The silent plight of Restless Leg Syndrome

For a condition that reportedly affects between 5% to 10% of the population, restless legs syndrome has a surprisingly low profile. It remains mysterious to many – even in the medical community – but for those who have to live with its effects it can have a profound impact on daily life.

Typically restless leg syndrome becomes more prevalent from middle age onwards. For many, the symptoms gradually increase in severity as they get older, but one of the frustrating aspects of the condition is that it is quite unpredictable. Symptoms may come and go with no apparent cause. The success or failure of various treatments for the condition is equally irregular.

What are the symptoms?
Restless leg syndrome, as the name suggests, involves a persistent involuntary urge to move the legs. The twitchy, jerky movements are an unpleasant sensation and the unfortunate reality for sufferers is that the effects are more common during the night. This means that sleep can be severely interrupted, adding to the debilitating nature of the condition.

Research has indicated that the night time onset may be linked to the body’s natural circadian rhythms, although no specific link has been made to explain why this is the case. Cold comfort to those who know that in the hours immediately after midnight the condition can often be at its most irritating.

Why does it happen?
There is no definitive or single answer to this puzzling question. Studies have indicated that family history is a factor, but the direct causes are not fully understood yet. One study in the early 2000’s identified that receptors in the mid brain were not transporting sufficient iron to specific cells. The good news from this same study is that there did not appear to be any nerve degeneration or damage of brain cells associated with the condition, which means there is greater potential for more successful drug treatments to eventually be developed.

The malaise can sometimes be brought on as a side effect to another medical condition such as anaemia, diabetes, alcoholism, rheumatoid arthritis, kidney failure or Parkinson's Disease. There seems to be strong suggestions that alcohol, caffeine and nicotine can intensify the problem too.

Is there any relief available?
There are a range of therapies that are worth considering and have shown positive effects, but what works for one person may not work for another. It’s important to firstly obtain a diagnosis from a medical professional, but you then need to be confident that the person treating you takes a serious and active role in trying to find the treatment that suits you. In days gone by, the mystery surrounding the condition led to some practitioners downplaying the condition and the chances of finding remedies. Fortunately, there is now a growing awareness of what can be attempted.

A variety of drug therapies, including sedatives, pain relievers and anticonvulsants, are sometimes prescribed. All have resulted in some success, but there is no consistent pattern and what works will depend on the patient and the severity and frequency of attacks. A critical factor in any drug-related treatment is a gradual and controlled management of doses, since some drugs can have unwanted side-effects and in some cases can actually exacerbate the condition rather than help it. It is also essential that you inform your doctor/ pharmacist about any other conditions and medications that you may be taking as these are important considerations when deciding on treatment.

Non-drug therapies
The connection with iron deficiency in some brain cells has led to iron supplements being a recognised course of action, although this needs to be done under professional medical supervision to be correctly managed and dosed.

Magnesium is generally beneficial to the nervous system and supplements of this element may be helpful.

When it comes to other therapies, there are a range of alternatives worth looking at, although impacts again will vary from person to person and benefits may fluctuate or dissipate over time. Options worth trying include acupuncture, therapeutic massage, hypnotherapy and reflexology. Relaxation techniques, including meditation, yoga, tai chi or other gentle stretching movements can work for some

At a simpler level, hot baths or hot and cold packs can be very relieving. Mental activity has also been connected with improvements, apparently resulting from the distraction it provides to the brain. This could be something as simple as reading, crosswords, hobbies or even video games.

Physical activity before bedtime may be helpful too, such as a treadmill, exercise bike or even leg stretching exercises. Maintaining good sleep habits is essential, since RLS can be intensified by fatigue and drowsiness, so try to get to bed at a consistent time and implement a calming routine to wind down.

For more information and to gain valuable support, visit rls.org.au or brainfoundation.org.au