Nonpharmacological Therapy For Intermittent Rls
The majority of patients with intermittent RLS symptoms have mild ones that typically do not require drug therapy. Nonpharmacological remedies are often sufficient to quell these patients symptoms.
Symptoms characteristically occur when patients are at rest both physically and mentally. Although the preferred activity to relieve symptoms is physical movement , it is not always possible . Mentally engaging activities, such as playing a video game, solitaire, chess, doing a crossword puzzle, or even having a mentally stimulating conversation can markedly reduce or eliminate RLS symptoms when the patient is sedentary, which is based on hundreds of anecdotal reports to the author and other RLS experts. However, patients report that passive activities, such as watching the in-flight movie provide no relief.
Abstinence from Caffeine, Nicotine, and Alcohol
The literature is also not very supportive for the effect of nicotine/tobacco on RLS. An early case report described a 70-year-old patient with severe RLS who had a complete remission of symptoms 1 month after smoking cessation. No significant differences in the incidence of RLS was found in a 1997 epidemiological study between Canadian adult smokers and nonsmokers, whereas 2 other epidemiological studies both found an increased risk of RLS in smokers. However, in clinical practice, the effect of smoking on RLS has not been very noticeable.
Avoid Medication That May Enhance RLS
The Scope Of Opioid Abuse
Opioid drugs include prescription drugs, like pain relievers such as morphine and fentanyl, and illicit drugs like heroin. These drugs have a highly addictive nature. As you might guess, this makes them an easy target for abuse.
But not everyone who abuses prescription drugs knows they will develop addiction after using these drugs. We tend to believe that when we get medications from our physicians these drugs come with low risk of adverse side effects. Prescription opioids are highly addictive and anyone who takes them would benefit from being aware of this fact.
When you take these drugs as directed, you can avoid abusing them. Yet if you increase dosage because your pain increased and you thought it would be ok just once, or you crush a tablet and snort it to get the effects faster, you put yourself at higher risk of developing addiction.
If you have abused prescription opioids, you also stand a higher likelihood of seeking other narcotics like heroin. For instance, if you were prescribed a pain reliever, and fell into abuse to help with the pain, but your prescription ends and you are becoming addicted to the effects, it may be all too easy to continue to seek those effects. Heroin is relatively inexpensive and easily obtained.
What Is Restless Legs Syndrome
Restless Legs Syndrome is an urge to move the legs. Its usually accompanied by uncomfortable or unpleasant sensations in the legs, says Dr DAnna. He adds that symptoms must:
a) Begin or worsen during periods of rest in activities such as lying down or sitting.
b) Be partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
c) Occur exclusively or predominantly in the evening or night rather than during the day.
We must discount other medical or behavioural conditions first, he says. These include myalgia , venous stasis , leg edema , arthritis, leg cramps, positional discomfort, or habitual foot tapping.
There are two types of Restless Legs Syndrome: primary and secondary. Primary or idiopathic RLS and secondary RLS, which causes the same symptoms as primary. The difference is that secondary RLS has an identifiable cause, he explains.
Medical Restless Legs Syndrome treatment, following a consultation with a neurologist, usually starts when symptoms interfere with a patients quality of life, says Dr DAnna. Diagnosis of RLS requires that its symptoms cause concern, distress, sleep disturbance, or other impairment. Mild or infrequent symptoms may not require treatment, he says, although the home remedies suggested below can help your symptoms.
Restless Leg Syndrome can be a frustrating condition.
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What Other Treatments Are Available
Addiction isnt a negative habit, but a medically-recognized disease that requires adequate treatment. Our rehab centers understand that just as with other diseases, there is no one treatment fits all methodeffective healing methods have to be specific to each individual.
Thats why research in the past decades has been dedicated to finding methods that work for anyone who enters addiction treatment services. Men and women have different needs, people seeking treatment for multiple abuse disorders have differing needs, people with mental health issues and abuse disorders have different needs than people without mental health issues. No matter what needs you bring to treatment, you can have them addressed, and comprehensive healing is necessary for a successful recovery.
Whatever rehab center you choose, make sure it offers treatment methods that work to give you the best overall chance of meeting your goals. Some of our evidence-based methods include:
- Gender-specific treatment
What To Do About Restless Legs Syndrome
Bedtime is far from relaxing for women with this common condition.
Restless legs syndrome is a sensory-motor disorder that causes an irresistible urge to move the legs, often accompanied by an uncomfortable “creepy-crawly” sensation. RLS affects 3% to 5% of adults and is twice as common in women as in men. Symptoms typically flare at night, just as you’re settling down in bed, but they may also arise when you’re resting in a chair. RLS not only causes discomfort and distress, but can also wreak havoc on sleep, causing daytime sleepiness and mood changes. Fortunately, certain lifestyle strategies can help you manage milder forms of RLS, and several medications can provide relief for more serious symptoms.
