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Restless Leg Syndrome

Restless Leg Syndrome

What is Restless Leg Syndrome (RLS)?

Restless legs syndrome, (RLS) also known as Willis-Ekbom disease, is a common condition of the nervous system that causes an overwhelming, irresistible urge to move the legs known as periodic limb movements in sleep (PLMS).

It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. The sensation is often worse in the evening or at night. Occasionally, the arms are affected too.

A classic feature of RLS is that the symptoms are worse at night with a distinct symptom-free period in the early morning, allowing for more refreshing sleep at this time.

Often triggering situations of RLS are periods of inactivity such as long car trips, sitting in a movie theatre, long-distance flights, immobilisation in a cast, or relaxation exercises. Many individuals also note a worsening of symptoms if their sleep is further reduced by events or activity.

RLS symptoms may vary from day to day and in severity and frequency from person to person.

  • Individuals with mild RLS may have some disruption of sleep onset and minor interference in daytime activities.
  • In moderately severe cases, symptoms occur only once or twice a week but result in significant delay of sleep onset, with some disruption of daytime function.
  • In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function.

Individuals with RLS can sometimes experience remissions—spontaneous improvement over a period of weeks or months before symptoms reappear—usually during the early stages of the disorder.  In general, however, symptoms become more severe over time.

What causes RLS?

In the majority of cases, there’s no obvious cause of restless legs syndrome. This known as idiopathic or primary restless legs syndrome, and it can run in families.

Some neurologists (specialists in treating conditions that affect the nervous system) believe the symptoms of restless legs syndrome may have something to do with how the body handles a chemical called dopamine.

Considerable evidence suggests that RLS is related to a dysfunction in the brain’s basal ganglia circuits that use the neurotransmitter dopamine, which is needed to produce smooth, purposeful muscle activity and movement. Disruption of these pathways frequently results in involuntary movements. Individuals with Parkinson’s disease, another disorder of the basal ganglia’s dopamine pathways, often have RLS as well.

Dopamine is involved in controlling muscle movement and may be responsible for the involuntary leg movements associated with restless legs syndrome.

In some cases, restless legs syndrome is caused by an underlying health condition, such as iron deficiency, anaemia or kidney failure. This is known as secondary restless legs syndrome.

Certain medications that may aggravate symptoms. These medications include anti-nausea drugs (prochlorperazine or metoclopramide), antipsychotic drugs (haloperidol or phenothiazine derivatives), antidepressants that increase serotonin, and some cold and allergy medications-that contain sedating antihistamines.

There’s also a link between restless legs syndrome and pregnancy. About 1 in 5 pregnant women will experience symptoms in the last three months of their pregnancy, although it’s not clear exactly why this is. In such cases, restless legs syndrome usually disappears after the woman has given birth.

As many as 1 in 10 people are affected by restless legs syndrome at some point in their life. Women are twice as likely to develop restless legs syndrome than men. It’s also more common in middle age, although the symptoms can develop at any age, including childhood.

How can you treat RLS?

Mild cases of restless legs syndrome that aren’t linked to an underlying health condition may not require any treatment, other than making a few lifestyle changes, such as:

