RLS – Restless Leg Syndrome
Written by Brenton Wight – LeanMachine
What is restless legs syndrome (RLS)?
This is a nervous disorder, affecting around 10% of the population, but more prevalent among middle aged or older people.
Up to 40% of women experience at least some mild symptoms during pregnancy, which usually passes at end of term.
Significantly affects more women than men, even allowing for the pregnancy factor.
Often interrupts sleep, so is also considered a sleep disorder.
Stress, pregnancy, heredity, hormonal changes, diabetes, Parkinsons disease, heart, lung, circulatory problems, arthritis and kidney failure are among the many trigger factors.
Smoking, caffeine and alcohol tend to increase symptoms.
Deficiency in iron, magnesium, folate, B-group vitamins can cause or aggravate RLS.
Problems mainly occur at night, but some patients can have symptoms at any time.
Sitting, relaxing, resting, or lying down tends to bring on symptoms, and moving, stretching, or massaging the legs tends to diminish symptoms.
Some people with RLS also have PLMD – Periodic Limb Movement Disorder. This is a sleep disorder where repetitive cramping or jerking of the legs occurs during sleep.
If the condition does not improve, most patients eventually start suffering from other chronic health issues due to lack of sleep. People with sleep disorders have a 65% greater risk to develop cancer.
Symptoms vary between patients, which is why it is often difficult to diagnose, but can include:
- Itchy feeling
- Pins and needles sensation
- Creepy crawly feeling, as if something is crawling on or under the skin
- Prickling, tingling, tugging, burning or aching sensations
- Uncontrollable need to move legs
- Legs jumping, jerking or twitching uncontrollably
- Uncomfortable sensations deep within the legs
- Feeling like a fizzy soda is bubbling through the veins
- Feeling an itch deep within the bones
- Some symptoms occur in the arms as well as the legs
- Some patients only have symptoms after stressful events, some have it every night
Causes of RLS
Officially, the cause is unknown and there is no cure.
Possibly an imbalance of dopamine, which transmits signals between nerve cells in the brain.
Some say that abnormal iron uptake by the brain may cause or aggravate RLS.
Around 60% of sufferers have other family members with the same condition.
Those consuming diet soft drinks have greater risk of RLS because these drinks leach potassium from the body. Potassium is imperative for correct nerve function, as well as all of the other electrolytes. Food sources of potassium include bananas, avocados, spinach, sweet potato, yogurt and more.
As well as helping with restless legs, potassium will help lower blood pressure and build strong bones.
There is no official cure, but doctors often prescribe Ropinirole, which can make symptoms better or worse, and side effects such as dizziness, fainting, severe nausea, narcolepsy, hallucinations and addictive behaviors can be very serious.
A study at Brigham and Women’s Hospital in Boston found that patients with restless leg syndrome have a 40% percent higher risk of death in the next eight years.
Some prescription drugs may mask symptoms, but side-effects may make the condition worse in the long run.
Speak to the doctor about medication.
If snoring or breathing is a problem, the doctor can organise a “sleep study” as a CPAP machine may improve health, lower blood pressure, and supply oxygen that the patient may be missing.
The doctor may simply refer patients to a sleep disorder clinic, as these specialists deal with RLS regularly.
Some doctors recommend dopaminergics, benzodiazepines, or opioids.
Medical conditions such as iron deficiency, diabetes, or nerve damage may be aggravating RLS, so treatment of the underlying problem may reduce symptoms.
If there is no underlying condition and all else fails, some prescription medication may help to reduce symptoms.
Medication works for some people, aggravates it for others, and several types may have to be tried for best results.
Prescription medications which initially work may become less effective over time.
Some side effects include nausea, headache, daytime sleepiness, and may increase risk of compulsive disorders like gambling, binge eating, shopping, etc.
Parkinsons medication may help with RLS – pramipexole (Mirapex), ropinirole (Requip), rotigotine transdermal system (Neupro), Sinemet (carbidopa/levodopa), cabergoline and pergolide.
Side effects of Parkinsons medications include nausea, lightheadedness, fatigue, and an increased risk of heart disease.
Prescription painkillers like Codeine, Oxycodone, Vicodin, Percocet, etc can provide relief in severe, unrelenting cases of RLS, but these can be addictive.
Side effects include nausea, dizziness, constipation, and can cause other problems, and the effect wears off over time, often leading the patient to over-dose.
Sleep medications and muscle relaxants such as Ambien, Sonata, Klonopin may help those whose RLS keeps them awake all night, but do not help the leg twitching, and can cause daytime drowsiness.
Anti-seizure medications such as Neurontin, Tegretol, Epitol may help painful daytime symptoms, but side effects include dizziness and drowsiness.
Obviously, pregnant women should always avoid prescription medication where possible.