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D1 Diagnosis Incorrect Including Primary Versus Secondary Etiology
Ask whether the diagnosis is correct. Early in their course, refractory patients should have met the four essential clinical criteria to diagnose RLS. The first author has proposed the acronym URGE to assist assessment:
Primary or idiopathic RLS is common. Secondary RLS can arise from iron dysregulation and neurologic disorders. Secondary causes of RLS include pregnancy , end stage renal disease , anemia,10,11 Charcot-Marie-Tooth disease ,12 Parkinsons disease ,13 and ADHD .14 Neuropathy can also increase RLS presentation.
RLS mimics should be excluded and include leg cramps, noted in up to 50% of seniors15 from muscle fatigue, vascular disease, or metabolic disturbance primary akathisia and secondary akathisia from treatment with neuroleptics and metoclopramide .
RLS PLMS Comparisons
|PSG = polysomnography, EDS = Excessive daytime sleepiness|
Intravenous Iron Infusion Therapy
As previously noted, Wang et al. demonstrated an improvement in RLS with oral iron in patients with low-normal serum ferritin levels . However, oral iron does not get absorbed very well,, and many patients do not tolerate iron due to gastrointestinal side effects. Several studies have demonstrated a benefit from different intravenous iron formulations, including iron dextran 1000 mg , iron gluconate 150 mg , and iron ferric carboxymaltose 500 mg , but not for iron sucrose 1000 mg . For iron dextran, the low molecular weight preparation should be used as it does not cause anaphylactic reactions and thus also avoids the need for premedication with diphenhydramine, which may exacerbate RLS. The intravenous iron infusion effect can be very dramatic in approximately 60 % of patients, but patients tend to relapse after 3 to 36 months , but these patients will respond to subsequent iron infusion therapy. Earley et al. has calculated that RLS patients who respond to intravenous iron therapy have a decline in weekly ferritin levels of 7.7±3.2 mcg/l/week compared to control normal subjects who decrease by < 1 mcg/l/week. Iron therapy should be considered for RLS patients with low serum ferritin levels who are failing traditional therapy, especially if they also have anemia. However, the long-term effects of repeated iron infusion therapy in this population have not been studied, so this treatment should be instituted with caution.
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Medicines For Aiding Sleep
If restless legs syndrome is badly disrupting your sleep, a short-term course of medicine may be recommended to help you sleep.
Hypnotics are usually only recommended for short-term use .
You may find you still feel sleepy or “hungover” the morning after taking your medicine.
D3 Drug Is Ineffective For The Patient
Responsiveness to therapies may be reduced in iron-deficient patients. Supplemental iron should be considered in these patients. Approximately 25% of patients receiving ropinirole16 or pramipexole17 responded inadequately in large clinical trials. Addition or change to another therapeutic agent is needed.
RLS Medication and Dosage
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The Six Ds Of Rls Diagnosis And Treatment
By Philip M. Becker, MD, and Muhammad Sattar, MD
Diagnosing and treating difficult cases of restless legs syndrome can be a complicated task, but identifying and managing the disorder can be less daunting when putting the six Ds into practice:
Cases of RLS can take unexpected twists, potentially leading patients to a knotted state of mismanagement. Proper use of the six Ds can help practitioners untangle difficult RLS cases and facilitate proper care. Mr D, the subject of this case report, required shifts in strategic management for his RLS and became a testimony to the positive outcomes when the six Ds are put into practice.
The First Step In Treating Restless Legs Syndrome
The first line of defense against restless legs syndrome is to avoid substances or foods that may aggrivate or worsen the problem. Stay away from alcohol, caffeine, and nicotine. This may help relieve your symptoms. In addition, review all medications you are taking with your doctor to determine if any of these drugs could be causing the problem.
Any underlying medical conditions, such as anemia, diabetes, nutritional deficiencies, kidney disease, thyroid disease, varicose veins, or Parkinson’s disease, should be treated. Dietary supplements to correct vitamin or mineral deficiency may be recommended. For some people, these treatments are all that is needed to relieve RLS symptoms.
You may also benefit from physical therapy and self-care treatments, such as stretching, taking hot or cold baths, whirlpool baths, applying hot or cold packs to the affected area, limb massage, or vibratory or electrical stimulation of the feet and toes before bedtime. Exercise and relaxation techniques also may be helpful.
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Restless Legs Syndrome Treatment: How To Stop Restless Legs With Home Remedies
Regular daily exercise can help, says Dr DAnna. But avoid exercising close to bedtime, he warns. Talk to your doctor about a plan that could work for you.
2. Find ways to relax
Relaxation exercises, such as yoga or tai chi, may help relieve your symptoms, says Dr DAnna. So can activities that distract your mind, such as reading or watching television, he suggests. A leg massage late in the day may also relax you and reduce RLS symptoms.
3. Say goodbye to stimulants
Avoid stimulants in the evening, such as caffeine, tobacco and alcohol, says Dr D Anna. In some cases, caffeine makes the symptoms of Restless Legs Syndrome worse. Try to avoid drinking tea and coffee and see if it makes a difference. Alcohol can also cause issues so consider giving up booze. According to the RLS-UK website, alcohol consumption also increases the span or intensity of symptoms for most individuals and smoking wont help your symptoms either, so cut down or give up. These NHS services can help you quit.
