What is restless legs syndrome?
Restless legs syndrome (RLS), is also known as Willis-Ekbom disease,and is a condition that creates uncomfortable sensations, most often in the legs. These sensations have been noticed as tingly, crawling, creeping feelings, and cause the overwhelming urge to move the affected limb.
RLS symptoms typically happen when the person is sitting, resting, or sleeping, and often happen at night. The movements cause by RLS are called periodic limb movements of sleep (PLMS). Due to these movements, RLS can cause serious sleep issues.
Some people have primary RLS, which has no known cause. Others have secondary RLS, which is typically associated with nerve problems, pregnancy, iron deficiency, or chronic kidney failure.
For most people with RLS, signs are mild. But if your signs are moderate to severe, RLS can have a big impact on your life. It can prevent you from sleeping enough, and thus cause problems with daytime focus and thinking, your job, and your social activities.
As a result of these problems, RLS can lead to anxiety and depression. And the longer you have the situation, the worse it can obtain. And It can even spread to other parts of your body, such as your arms (1).
READ ALSO:22 SIMPLE WAYS TO GET HEALTHIER WITH REDUCED EFFORT
Because of the effects RLS you can have on your life, treatment is significant. Methods of treatment are varied, as the root cause of RLS isn’t truly known. case in point, some researchers suggest that RLS is caused by problems with the brain chemical dopamine, while others suggest that it’s related to poor circulation.
And here we list the best treatments for RLS. Some of these you can try on your own. Others you can talk about with your doctor, who can help you generate a treatment plan to help relieve your RLS symptoms.
RULING OUT CAUSES
1. Ruling out potential causes
Your first steps in addressing RLS should be to figure out if something is causing it. at the same time as RLS can be related to things that are largely out of your control, such as genetics or pregnancy, other possible factors can be addressed.
These reasons could be daily habits, medications you’re taking, health conditions you have, or other triggers.
The use of caffeine, alcohol, and tobacco can increase RLs symptoms. Limiting these substances could help lessen your RLS symptoms (2).
- older antihistamines such as diphenhydramine
- antinausea drugs such as metoclopramide or prochlorperazine
- antipsychotic drugs such as haloperidol or olanzapine
- selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, or escitalopram
- tricyclic antidepressants such as amitriptyline or amoxapine
Ensure your doctor knows about all drugs you’re taking, both prescription and over the counter. Speak with your doctor about whether they could be making your RLS worse, especially if you’re taking any of the medications listed above.
Certain health conditions have been found to be related to RLS. End-stage renal (kidney) disease, or ESRD, and nerve damage from diabetes have been linked with RLS. Iron deficiency anemia also has a strong connection with RLS (see iron below) (4, 5, 6).
You should talk to your doctor how your health history might impact your RLS, especially if you have any of these conditions.
Some people feel that eating lots of sugar or wearing tight clothing heighten their RLS symptoms. While there’s not a lot of research to back up these connections, you may want to do some trial-and-error to see what seems to affect your own symptoms and signs.
BOTTOM LINE:The first step in treating RLS should be finding out if something is causing it. You should consider habits such drinking alcohol or smoking, certain medications or health conditions, and other triggers for their impact on your RLS symptoms.
2. Healthy sleep habits
Having good sleep habits is advisable for anyone, but perhaps especially for people who have trouble sleeping, such as those with RLS.
While sleeping better may not resolve your RLS signs, it could assist you offset the sleep loss you suffer from your condition. Try the following tips to make your sleep as restful and restorative as possible.
- Go to sleep and wake up at the same times every day.
- Keep your sleep area cool, quiet, and dark.
- Keep distractions, such as the TV and phone, to a minimum in your bedroom.
- Avoid electronic screens for the two to three hours before you go to sleep. Blue light from these screens can throw off your circadian rhythm, which helps you keep a natural sleep cycle (7).
BOTTOM LINE:While they may not resolve your RLS signs, healthy sleep habits can improve your sleep and may help offset some of the effects of RLS.
3. Iron and vitamin supplements
A simple blood test can check for iron deficiency, so if you think this could be an issue for you, talk to your doctor.
If you test positive for iron deficiency, your doctor may recommend oral iron supplements, which you can find at your local pharmacy. In some situations, intravenous (IV) iron might be required (1, 8).
