Restless Legs Syndrome: Seeking Help
Studies estimate that one out of 10 people suffer from restless legs, yet its not always easy to find help and support. Many people with RLS never receive proper treatment. Part of the problem is that its hard to explain and sufferers are often dismissed as being nervous. Those who havent experienced the distressing symptoms may not understand how severely they can impact the quality of your life. Even doctors may not take restless legs seriously, recognize the symptoms, or realize that they point to a real medical condition.
The good news is that recent research has increased our understanding of restless legs syndrome, leading to more effective treatments. At the same time, RLS is becoming more widely recognized. If you or your partner suffers from restless legs, theres never been a better time to find relief.
A night in the life of RLS
If you have restless legs syndrome, a typical night might go like this: You lie down in bed, ready to go to sleep, and just as your body begins to relax, the crawling, tingling, or itching in your legs begin. You try to ignore the uncomfortable sensations, hoping they will go away, but eventually the urge to move is too much. You get out of bed to stretch and pace the floor and, for a moment, you find relief. But when you lie down again, the restless sensations in your legs start all over again.
Repetitive Transcranial Magnetic Stimulation
A noninvasive procedure thats typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising (4, 41,
Repetitive transcranial magnetic stimulation sends magnetic impulses to certain areas of the brain.
Its not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS .
In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended .
Iron Supplementation May Be All It Takes To Reduce Symptoms Of Restless Legs Syndrome But Many Doctors Don’t Know About It
People with restless legs syndrome experience an overwhelming need to move the legs, particularly at night or as they fall asleep. But a simple treatment that may help reduce RLS symptoms is often overlooked as a potential first line of defense.
“The concern is that people are being started on medications first when iron might be a valuable treatment. It’s simple, with relatively few side effects,” says Dr. John Winkelman, an RLS specialist at Harvard-affiliated Massachusetts General Hospital.
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How To Reduce Leg Cramps At Night
Although the exact cause of nocturnal leg cramps is unknown, there are ways to reduce the likelihood that you will experience them. Typically, leg cramps do not indicate a serious health problem. However, if you are experiencing frequent leg cramping, you should reach out to your doctor. You may be able to reduce the likelihood of experiencing leg cramps through:
Hydration: Staying consistently hydrated throughout the day may help reduce the frequency of muscle cramps, since dehydration can cause cramps. Though some research suggests that nocturnal leg cramps are not caused by dehydration, it may help to drink water during long periods of outdoor activity or strenuous activity. There is also research to suggest that drinking pickle juice during a cramping episode helps inhibit the cramp quickly.
Stretching: Doing some stretching or yoga before bed may help you reduce both the frequency and intensity of nocturnal leg cramps. Research suggests that engaging in a stretching routine before bed helps reduce cramps and leg pain after about six weeks.
Baths: Some people claim that taking a bath helps relieve their nighttime cramps, though further research is needed. An epsom salt bath in particular could help reduce muscle pain. Epsom salt contains magnesium sulfate. An epsom salt bath could increase your magnesium levels, which may help relieve leg cramping.
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.
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Surgery For Varicose Veins
Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency , which means your body cant properly circulate blood. As a result, the blood pools in your legs.
In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery .
Again, more research is needed on this surgery as a treatment for RLS.
If youre interested in any of these less-researched treatments, ask your doctor about them. Of course, you can try hot and cold treatments on your own, but your doctor can tell you more about the other treatments and whether they might be able to help you.
Periodic Limb Movement Disorder
Periodic limb movement disorder is also known as nocturnal myoclonus. Characteristics of PLMD include:
- Nighttime episodes that usually peak near midnight .
- Contractions and jerking of the leg muscles every 20 to 40 seconds during sleep. These movements may last less than 1 second, or as long as 10 seconds.
- Movements of PLMD do not wake the person who actually has it, but they are often noticed by their bed partner. This condition is distinct from the brief and sudden movements that occur just as people are falling asleep, which can interrupt sleep.
- Association with RLS: Four out of five people who have RLS also report having PLMD, but only a third of people with PLMD report having RLS.
While treatments for the two conditions are similar, PLMD is a separate syndrome. PLMD is also very common in narcolepsy, a sleep disorder that causes people to fall asleep suddenly and uncontrollably.
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Stretching And Movement Tips To Ease Restless Legs
Take Good Care Of Your Feet
It does not really matter what the cause of the leg pain at night is. You should pay close attention to your feet. This is even more important if the cause is poor circulation. Until blood flow is restored to your feet, you should do your absolute best to avoid any injury to the skin. Even the smallest of wounds can flare up and become infected and spread. For this reason foot care is really important when there is rest pain. Here are a few things you may want to consider:
You may want to read more about foot care.
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What Causes Restless Legs Syndrome
In most cases, the cause of RLS is unknown . However, RLS has a genetic component and can be found in families where the onset of symptoms is before age 40. Specific gene variants have been associated with RLS. Evidence indicates that low levels of iron in the brain also may be responsible for RLS.
Considerable evidence also suggests that RLS is related to a dysfunction in one of the sections of the brain that control movement that use the brain chemical dopamine. Dopamine is needed to produce smooth, purposeful muscle activity and movement. Disruption of these pathways frequently results in involuntary movements. Individuals with Parkinsons disease, another disorder of the basal ganglias dopamine pathways, have increased chance of developing RLS.
RLS also appears to be related to or accompany the following factors or underlying conditions:
- end-stage renal disease and hemodialysis
- iron deficiency
- 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 older antihistamines
- use of alcohol, nicotine, and caffeine
- pregnancy, especially in the last trimester in most cases, symptoms usually disappear within 4 weeks after delivery
- neuropathy .
