Restless Leg Syndrome (RLS)
What is Restless Legs Syndrome?
Restless Leg Syndrome is a neurological disorder that causes unpleasant sensations in the legs with an uncontrollable urge to move when at rest. The sensations range in severity from uncomfortable to irritating to painful.
RLS symptoms are usually activated by lying down and while in a relaxed state making it difficult to sleep or stay asleep.
The exact cause of restless legs syndrome is not known at this time. However there is evidence that it could be hereditary. People with genetic RLS tend to be younger when symptoms start and have a slower progression of the condition.
It is not yet known for sure, but is believed that people with low iron levels, anemia, kidney failure, diabetes, Parkinson's disease, and peripheral neuropathy are more prone to RLS.
Pregnant women may experience RLS, especially in their last trimester. Usually symptoms disappear within 4 weeks after delivery.
RLS may start at any age, including early childhood, and is a progressive disease for many that are afflicted, it is possible the symptoms can disappear permanently.
The most distinctive characteristic of this condition is symptoms occur or worsen when you are lying down, sitting, resting or relaxing for long periods of time. You may often feel an uncontrollable urge to get up and move around.
RLS is more common in women then in men and while RLS can start at any age, it usually affects the middle-aged or elderly.
The severity seems to increases with age, older patients experience symptoms more frequently and for longer periods of time.
It is estimated that RLS affects more than 12 million people in the United States alone.
Restless legs syndrome can be difficult to diagnose. Without laboratory test available to pinpoint it, RLS can only be clinically diagnosed by checking your health, symptoms and family history.
It seems that many people suffering with RLS do not discuss the symptoms with their doctor. Because the sufferer has; never heard of RLS or explaining the symptoms are very difficult to describe.
Restless Legs Syndrome can be further divided into two categories primary or secondary.
Primary RLS is considered idiopathic, meaning that the cause is unknown. Primary RLS usually begins before approximately 40 to 45 years of age, and can even occur as early as the first year of life. In primary RLS, the onset is often slow and even disappear for months or even years. But they usually return. Primary RLS is progressive, which means it generally gets worse with age. RLS in children is often misdiagnosed as growing pains.
Secondary RLS is symptomatic, which is to say that the underlying problem of restless legs is thought to be secondary to, or caused by, a primary disorder such as anemia, or physical condition like pregnancy. Secondary RLS often has a sudden onset and may be daily from the very beginning. It often occurs after the age of 40, however it can occur earlier. It is most associated with specific medical conditions or the use of certain drugs.
Treating the restless legs, in the case of secondary RLS, often means treating the underlying condition. Some studies show that there is a genetic component as well, indicating that the disorder may be hereditary.
Symptoms of Restless Legs Syndrome
Restless legs syndrome (RLS) is defined as substantial discomfort in the legs that occurs only at rest and is immediately relieved by movement. The abnormal feelings typically seem deep and are always present below the knees.
Patients with RLS tend to fidget or move their legs in bed for relief. Sometimes the symptoms are so severe that the patient is forced to get out of bed and pace the room.
Symptoms usually occur deep inside the leg, between the knee and ankle; more rarely, they occur in the feet, thighs, arms, and hands with the urge to move, usually due to uncomfortable sensations that occur.
The sensation and the urges can effect any body part; the most common location is the legs, followed by arms. Some people have little or no sensation but still have a strong urge to move.
The sensations are unusual and unlike other common sensations. While an RLS sufferer may find it hard to discribe the sensations to a non-sufferer, someone with RLS can perfectly understand the indescribable nature of the unpleasant sensations. These sensations are sometimes described as, burning, creeping, tugging or feel as if insects are crawling inside the legs, uncomfortable, antsy, electrical, painful, itching, pins and needles, pulling, creepy-crawly and many others.
This kind of abnormal sensation is known as Paresthesia or Dysesthesias which means unpleasant abnormal sensations. The sensations range in severity from uncomfortable to irritating to painful.