In addition, vitamin D deficiency could be associated with RLS. A 2009 study found that vitamin D supplements reduced RLS symptoms in people with RLS and vitamin D deficiency (9).
BOTTOM LINE:Supplementation with iron or vitamins D, C, or E can help certain people with RLS. Your doctor can tell you if trying supplements would be a good idea for you.
Exercise can assist you feel better if you have RLS.
The National Institutes of Health states that moderate exercise may help ease mild RLS symptoms (3).
And a 2006 study of 23 people also with RLS found that aerobic exercise and lower body resistance training, done three times per week for 12 weeks, significantly decreased RLS symptoms (11).
Given these studies, plus others showing that motion can help improve sleep, exercise seems a natural fit for people with RLS (13).
One recommendation from the fidgety Legs Foundation — exercise in moderation. Don’t work out to the point of aches and pains, as this could make your RLS symptoms worse (14).
BOTTOM LINE: Given its advantages for reducing RLS symptoms and improving sleep, regular exercise is a good habit to develop for people with RLS.
5. Yoga and stretching
Like other kinds of exercise, yoga and stretching exercises have been shown to have benefits for people with RLS (12).
A 2013 eight-week study of 10 women discovered that yoga helped reduce their RLS symptoms. It also assisted improve their mood and reduce their stress levels, which could in turn improve their sleep. And a 2012 study indicated that yoga improved sleep in 20 women with RLS (15, 16).
Another study indicated that stretching exercises made significant improvements in the RLS symptoms of people on hemodialysis (17).
It’s not entirely clear to researchers why yoga and stretching works, and more research would be beneficial. But given these results, you might want to add some calf and upper leg stretches to your daily exercise routine.
BOTTOM LINE: Although it’s not very sure why, yoga and other stretching exercises could help relieve RLS symptoms.
Massaging your leg muscles could assist ease your RLS symptoms. Many health organizations, such as the National Institutes of Health and the National Sleep Foundation, suggest it as an at-home treatment (3, 18, 19).
Although there’s not a lot of other study that backs up massage as an RLS treatment, a 2007 case study illustrated its benefits.
A 35-year-old woman who had 45-minute leg massages twice a week for three weeks had improved RLS signs throughout that time period. Her massages included a range of techniques, including Swedish massage and direct pressure to leg muscles (20).
Her RLS symptoms reduced after two massage treatments, and didn’t start to return until two weeks after the massage regimen ended (20).
The author of that study suggested that the heighten release of dopamine caused by massage could be a reason for the benefits. Also, massage has been shown to improve circulation, so that might be a reason for its effects on RLS (20, 21, 22).
As an added bonus, massage can assist in relaxation, which could help improve your sleep.
BOTTOM LINE:Whatever the reason, leg massage is an easy and relaxing treatment that could help ease your RLS symptoms.
7. Prescription medications
Medication is a key treatment for moderate to severe RLS. Dopaminergic drugs are typically the first medications prescribed. They’re effective in relieving RLS symptoms, but they can create side effects and other problems (1).
Other types of drugs can also help relieve RLS signs without causing these same types of problems.
Dopaminergic drugs increase the release of dopamine in your brain. Dopamine is a chemical that helps assist normal body movements (1).
Dopaminergic drugs likely assist relieve RLS symptoms because the condition is associated with issues in the body’s production of dopamine.
Three dopaminergic medications have been approved by the U.S. Food and Drug Administration (FDA) to treat moderate to severe primary RLS:
While dopaminergic drugs have been recorded to help improve RLS symptoms, long-term use can actually worsen symptoms. This phenomenon is called augmentation. To help delay this issue, doctors typically prescribe the lowest possible dose of these drugs (1, 26).
In addition, these drugs can become less effective over time. To help delay or keep both of these problems, your doctor may prescribe a combination of dopaminergic drugs with other types of drugs to treat RLS (1).
A fourth drug that’s been approved by the FDA to treat RLS is known as gabapentin (Horizant). This is an antiseizure medication (27).
It’s not entirely clear how gabapentin works to relieve RLS symptoms, but studies indicate it to be effective (28).
In one study, 24 people with RLS were treated with gabapentin or a placebo for six weeks. Those treated with gabapentin had improved sleep and reduced leg movements from RLS, while those treated with a placebo did not (28).