Sleep deprivation and other sleep conditions like sleep apnea also may aggravate or trigger symptoms in some people. Reducing or completely eliminating these factors may relieve symptoms.
How To Stop Thigh Pain At Night
Is thigh pain at night keeping you awake? There are several causes of nighttime thigh pain, including–muscle strains, charley horse, or restless leg syndrome. Before you can stop your nighttime discomfort, the first step is to identify the cause. Keep scrolling to learn about the most common causes then once youve received a proper diagnosis, try these remedies for nighttime relief.
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Home Remedies For Restless Arms & Legs At Night
Restless arms and legs at night are common symptoms of what is known as “restless legs syndrome.” If you suffer from restless legs syndrome, you typically feel as though something is crawling on or tingling underneath the skin of your arms and legs when you sit or lay down. This results in an overwhelming urge to move your arms and legs and makes it difficult to sleep. There are some things you can do to treat your restless arms and legs at home.
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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Avoid These Before Bed
When it comes to what not to consume, Dr. Berkowski lists the four things you should avoid to help ease your RLS symptoms:
These products are all known to trigger RLS symptoms, Dr. Berkowski says.
Additionally, if you have wheat or dairy allergies but still consume those products, that could also be a source of trouble. What and dairy allergies can cause inflammation which, in turn, cause issues with iron absorption, says Dr. Berkowski, so its something to keep in mind.
What Are The Symptoms Of Rls
RLS produces a set of uncomfort-able sensations, most often in the area of the leg above the ankle but below the knee. Other possible locations include the upper legs, feet, and arms. The discomfort can start during the day when you have been sitting for a long period of time, or at night when you lie down to sleep. It may subside after an hour or so, but it may be present for so long that sleep is disrupted. The discomfort of RLS can be described as an aching, creeping, tingling, crawling, pulling, searing, or bubbling sensation.
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Heat And Cold Therapy
Alternating between hot and cold compresses can help alleviate uncomfortable twitching and aching sensations in the legs caused by RLS. Through the fluctuation of temperature and the pressure of the compresses, you can reduce muscle strain and inflammation, which relaxes the legs and can cause RLS symptoms. Moist heat is preferable to dry heat, so using steam towels or heating packs along with cold gel packs will give you the best results.
Be sure to test the temperature before applying any compresses, especially if you tend to have a loss of sensation/temperature where they are being applied. If your compresses are too hot they can cause skin damage likewise, with cold compresses, limit usage to 15 minutes or less, and always use a wrap or towel so it isn’t directly on your skin.
Make Exercise A Habit
Moderate exercise during the day pays off with better sleep at night. Walk, jog, lift weights, or find any exercise you enjoy. One study found that exercise led to less leg movement and longer and deeper sleep for people with RLS. Be careful not to overdo it. Intense exercise or working out just before bedtime could make your symptoms worse.
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What Can I Do About My Restless Leg Syndrome
Is restless leg syndrome keeping you up at night? Portland and Astoria, OR, sleep medicine specialists Dr. Gerald Rich, Dr. Radhika Breaden and Dr. Gregory Clark share a few tips that will help you cope with RLS.
What is RLS?
RLS causes a creepy, crawly, tingling sensation in your legs that makes it impossible to stay still. Moving relieves the symptoms, but often they occur again as soon as you sit or lie down. Although the annoying symptoms of RLS can occur during the day, people tend to notice them more at night when they’re trying to fall asleep.
Nobody knows why some people get RLS, but the symptoms can be worse if you don’t get enough sleep, drink alcoholic or caffeinated drinks, or use nicotine products. In some cases, RLS can be caused by nerve damage, kidney failure or iron deficiency.
How can I relieve my RLS symptoms?
You may find that RLS symptoms occur less often if you:
If those tips don’t help, give us a call at our Portland or Astoria, OR office. Our sleep medicine specialists can offer recommendations and medications that will help you sleep better and eliminate those unpleasant sensations in your legs.
Restless leg syndrome treatment can relieve your discomfort. If you’re troubled by RLS, schedule an appointment with sleep medicine specialists Dr. Gerald Rich, Dr. Radhika Breaden and Dr. Gregory Clark by calling 325-3126 for the Astoria, OR, office or 228-4414 for the Portland, OR, office.
Avoid Alcohol And Cigarettes
Alcohol and cigarettes can bring on the symptoms of RLS and harm your sleep in other ways, too. A drink may make you drowsy at first, but you’re more likely to wake up during the night or have poor sleep that doesnât leave you feeling rested. The nicotine in cigarettes is what triggers RLS symptoms, so avoid cigars, “chew,” and any other tobacco products.
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Treatment For Restless Legs Syndrome
If your RLS is mild, taking a hot bath, massaging your legs, exercising, eliminating caffeine, and using an ice pack and/or a heating pad may be suggested as options to help alleviate your symptoms. Medication may be prescribed to control symptoms for people with more severe cases of RLS. Some medications may lose their effectiveness when used nightly, so your doctor may want to alternate different medications to prevent them from giving you diminishing relief from your symptoms.
Medications For Restless Legs Syndrome
- Benzodiazepines depress the central nervous system and allow many patients to obtain sleep, even though they may not suppress the RLS sensations or jerking movements. People with sleep apnea should not use benzodiazepines.
- Dopaminergic agents, often used to treat symptoms of Parkinson’s Disease, can be effective for RLS and PLMS. These medications may reduce the symptoms of RLS and leg movements during the night.
- Opioids, or relaxing, pain-killing drugs, can help suppress symptoms of RLS in some patients. Patients with severe symptoms have found relief by using opioids.
Nighttime And Sleep Tips To Ease Restless Legs Syndrome