Imagine that it’s the end of a long day. Just as you unwind for the evening, your legs begin to throb, tingle, and squirm. As the agitation grows, you find yourself shaking, rubbing, and stretching your legs for relief.
You’re tired. Your mind wants to rest, but your legs must move.
This is what it’s like to live with Restless Leg Syndrome (RLS)—a condition that affects between 10 and 15 percent of Americans.
There is no test for RLS, but doctors use four basic criteria to diagnose it:
- An overwhelming desire to move limbs (mostly legs) due to tingling or pain.
- Symptoms are worse at night, but are usually gone by morning.
- Rest and relaxation triggers agitation.
- Movement relieves symptoms.
RLS affects more women than men, and more adults than children, but no one is quite sure what causes it.
While the irresistible urge to move your tired limbs can be an annoying symptom, the biggest problem with RLS is a lack of sleep. The condition was first described in 1672 by English physician Sir Thomas Willis. According to his observations, symptoms would become so severe that sufferers would be “no more able to sleep than if they were in a place of the greatest torture.”
Once the RLS sufferer finally falls asleep, symptoms may still persist. According to the National Institute of Neurological Disorders and Stroke, More than 80 percent of people with RLS also experience “involuntary leg twitching or jerking movements during sleep that typically occur every 15 to 40 seconds, sometimes throughout the night.”
Desperate for sleep, RLS sufferers often turn to sedatives (benzodiazapenes), painkillers (opioids), even anti-convulsive drugs to stop the incessant agitation.
The only approved remedy for RLS is dopaminergic antagonist drugs—the same drugs used to treat Parkinson’s and Tourette syndrome.
These drugs, which include brand names such as Requip, Miraprex, and Neupro, provide relief but they come with a price. Hallucinations are a common side effect, and users are cautioned against driving, operating heavy machinery, and climbing ladders.
Dopaminergic drugs address RLS symptoms by influencing brain chemistry—specifically dopamine. Clinical and laboratory evidence indicates that dopamine plays a major role in RLS. However, dopaminergic drugs may only be a short-term fix.
According to a May 2015 newsletter from Harvard Medical School, dopaminergic drugs lose effectiveness over time. Many see symptoms return or worsen with continued use. Some may also develop an obsessive attraction to gambling or shopping until they stop taking the medication.
Thankfully, most are able to manage their symptoms without drugs.
Although RLS has been around for centuries, widespread acknowledgement of a syndrome is rather recent. Swedish physician, Dr. Karl-Axel Ekbom was the first to give RLS a name in 1945, but it’s only been in the last 20 years or so since the concept has reached the general public.
Traditional healers didn’t have specific remedies for RLS, but they were certainly familiar with similar symptoms.
In traditional Chinese medicine, for example, restless limbs are a symptom of internal wind—diseases which cause excessive movement. Today, many turn to acupuncture for RLS relief. A 2011 study found that those on dopaminergic drugs were able to stop or significantly reduce their medication with acupuncture treatment.
Massage, chiropractic, and certain yoga poses may also help address RLS symptoms.
In a review of RLS in the Journal of American Herbalist Guild, Erin Holden discusses herbs that “may demonstrate pharmacologically relevant actions.”
Holden recommends herbs known to sedate and relax. Her list includes St. John’s wort, skullcap, black cohosh, passion flower, valerian, and lobelia. But herbs that address inflammation (like turmeric) and encourage circulation (like cayenne) may also help.
Trends and Deficiencies
While a definitive cause for RLS remains elusive, researchers have mapped several interesting trends. For example, many patients undergoing kidney dialysis experience RLS, and may later see RLS symptoms disappear after a transplant. Incidents of RLS are also prevalent among those with low thyroid function, diabetes, and attention deficit disorder.
Pregnant women often develop RLS, but it usually disappears a month or so after giving birth. Some suggest that the later stages of pregnancy puts extra pressure on the spine, compromising nerves, which directly affect the legs.
RLS symptoms also seem to correlate to specific vitamin and mineral deficiencies, and many find relief with supplements or dietary changes. Iron tends to be the most common deficiency with RLS, but folic acid and magnesium may also play a significant role. Some research has shown that extra Vitamin D can relieve symptoms. Other evidence supports the need for more Vitamin C and E.
So far, there is no magic bullet for RLS, but certain habits tend to trigger symptoms, such as caffeine, tobacco, and alcohol. Over-the-counter allergy medication and sleep aids, as well prescription antidepressants have also been identified as RLS triggers.
Experts said cultivating better sleep habits can also reduce symptoms. Aim for a consistent bedtime every night, even on weekends. Get up at the same time too. Make sleep a priority.
Finally, give your legs the movement they crave, just earlier in the day. Evidence suggests that a sedentary lifestyle contributes to RLS symptoms. According to the RLS Foundation, regular exercisers are 3.3 times less likely to develop the disease. One study found that daily physical activity could cut RLS symptoms by as much as 40 percent.
To keep RLS symptoms at bay, make sure to clock between 30 to 60 minutes a day of sustained physical activity. But go easy—exercise that is too extreme or strenuous can aggravate symptoms. Find exercises you enjoy, and choose movements that focus on the legs.