Restless legs syndrome is a brain (neurological) disorder described as an irresistible urge to move your body to make strange or uncomfortable sensations stop. It actually sounds worse than it is. It’s also known as Wittmaack-Ekbom syndrome or Willis-Ekbom disease. It mostly affects your legs, but can also affect your arms, head, and body. When you move your body, it provides temporary and symptomatic relief. The more you move, the more relief you feel.
There are two types: primary and secondary. The exact cause of primary restless legs syndrome is unknown. Secondary restless legs syndrome is mostly associated with renal disease, Parkinson disease, and pregnancy.
What causes restless legs syndrome?
While the exact cause of this condition is still largely unknown, researchers have found that the symptoms are associated with poor dopamine function in the brain. A small study also found that hydrocortisone treatment (used for inflammation) improved the symptoms of restless legs syndrome which suggests that this syndrome has an inflammatory component.
Who gets it?
Restless legs syndrome is more common among elderly females. It can have a genetic basis, meaning if you have it, a first-degree relative may also have it. Risk factors for restless legs syndrome include diabetes mellitus, anaemia (iron deficiency), Parkinson’s disease, pregnancy and people undergoing haemodialysis. You increase your chances of developing it if you have any of those conditions.
How common is restless legs syndrome?
This syndrome is more common among Europeans (around 10% of their population) and East Asians (as high as 12% of their population).
Clues that indicate you that you may have restless legs syndrome:
Unpleasant sensation in the legs (called dysesthesia). It’s frequently described as a creepy-crawling sensation occurring on both your legs. Your arms can also be involved.
As long as you move your legs (or arms), you have a sense of relief.
Your symptoms are worse in the evening or at night. Which may keep you awake until the early morning hours.
On a deeper level (criteria your doctor uses), you may have restless legs syndrome (RLS) if you have the following:
Criteria used to Diagnose Restless Legs Syndrome
Desire to move your legs normally with paresthesias (abnormal tingling or pricking sensation)
Restless legs often shown as leg rubbing, stretching, flexing or floor pacing
Worst at night
Relieved by movement or activity, and worse at rest
Involuntary movements, such as of the legs, during sleep or while awake
Disturbed sleep, usually difficulties getting to sleep and maintaining sleep with daytime drowsiness and fatigue.
Family history – ⅓ of cases are autosomal dominant
Normal neurologic examination with idiopathic restless legs syndrome
Syndrome may start at any age, but is worst in middle and older age groups
Pharmacologic therapy. Doctors use dopaminergic drugs to improve your sleep and minimise your movements. The dopamine agonists are the first-line drugs used to treat restless legs syndrome. Also, an anticonvulsant medication (known as Gabapentin) has been found to be effective in several studies. Methadone (an opiate) serves as a last line of treatment.
Nonpharmacological treatment. Here are some natural options to take a look at:
Practice good sleep hygiene so that you’re getting enough sleep each night and that you get quality sleep.
Avoid drinking alcohol and smoking cigarettes.
Follow an anti-inflammatory diet which is low in sugars, grains and starches with plenty of nutrient-rich fresh vegetable, quality protein and good fats. Avoid most vegetable oils as they are rich in omega-6 which promotes inflammation with the exception of olive oil and coconut oil. Butter and other animal fats are also fine.
Poor gut health is a common cause or contributor to systemic inflammation. So if you experience any gut symptoms like bloating, gas, discomfort, indigestion, diarrhea or constipation see a Naturopath to help you heal your gut.
Indulge in daily physical (exercise) and mental activities (reading, writing, etc.) to keep you active.
Identify the stressors in your life and deal with them properly to reduce stress levels.
Use relaxation techniques to release tension – warm baths, massages, hot and cold compresses, yoga. In one study yoga helped to improve symptoms of RLS, reduce stress and aid sleep.
Vitamins and minerals.
Iron – Iron deficiency anaemia is well known to contribute to RLS because iron is needed for healthy dopamine signaling in the brain. But you shouldn’t take iron unless you need it, so get your iron levels checked by your doctor first.
Vitamin D – Deficiency of this vitamin has also been linked to impaired dopamine function in the brain. In one study, symptoms of RLS improved with vitamin D supplementation.
Vitamin C and E – Supplementation of these helps to reduce oxidative stress which is present when RLS is secondary to another condition like renal disease.
Magnesium – You need plenty of this mineral for your muscles to relax properly. So not surprisingly it’s one of the first nutrients recommended for RLS. Magnesium also helps you to relax at night ready for sleep and aids in stress management.
Electrolytes – Make sure you’re getting enough of the other electrolytes ( sodium, potassium, chloride, phosphorus, calcium) too. These are important for healthy fluid balance.
Restless legs syndrome may seem scary at first, but the symptoms can be managed. Pharmacologic and nonpharmacological treatments are available. If you feel you might have it, consult your healthcare practitioner.