Another research compared the use of gabapentin with the use of ropinirole (one of the drugs approved by the FDA to treat RLS). Eight people with RLS trialed each of the drugs for four weeks, and both groups got similar levels of relief from RLS symptoms (29).
Benzodiazepines are drugs meant to treat anxiety and sleep problems. Clonazepam and other types of these drugs are often recommended for people with RLS in combination with other drugs (30).
While these drugs may not relieve RLS symptoms themselves, their benefit of improved sleep can be very useful people with RLS (30).
Opioids are typically used to treat pain. In some situation, usually when other medications aren’t helpful or cause augmentation, opioids can be used carefully in low doses to assist treat RLS (26, 8).
Prolonged-release oxycodone/naloxone is one opioid that could assist relieve RLS symptoms and improve sleep (4). However, because of the newer guidelines being developed for the use of opioids, this should be a last resort.
As with all opioids, use of these drugs should be carefully directed by a doctor, due to their risk of misuse and dependence.
BOTTOM LINE:If you have moderate to severe RLS, your doctor will likely suggest one or more medications. Dopaminergic drugs are typically a primary RLS treatment, but they can create side effects and augmentation, so their use must be managed carefully.
8. Foot wrap (restiffic)
A foot wrap has been indicated to help relieve RLS symptoms.
Called restiffic, the foot wrap mounts pressure on certain points on the bottom of your foot. The pressure sends messages to your brain, which responds by telling the muscles affected by RLS to relax. This helps relieve your RLS symptoms (31).
A 2013 study of 30 people using the foot wrap for eight weeks discovered significant improvements in RLS symptoms and sleep quality (32).
The restiffic foot wrap is offered by prescription only, and per the company’s website, it costs about $200. It may or may not be covered by your insurance (31).
BOTTOM LINE:The restiffic foot wrap wants a prescription and an initial monetary investment, but could provide RLS relief by applying pressure on certain points on the bottom of the foot.
9. Pneumatic compression
If you’ve ever stayed overnight in the hospital, you may have had pneumatic compression. This treatment makes use of a “sleeve” that goes over your leg and inflates and deflates, gently squeezing and releasing your limb.
In the hospital, a pneumatic compression device (PCD) is typically meant to improve circulation and prevent blood clots. Improved circulation might also be the reason pneumatic compression has been indicated to help relieve RLS symptoms (33).
Some researchers believe that a cause of RLS is low oxygen levels in the limbs. They think that the body responds to this problem by increasing circulation through the muscle contractions that occur when the person moves their limb (33).
Whatever the reason, some research has indicated that pneumatic compression can assist relieve RLS symptoms.
A 2009 study of 35 people who used a PCD for at least an hour every day for a month had markedly improved RLS symptoms, sleep quality, and daytime function. However, other study has not shown the same effects (33, 34).
BOTTOM LINE:A PCD is a non-drug treatment that can be bought over the counter or with a prescription. It could assist relieve RLS symptoms by improving circulation in your legs. Results from research on this device have been conflicted.
10. Vibration pad (Relaxis)
A vibrating pad known as the Relaxis pad may not relieve your RLS symptoms, but it could assist you sleep better (4).
You use the vibrating pad while you’re at rest or sleeping. You keep the pad on the affected area, such as your leg, and set it to the desired vibration intensity. The pad vibrates for 30 minutes and then shuts itself off (33).
The idea behind the pad is that the vibrations provide “counterstimulation.” That is, they override the uncomfortable sensations caused by RLS so you feel the vibrations instead of your symptoms (33).
There’s not a lot of research offered on the Relaxis pad, and it hasn’t been shown to actually relieve RLS symptoms. However, it has been shown to improve sleep (33).
In fact, one study found it to be as effective in improving sleep as the four FDA-approved RLS drugs: ropinirole, pramipexole, gabapentin, and rotigotine (36).
The Relaxis pad is available only by prescription from your doctor. Per the company website, the device is not covered by insurance, and it costs a little over $600 (37).
BOTTOM LINE:The vibrating Relaxis pad wants a prescription and costs over $600. It may not treat actual RLS symptoms, but its counterstimulation effects could help you sleep better.