The symptoms worsen by relaxation. Any type of inactivity involving sitting or lying, reading a book, a plane ride, watching TV or a movie, taking a nap the inactive situations can trigger the sensations and urge to move. This depends on several factors: the severity of the person's RLS, the degree of restfulness, the duration of the inactivity, etc.
Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night.
Symptoms are usually less noticeable during the day and more pronounced in the evening or at night. Some experience symptoms throughout the day and night, especially at the onset of sleep. For many, the symptoms disappear by early morning.
Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations. They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.
Movement may bring temporary relief to those with RLS, but finding any possible underlying cause and treating the associated medical condition may be more effective at eliminating or reducing the symptoms of RLS.
Some people also have problems concentrating and have impaired memory, insomnia and extreme fatigue that may interfere with daily functioning due to the sleeping patterns that are severely disrupted by RLS. It is important not to ignore these symptoms.
Treatment is usually based on correcting the disorder that is causing RLS. Often when the cause is not found, pain killers, sedatives or anticonvulsant are prescribed which can be addictive and have adverse side-effects.
Check for Underlying Causes
RLS can be a symptom of another disorder. People who suffer from depression, hypertension, ADHD, gastro-reflux disease and diabetes suffer higher incidents of RLS.
How do I know if I have Restless Leg Syndrome?
Ask yourself these questions:
- Do I have urges to move my legs, arms or other parts of my body?
- Do I have uncomfortable and unpleasant sensations in my legs?
- Do my urges to move or unpleasant sensations begin or worsen during periods of inactivity, such as lying or sitting?
- Do I have any kind of relief when I walk or stretch?
- Are my urges to move or my unpleasant sensations worse during the evening or night than they are during the day?
Diagnosis of RLS is predominantly based on signs and symptoms. However, your doctor may order some blood tests to rule out other causes of such symptoms. These may include blood counts, kidney and liver functions, thyroid tests or vitamin levels.
What you can do to relieve and/or eliminate RLS
The methods below can be helpful if you don't want to take medication or if medication is not helping.
Exercise
Exercise helps to release endorphins in the blood thereby changing the chemical balance in the brain and providing more sound restful sleep.
A moderate amount of exercise every day reduces stress and other conditions that contribute to RLS. Stretch throughout the day and take a brisk walk in the afternoon or before dinner.
Remember that you should not over-do-it when exercising, this may cause more harm than not exercising at all.
Walking is most common exercise.
Stretching, yoga, biking, or other physical activity may relieve the symptoms just as well as walking.
Yoga, meditation, and massaging, are all natural ways to cure or reduce symptoms of RSL.
Movement usually brings immediate relief, but it is often only temporary and partial.
Sometimes a specific type of movement will help one person more than another.
Because the symptoms of RLS are especially worse at night, try walking or exercising before going to bed. You may find that just taking a short walk around your house before going to bed to be helpful.
Deep knee bends and other leg exercises during the day and again near bedtime also proves to be helpful.
Stress
Try to lower your stress levels, stress can cause worsening of the symptoms. Relaxation techniques like yoga, meditation may help to reduce stress levels significantly.
Some doctors think that RLS is caused by or exacerbated by high levels of stress. If you're stressed, take up yoga or aroma therapy to help you relax.
When you experience this condition, it is important to ensure that keep tabs on your stress levels throughout the day.
It has been discovered that RLS suffers with high levels of stress are more likely to suffer from uncomfortable symptoms.
There are many different ways that you can manage and cope with stress each day. Relaxation techniques, such as breathing exercises, yoga, and even listening to soothing music may prove to be effective.
Sleeping
Get plenty of rest. RLS may be worse if the sufferer isn't getting enough rest. Try to get at least 8 hours of sleep each night.
Sleeping positions - Experiment different sleeping positions and see which is more comfortable for you.
For some, sleeping only in one position can develop more symptoms.
Good sleep includes getting enough sleep, but it also includes going to bed at the same time and getting up at the same time daily. These sleep patterns can help people to get the most out of their sleep.
Get plenty of rest, symptoms of RLS can become worse if you are overactive.
Try kava kava and valerian supplements, as they promote healthy sleep and calm nerves.