4. Try hot and cold therapy
A warm bath before bed can help you relax and may ease symptoms. Alternatively, apply a hot or cold compress to your leg muscles, says Dr DAnna. You can also alternate between hot and cold compresses to relieve the twitching or pain.
Magnesium may help relax the muscles and lesson symptoms.
5. Give magnesium a go
6. Get your iron levels checked
7. Practice good sleep habits
8. Avoid certain medications
What Antidepressant Does Not Aggravate Restless Leg Syndrome
farmerswife over a year ago
Guest over a year ago
over a year ago
In reply to marti on 2012-11-20 – click to read
over a year ago
I suddenly started with this RLS problem. Then I checked out this site. I quit the St. John’s wort I had been taking three times a day and the problem has subsided. I was taking the Research Grade as prescribed. So, It must be true that something that affects seratonin which, I believe tamps down dopamine will do this. It is scary. As movement disorders from medication can become permanent. I would stay away from Ldopa or the others that help RLS as they , as far as I can gather from reading about this up dopamine. Maybe wrong, but experience is the best teacher.
Trying to cope with mild depression and anxiety with upbeat thinking and exercise.
Once I took Celexa for six years and woke up one morning with my little finger on my right hand moving and it did not stop for days. I took benedryl finally and it stopped. But, needless to say, this scared me big time. Then I went to St. John’s Wort. Must be careful with that too.
I quit all meds and am trying my best to get by without. I know for some this is not easy.
Good Luck To All Of You
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Medications For Restless Legs Syndrome
Daily medication is usually recommended only for people who have symptoms of restless legs syndrome at least three nights a week, or as determined by your doctor. Keep in mind that drugs used to treat primary RLS do not cure the condition, but only relieve symptoms. People whose RLS symptoms occur sporadically may be prescribed medication to take only when they have symptoms.
The following medications are the most widely prescribed to treat RLS. They may be given alone or, in certain cases, in combination. Your doctor will prescribe the best treatment plan for you.
Can Trazodone Make Rls Worse
Similarly, you may ask, what medications aggravate restless leg syndrome?
certain medications that may aggravate RLS symptoms, such as antinausea drugs , antipsychotic drugs , antidepressants that increase serotonin , and some cold and allergy medications that contain
Beside above, how can I get immediate relief from restless leg syndrome? 5 Doctor-Approved Home Remedies for Restless Legs Syndrome
Beside above, what causes RLS flare ups?
The most common RLS triggers are prescription and over-the-counter medications, Dr. Buchfuhrer says. Because they block dopamine, the worst culprits include: Over-the-counter antihistamines, cold and allergy medications
Do SSRIs make restless legs worse?
The selective serotonin reuptake inhibitors, or SSRIs, are commonly used antidepressants and can be very helpful, even for people who have RLS. These medications worsen RLS, so they should not be used to treat depression or sleeplessness when patients have RLS. Both RLS and depression are treatable.
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Tips For Coping With Restless Legs Syndrome
Learning to recognize and avoid your personal triggers can help you manage RLS over time.
Effective techniques for minimizing RLS symptoms vary from person to person. Many people find relief from keeping active throughout the day and using acupuncture, massage, stretching, or relaxation techniques at night. During the day, you may be able to ward off RLS symptoms by keeping your mind busy even when you are sitting still with activities like reading or chatting to a friend.
Though RLS is not life-threatening, the frustration of not being able to sleep well can take a toll on mental health. Cognitive behavioral therapy, support groups, or reaching out to family and friends may provide additional emotional resources for coping with RLS.
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Articles On Restless Legs Syndrome
Restless legs syndrome, or RLS, is a common nerve condition where you have unpleasant creeping, tugging, or pulling feelings in your legs. You might also have an overwhelming urge to move your legs. The symptoms are usually worse at night or when you’re resting.
Doctors don’t know the cause of RLS, and thereâs no cure. But certain things can trigger symptoms. Knowing your triggers and how to avoid them will help.
Possible triggers include:
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Tips For Better Sleep For Rls Sufferers
The effects of RLS often extend well beyond the acute sensations in a patients limbs. When dealing with prolonged attacks, sufferers are often robbed of a full nights sleep. When researching tips for better sleep, people with RLS will likely encounter a wealth of information and advice about insomniabut what works for insomnia may not work for RLS.The following tricks and tips from doctors and RLS patients can help you get more beauty rest.
Tips from doctors and patients:
- Avoid alcohol and caffeine.
- Change your temperature. Sometimes a switch from hot to cold or vice versa can help. Try alternating warm and cold packs.
- Exercisebut not too much. Exercise to fatigue your muscles is helpful, but too much exercise may trigger your RLS, says Margaret Fieland, who has had RLS for 15 years.
- Take pain relievers. Over-the-counter pain relievers such as Motrin or Tylenol may help if you have mild symptoms.
- Put a bar of soap under the sheets. For unknown reasons, this strange home remedy seems to work for many people who have RLS.
- Keep a sleep diary to identify your triggers. You can find one on the Restless Leg Foundation website, www.rls.org.
Last medically reviewed on July 1, 2012