreciated.
XXXXXXX Livingston
doctor
Answered by Dr. Olsi Taka (51 minutes later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully. I must say that I am not sure whether you had a specific questions or were just wondering whether you were simply wondering if we had some input to add.

If you were wondering about the diagnosis being correct I would say that I agree with your doctor's opinion, from your description of the symptoms your case looks like restless legs syndrome. One diagnosis it might have to be differentiated with might be akathisia, which may have a similar urge, but is not related to any particular time of day and is usually related to use of medication such as antipsychotics, antidepressants etc, so not likely to be your case.

If you were wondering about the medication, pramipexole is one of the first choice treatments for RLS. Since you have a fairly early onset of the symptoms it could be tried to take two tablets in the afternoon.
Other medication options which could be tried if therapy is ineffective and symptoms are very bothering might include benzodiazepines (like clonazepam), antiepileptics (like gabapentin or pregabalin), opioids (like codeine), alpha-agonist (like clonidine).

If you wanted an opinion on the Chrystal Light thing, I must confess I had never heard of that as it's not present here in Europe at all. It is not included in medical literature (whether XXXXXXX or european sources). There are no studies on its use and efficacy and comparison to other options. From what research I did I found two mentions one from a patient who claimed it helped and the other one who claimed it triggered the symptoms. Again I found no scientific evidence. If you can provide a link to your source I will gladly review, there is no medical evidence on the matter.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Olsi Taka (2 hours later)
Thank you very much for the information on RLS. I tried 300 Mg. Gabapentin and never slept a wink all night. I tried 25Mg Lyrica and hallucinated.
doctor
Answered by Dr. Olsi Taka (3 hours later)
Brief Answer:
Read below.

Detailed Answer:
Thank you for bringing that additional info. I am sorry that antiepileptics have caused such side effects.

As I said Pramipexol is a first choice drug, the list of other drugs are only in case it doesn't work.
One addition I forgot to include is also Amantadine which is also effective in treating RLS.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Painful Sensation In Lower Legs And Knees?

Brief Answer: Read below. Detailed Answer: I read your question carefully. I must say that I am not sure whether you had a specific questions or were just wondering whether you were simply wondering if we had some input to add. If you were wondering about the diagnosis being correct I would say that I agree with your doctor's opinion, from your description of the symptoms your case looks like restless legs syndrome. One diagnosis it might have to be differentiated with might be akathisia, which may have a similar urge, but is not related to any particular time of day and is usually related to use of medication such as antipsychotics, antidepressants etc, so not likely to be your case. If you were wondering about the medication, pramipexole is one of the first choice treatments for RLS. Since you have a fairly early onset of the symptoms it could be tried to take two tablets in the afternoon. Other medication options which could be tried if therapy is ineffective and symptoms are very bothering might include benzodiazepines (like clonazepam), antiepileptics (like gabapentin or pregabalin), opioids (like codeine), alpha-agonist (like clonidine). If you wanted an opinion on the Chrystal Light thing, I must confess I had never heard of that as it's not present here in Europe at all. It is not included in medical literature (whether XXXXXXX or european sources). There are no studies on its use and efficacy and comparison to other options. From what research I did I found two mentions one from a patient who claimed it helped and the other one who claimed it triggered the symptoms. Again I found no scientific evidence. If you can provide a link to your source I will gladly review, there is no medical evidence on the matter. I remain at your disposal for further questions.