Vitamins
Take your vitamins. A lot of cases of RLS are caused by a deficiency of iron, B6, or magnesium. Taking a common high-quality multivitamin can fix this.
Iron deficiency has been known to contribute to the symptoms of RLS. By adding more iron into your diet, you may find that your condition can be decreased or eliminated. This can be done through eating more iron-rich food or through taking iron supplements.
Other vitamins and minerals including calcium, magnesium, and zinc can also be added to the diet to naturally help with the symptoms of RLS. Although multivitamin supplements can help, getting them from real food is more beneficial.
Vitamin Deficiencies
If you're RLS is due to iron deficiency or folate deficiency make sure to take a multi-vitamin supplement as suggested by your specialist.
Folate is a water-soluble B vitamin that occurs naturally in food.
Take supplements to correct iron, folate and magnesium deficiencies. A quarter of RLS patients have low serum iron levels. Vitamin C and 400 IUs of Vitamin E daily day can curb instances of RLS.
Other Things You Can Try
Soak your leg in cold or hot water (not ice water as it can cause sever damage to the nerves and not too hot as to burn yourself) it provides relief for many people.
Some people have found that heating pads or ice packs helpful in reducing pain.
Acupuncture can be used to help to relieve the symptoms of RLS.
Chiropractors can recommend exercises that will help symptoms of RLS. By strengthening your pelvic muscles it will help relieve pain associated with RLS.
Massage your legs before bedtime.
If you find that you often experience anxious muscles when you lay down to go to sleep, take a warm bath prior to bedtime. This can help to relax and soothe muscles and other symptoms such as stress that may be associated with RLS.
Soaking in a hot bath using oatmeal, lavender or chamomile powders or salts helps to relieve stress.
Place a bar of soap under your fitted sheet - at calf-level. Nobody is sure why this works, but thousands have reported a complete halt in their RLS symptoms when doing this.
What Not To Do
One area to look at when searching for natural cures for RLS is the elimination of substances that could be causing the condition.
Caffeine, alcohol, and tobacco have also been linked to RLS.
Avoid coffee, cola, black tea and energy drinks containing taurine, caffeine or chocolate. The stimulating properties of these foods and beverages cause restlessness and insomnia.
Eliminate stimulants from your diet. Caffeine (including chocolate) seems to worsen symptoms of RLS, so if you experience the symptoms, you need to stop drinking coffee, tea, and sodas.
Caffeine can make people jittery. This can worsen the symptoms of RLS. By eliminating caffeine or at least reducing your intake of it, your RLS symptoms can be eliminated or at least reduced. Alcohol and tobacco elimination can also help people to reduce their symptoms.
Stop drinking alcohol. It's believed that alcohol worsens RLS symptoms, so cutting it out of your life will benefit you on several levels.
Quit smoking - it works for many as it is believed smoking may impair the blood flow to the leg muscles.
Try to reduce or eliminate these things to determine if they maybe a trigger for your symptoms.
Diet
Eat a balanced diet.
Don't have a fatty or a large meal late at night as this may trigger the symptoms.
Massage your leg with certain aromatherapy oils or just run a vibrator over them for relief.
You need a balance of proteins, vegetables, fruits, whole grains, and healthy fats.
Medications (prescribed and/or over the counter)
It is important to evaluate the medications that you purchase over-the-counter. Many of these medicines contain high amounts of caffeine and other ingredients that can actually trigger the onset of RLS symptoms.
It is also suggested medications-such as anti nausea drugs (prochlorperazine or metoclopramide), anti seizure drugs (phenytoin or droperidol), anti psychotic drugs (haloperidol or phenothiazine derivatives), and some cold and allergy medications may aggravate symptoms.
If you take any of these medications and suspect RLS you should speak to your doctor about changing your medication.
If you do find that your medication contains ingredients that can result in active muscles, it is important that you attempt to find a safer alternative.
Drugs - Warning!!!
There are different medications being used for the symptoms of RLS.
I hope people will try natural cures for RLS rather then using prescription drugs.