  • Adopting sleeping habits e.g. following a regular bedtime ritual, sleeping regular hours,
  • If you smoke – try stopping or at least cut down
  • Eliminating or lessening alcohol intake.
  • Exercise regularly during the daytime, (If you have a sedentary lifestyle this can be adding as little as a daily 20-minute brisk walk to your daily routine)
  • Identifying habits and activities that worsen RLS symptoms
  • Looking at diet to assure it is healthy and balanced.
  • Magnesium deficiency can be a factor in RLS.
  • A hot bath adding to it a large mug full of organic magnesium salts and soak for 20 mins x 3 times a week. This is very beneficial to reduce stress and calms the nervous system. There are also Magnesium sprays that can be used topically on the area.
  • Bananas particularly at night are a good source of magnesium and will help relax the body due to their concentration of tryptophan which the body uses to produce 5-HTP, which helps regulate mood and sleep-regulating neurotransmitters.
  • Watermelon: is rich in vitamins A, C & B6 which is used by the body to produce neurotransmitters serotonin and dopamine.
  • Checking to see if there is an underlying iron or vitamin deficiency and then possibly supplementing the diet with iron, vitamin B12 or folate.
  • Running low on potassium can be a cause of RLS. Eating oranges or drinking natural orange juice can increase the amount of potassium in the body –  Potassium assists in muscle contraction and in maintaining fluid (water) and electrolyte balance in body cells. Potassium is also important in sending nerve impulses as well as releasing energy from protein, fat, and carbohydrates during metabolism.
  • Ginkgo has been considered useful in treating RLS as it promotes nerve transmissions and tones the blood vessels throughout the body. Ginkgo is known as the memory herb. It increases blood flow to the brain and strengthens cell membranes. It is also an antioxidant, combating free radical damage in the body. It is widely used in conventional medicine throughout Europe and has no known side effects. Ginkgo is most commonly taken in capsule form, although it is also available in a tincture.
  • Quinine which can be found in tonic water has been used to reduce the onset of RLS and muscle cramps, it is suggested you drink a small glass at night, an hour before bed.
  • Look at medications (including herbal remedies) you may be taking which could make RLS symptoms worse. These may include drugs used to treat high blood pressure, heart conditions, nausea, colds, allergies, and depression.
  • Use of Complementary therapies  – massage, reflexology, reiki, mindfulness

If symptoms are more severe, the individual may need medication to regulate the levels of dopamine and iron in the body.

We would always recommend that anyone with symptoms goes and sees the Doctor in case additional investigations are required.

How can we assist relieve the symptoms of RLS at Tree of Health and Wellbeing?

Use of Complementary Therapies
Massage

People who attend for massages know that post-massage feeling, where the mind is clear and the body is relaxed. An occasional massage leaves you feeling great, but regular massage can do so much more. The work we do each time someone attends a session at Tree of Health and Wellbeing builds on itself, helping the body maintain its relaxed state and muscles to remain loose, even during times of physical and mental stress.

The National Institute of Neurological Disorders and Stroke theorises that poor circulation may be related to RLS. Massage is known to boost circulation and helps move blood through congested areas.

Releasing that congestion makes new blood flow in, while also improving circulation of the lymph fluid that removes metabolic waste from your muscles and internal organs. It adds up to improved body function as well as lower blood pressure. Also assists by improving circulation. It can also help decrease cortisol levels and increase dopamine as well as promote relaxation and restful sleep.

When the muscles become relaxed and any toxins in the body removed, this assists the body to work more effectively and regaining balance.

What tends to promote the greatest relief is concentrating on the hamstrings, glutes and the piriformis muscles, as increasing circulation in these areas can relieve uncomfortable sensations in the legs, so our therapists may focus on the lower half of the body using a combination of soft tissue massage, trigger point therapy and fascial stretching.

The frequency of massage therapy sessions depends on the severity of the condition.

Reiki

Please see our detailed section on Reiki to see a full list of benefits but as an overview, our Reiki Masters at Tree of Health and Wellbeing channel energy to the individual to activate the natural healing processes of the person’s body to restore physical and emotional well-being.

Mindfulness

Mindfulness-based stress reduction teaches psychological techniques for managing symptoms. With this approach, people with RLS tackle anxious thoughts proactively instead of allowing themselves to become panicked or trying to push the thoughts away.  Our therapists at Tree of Health and Wellbeing can advise people how to do the therapy before symptoms happen, and it relaxes them; helping you to be mentally prepared  – a 6-week program of MBSR can improved symptom severity, sleep quality, RLS-specific quality of life, and overall mental health in participants with RLS.

Come and talk to us today at Tree of Health and Wellbeing and we will seek to identify a plan with you to reduce these symptoms.