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May 5, 2011

Respite for Restless Legs

Restless Leg Syndrome (RLS) is characterized by the irresistible urge to move the legs. People who experience this condition describe having unpleasant sensations in their legs such as pulling, itching, tingling, burning, or aching. These unpleasant sensations are temporarily relieved by voluntary movement of the legs. RLS can cause significant distress to those who have it. It tends to occur when people are trying to relax or sleep, and if severe enough can ultimately end up leading to sleep disruption, exhaustion, and eventually problems with work and mental performance. Individuals with RLS usually also have an associated condition known as nocturnal myoclonus. This is a neuromuscular problem whereby the muscles, usually in the legs, repeatedly contract during sleep for intervals of less than 10 seconds. Individuals are unaware of the muscle contractions, but may report frequent sleep disruptions and daytime sleepiness.

Although the cause(s) of RLS and nocturnal myoclonus are still to be determined, theories do exist. Some researchers believe it has to do with central nervous system dysfunction, more specifically dysfunction of the neurotransmitter dopamine, leading to excitability in a particular region of the brain. A new drug known as Horizant has recently been approved by the FDA for treatment of moderate to severe restless leg syndrome (RLS). But before rushing out to try this new drug (and its probable side effects), consider a few other options first. Since RLS is common among people with malabsorption, it's a great idea to determine and then optimize one's nutritional and digestive status. Iron deficiency, with or without anemia, is a common finding in individuals with this problem. A simple blood test can be done to determine whether iron stores are sufficient and whether a supervised trial of iron supplementation may be helpful. In people with family history of RLS, appropriate folic acid supplementation has a high success rate. If nutritional status proves to be ideal in a person with RLS or if a multi-tiered treatment approach is desired, therapeutic trials with specific botanical medicines should be attempted. Herbs like passiflora and valerian have sedative properties to help induce deep relaxation and sleep in those with RLS. Therapies such as acupuncture have proven extremely effective at mitigating and even completely alleviating this condition. Other recommendations, from both conventional and naturopathic worlds, include making sure to get plenty of regular exercise, develop healthy sleep habits, and eliminate intake of tobacco, alcohol, coffee, and other stimulants.

Dr. Shana McQueen