Medications that can make RLS worse
The doctor should review all medications you are taking. Some prescription and over the counter drugs can aggravate RLS. Some known medications to watch out for are:
- Over-the-counter sleeping pills
- Antihistamines – found in allergy and many cold meds like Benadryl, NyQuil, Dimetapp
- Anti-nausea medications – like Antivert, Compazine, Dramamine
- Calcium channel blockers (drugs for heart and high blood pressure)
- Antidepressants such as Prozac, Effexor, Lexapro
- Antipsychotics – used for bipolar disorder and schizophrenia
The Leg Wrap Cure
This natural treatment is more effective than any drug, according to the Lake Erie Research Institute in Pennsylvania.
Researchers created a leg/foot wrap which places pressure on two foot muscles: The abductor hallucis and the flexor hallucis brevis. The wrap was used in an eight-week clinical trial of 30 moderate RLS patients, with great results. 90% of the participants using the leg wrap experienced improvement in their symptoms, while only 63% of those taking Ropinirol found improvement. Those using the leg wrap reduced sleepless nights by 82%.
The wrap is believed to be more effective in the way it targets the two muscles known to ease RLS symptoms, and because this causes the brain to release dopamine. RLS sufferers are thought to have a dopamine deficiency.
Conventional leg wraps, physiotherapy, acupuncture or massage directed at these muscles, all appear to have the same benefits.
- Exercise every day – walk, swim, aerobic, yoga, pilates, tai chi, but avoid very strenuous exercise
- Calf stretch – with hands against a wall, bend the right knee, step the left leg back with foot flat on the floor to stretch the calf muscle, hold for 20 seconds, switch legs and repeat
- Front thigh stretch: grab an ankle and pull toward the buttock, keeping the other leg straight, hold for 30 seconds, switch legs and repeat
- Hip stretch: place the left foot on a chair with the knee bent, keeping the back straight, press the pelvis forward to stretch the top of the right thigh, hold for 30 seconds, switch legs and repeat
- Cut back or give up caffeine, smoking and alcohol
- Wear warm socks to bed
- Wearing compression stockings to bed
- Get sunlight during the day and sleep in a pitch-black room or wear a mask – helps the circadian rhythm required for a good sleep
- Leg massage, any time through the day, but most important before bed
- Acupuncture (do not be afraid of needles – it might just work!)
- Avoid intense exercise before bedtime
- Losing excess weight will reduce symptoms – cut back on carbohydrates, processed foods and trans fats
- Change ergonomics, changes such as working from a high stool allowing legs to dangle
- Let co-workers, friends and family know why you must keep moving so they can help create a healthy environment at work and home
- Sit in an aisle seat during movies, meetings, aircraft etc, allowing periodic walking around
- Get adequate sleep – always a problem when sleep is interrupted
- Improve sleep patterns: try a consistent bed time, or sleep later in the morning
- Aromatherapy: Lavender, eucalyptus or other oils in the bedroom can help sleep
- Drink plenty of water, sipped slowly throughout the day and evenings to prevent dehydration of muscles
- Take a hot (hot as you can stand it) shower just before bed, scrubbing legs vigorously
- Have more sex! Orgasm releases natural dopamine and opioids which can help calm the legs
- Slowly slide the leg back and forth on the bed for a few minutes and repeat with the other leg. May help relieve jumping
- Leg lunge exercises at bedtime, but be careful not to overdo it. More intense lunges are better earlier in the day
- Menthol creams such as Tiger Balm or Vicks Vapor Rub, rubbed into the legs before bed
- Balance electrolytes: sodium, potassium, calcium, magnesium, chloride, phosphate. Read the electrolyte section in my Blood Tests article
- A hot soak in the bathtub with Epsom salts, apple cider vinegar or baking soda, before bed
- Relaxation, meditation, deep breathing and other stress-reducing activities
- Apply hot or cold packs to the legs. Alternating between hot and cold can help
- Sleep with a pillow between the legs to help prevent compressing leg nerves
- Keep a sleep diary for RLS symptoms – this will help determine which foods or activities aggravate symptoms
- Muscle relaxation, deep breathing and meditation at bedtime – see below
Muscle relaxation and breathing
Breathe deeply for a few minutes to oxygenate the lungs (breathing out fully is just as important as breathing in).
Tense the muscles in the feet and hold for a few seconds.
Breathe deeply again, and do the same with the calf muscles, and repeat with the thigh muscles.
Repeat with the other muscles all the way up to the neck.
The major muscle groups should now be more relaxed and oxygenated.
Fatigue can worsen the symptoms of RLS, so getting enough sleep is vital.
Regular exercise: If push-ups or squats do not appeal, then tennis, swimming, bowls, dancing, zumba, tai-chi, pilates, yoga, walking are a few more pleasant options.
Hit the sack at the same time every night, (or try warm baths before bed, or reading in bed) allowing plenty of time for winding down.
A warm bath with half a cup of Epsom Salts in the water can increase magnesium intake through the skin, avoiding diarrhea which can be the result of taking too much magnesium in supplement form. Magnesium also helps lower blood pressure, improve the cardiovascular system, and improve all nerve conditions.
Avoid TV, bright lights, etc for an hour or more before bed time.