Here are two good reason why...
The two common drugs used for RLS are Requip and Mirapex. The side effects vary from one individual to the other, as well as the dose that has been administered.
The use and possible side effects listed below is information from Requip and Mirapex.
Requip
Requip helps relieve the signs and symptoms of Parkinson's disease. Caused by a deficit of dopamine (one of the brain's chief chemical messengers), this disorder is marked by progressive muscle stiffness, tremor, and fatigue. Requip is also used to relieve symptoms of restless legs syndrome. It works by stimulating dopamine receptors in the brain, thus promoting better, easier movement.
Unusual urges: Some patients taking REQUIP or REQUIP XL get urges to behave in a way unusual for them. Examples of this are an unusual urge to gamble or increased sexual urges and behaviors. If you notice or your family notices that you are developing any unusual behaviors, talk to your healthcare provider.
What are the possible side effects of Requip?
- Most people who take REQUIP tolerate it well. The most commonly reported side effects in people taking REQUIP for RLS are nausea, vomiting, dizziness, and drowsiness or sleepiness. You should be careful until you know if REQUIP affects your ability to remain alert while doing normal daily activities, and you should watch for the development of significant daytime sleepiness or episodes of falling asleep. It is possible that you could fall asleep while doing normal activities such as driving a car, doing physical tasks, or using hazardous machinery while taking REQUIP. Your chances of falling asleep while doing normal activities while taking REQUIP are greater if you are taking other medicines that cause drowsiness.
- When you start taking REQUIP or when you increase your dose, you may feel dizzy, nauseated, sweaty or faint, when first standing up from sitting or lying down. Therefore, do not stand up quickly after sitting or lying down, particularly if you have been sitting or lying down for a long period of time. Take a minute sitting on the edge of the bed or chair before you get up.
- Hallucinations (unreal sounds, visions, or sensations) have been reported in patients taking REQUIP. These were uncommon in patients taking REQUIP for RLS. The risk is greater in patients with Parkinson's disease who are elderly, taking REQUIP with L-dopa, or taking higher doses of REQUIP than recommended for RLS.
Some patients taking REQUIP get urges to behave in a way unusual for them. Examples of this are an unusual urge to gamble or increased sexual urges and behaviors. If you notice or your family notices that you are developing any unusual behaviors, talk to your healthcare provider.
This is not a complete list of side effects and should not take the place of discussions with your healthcare providers. Your doctor or pharmacist can give you a more complete list of possible side effects.
Call your healthcare provider for medical advice about side effects.
Also found this information about Requip from another source:
If Requip is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Requip with the following:
Alcohol
Benzodiazepines such as alprazolam
Certain antidepressants
Ciprofloxacin
Drugs that contain levodopa
Estrogen medications such as ethinyl estradiol
Metoclopramide
Tranquilizers
Mirapex
Important Information about MIRAPEX:
MIRAPEX is indicated for the treatment of moderate-to-severe primary Restless Legs Syndrome (RLS).
MIRAPEX may cause you to fall asleep without any warning, even while doing normal daily activities, such as driving.
Before taking MIRAPEX, talk to your doctor if you drink alcohol or take other medications that make you drowsy as these can increase the chance that MIRAPEX will make you feel sleepy or fall asleep when you should be awake.
When taking MIRAPEX, hallucinations (seeing, hearing, feeling, or tasting something that isn't there) may occur and you may sometimes feel dizzy, nauseated, faint or sweaty when you sit up or stand quickly. In clinical trials for RLS, the most commonly reported side effects of MIRAPEX that were more frequent than with placebo are nausea, headache, and tiredness. Talk to your doctor if you experience any of these symptoms.
There have been reports of impulse control disorders and compulsive behaviors in patients taking certain medicines, including MIRAPEX. If you or your family members notice that you are experiencing new or increased gambling urges, increased sexual urges or other intense urges, such as compulsive shopping or eating, while taking MIRAPEX, talk to your doctor.
This information is intended for U.S. residents only. Products discussed herein may have different labeling in different countries.