Get support from family members. It will not hurt them to follow the same routine.
Reduce stress. Engage in a hobby, craft, or any pleasing activity can help calm down the nerves, and help forget the stressful events of the day, preferably something not involving sitting for long periods.
Supplements which can help RLS
- A tablespoon of apple cider vinegar in water at bedtime (or ACV capsules if the taste is a problem)
- 5-HTP before bed can help calm the legs and improve sleep quality
- Magnesium supplements 400 to 600mg daily – also helps diabetes, blood pressure, etc
- vitamin D3 also builds bones, improves immunity
- vitamin K2 to keep calcium in bones and out of blood vessels
- MSM – (Methylsulfonyl Methane) – to reduce inflammation and pain, improve nerves, increase pain tolerance
- Vitamin B-Group for nerve health
- Active Vitamin B12 for extra nerve health
- Active Folate essential for nerve function
- Iron – ONLY after a blood test showing deficiency, and NEVER overdose!
- Valerian may help get a better night’s sleep
- Vitamin E may improve symptoms
- D-ribose 5 grams powder once daily for prevention, 3 daily for treatment
- Potassium and Iodine Potassium deficiency is not uncommon, especially in hot weather. Many prescription drugs deplete potassium
Over-the-counter pain relievers may reduce symptoms temporarily, but long-term make the body more sensitive to pain.
Paracetamol (Panadol), known in the USA as Tylenol or Acetaminophen all deplete Glutathione, the body’s master antioxidant. Even small doses may damage the liver.
The recommended 8 pills per day (500mg each) has now been reduced to 6 per day, but anyone in severe pain invariably overdoses, so it is best not kept in the house!
It is estimated that 90% of those on the liver transplant waiting list are there because of Paracetamol overdose!
If you have children, note that in Cuba, where Panadol/Tylenol cannot be bought off-the-shelf, Autism cases are less than 1 in 12,000 compared to the USA at 1 in 50, and Australia very close to the USA.
A few decades ago, Autism cases were 1 in 100,000. Perhaps some were not diagnosed, but the increase is still alarming. If one were to include cases of ADD, ADHD, hyperactivity, etc in with the Autism count, it is 1 in every 10 new births!
No double-blind studies have been carried out to prove or disprove the relationship, but LeanMachine requires no further evidence to make a logical conclusion.
More info at www.leanmachine/catalog/articles/autism-spectrum-disorder.php
Aspirin is now proven to cause deadly side effects such as intestinal bleeding.
Supplements to NOT take
Surprisingly, Melatonin supplements (well-known for improving sleep) may aggravate leg movements in those with restless legs syndrome.
Caffeine, alcohol, SSRI antidepressants, antihistamines, and most antipsychotic and antinausea medications can potentially increase symptoms.
Also be aware that RLS can occur as a result of kidney or liver disease. People with these conditions should consult with a healthcare professional before taking supplements
All information here is for education only.
There is no intention to provide medical advice.
LeanMachine no longer sells supplements, but links to the best suppliers are available in our LeanMachine Supplement site.
The information provided is completely independent. Most products can easily be purchased world-wide at health stores, chemists, supermarkets, etc.
LeanMachine cannot take responsibility for any consequences from any treatment, supplement, procedure, exercise, diet, etc resulting from reading or following this information.
This information does not replace the advice of your physician or other health care provider. It is only intended to aid the reader to arriving at a better understanding so that a better outcome with the health provider may be hopefully achieved.
The reader should seek the advice of their physician or other health care provider before undertaking any course of treatment, supplementation or medication.
LeanMachine is not a doctor, and everyone should consult with their own health professional before taking any product to ensure there is no conflict with existing prescription medication.
LeanMachine has been studying nutrition and health since 2011 and has completed many relevant studies including:
Open2Study, Australia – Food, Nutrition and Your Health
RMIT University, Australia – Foundations of Psychology
Swinburne University of Technology, Australia – Chemistry – Building Blocks of the World
University of Washington, USA – Energy, Diet and Weight
Johns Hopkins Bloomberg School of Public Health, USA – Health Issues for Aging Populations
Johns Hopkins Bloomberg School of Public Health, USA – International Nutrition
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics I
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics II
Johns Hopkins Bloomberg School of Public Health, USA – Principles of Human Nutrition
TUFTS University, USA – Nutrition and Medicine
TUFTS University, USA – Lipids/Cardiovascular Disease I and Lipids/Cardiovascular Disease II
Technical Learning College, USA – Western Herbology, Identification, Formulas
Bath University, England – Inside Cancer
WebMD Education – The Link Between Stroke and Atrial Fibrillation
WebMD Education – High Potassium: Causes and Reasons to Treat
Leiden University Medical Center, Netherlands – Anatomy of the Abdomen and Pelvis
MIT (Massachusetts Institute of Technology) – A Clinical Approach to the Human Brain
LeanMachine has now examined thousands of studies, journals and reports related to health and nutrition and this research is ongoing.
Updated 22nd September 2019, Copyright © 1999-2019 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285