Restless leg syndrome is a condition in which the legs are uncomfortable and the patient feels a need to move them to get away from the discomfort. Many of us are familiar with a mild version of this, but for some the sensation can be very intense and greatly interfere with sleep or even attempts to rest or sit for any period of time. Sometimes the legs move even while the person is sleeping and the sleep is not restful.
About 10 percent of the U.S. population suffers with this condition, with 2 to 3 percent having a moderate to severe case.
When treating patients with RLS, I find it helpful not to think of it as a specific diagnosis but as a symptom. This symptom can have many causes, even if the patients all describe very similar complaints. For some patients, the problem is found in the leg muscles themselves. For others, it may reflect imbalances in their brain chemistry, an iron deficiency or a drug reaction.
The easiest cases to treat are caused by stored tension in the muscles. The diagnosis does not depend on finding “knots” and tender points in the muscles; this is common to all types of RLS, regardless of cause. The difference is that these knots will respond to deep tissue massage. Many of these patients also benefit from manipulation to the joints of the legs and low back. The muscles react to these problems by tensing up. If the joint problems persist, the tension builds up enough to interfere with sleep.
When examining a patient with RLS, I also ask if they started taking a statin drug such as Lipitor, Crestor or Zocor before it started. Leg complaints are a very common side effect of these cholesterol-lowering drugs; up to 75 percent of patients taking a statin have muscle pain as a side effect.
Some patients have this muscle pain “all over,” but it is not unusual to feel it mostly in the legs.
There are other drugs that have RLS as a side effect, as well, including medications for anxiety and depression. I agree with the advice of the American Society of Consultant Pharmacists when they say, “any new symptom in an older adult should be considered a drug side effect until proven otherwise.”
Of course, there are natural alternatives for RLS. As always, the treatment depends on the cause. If it is because of a medication, it might be possible to eliminate the need for that drug naturally. If it’s because of iron deficiency, the patient often requires not only supplements but also help with digestion — iron can only be absorbed in a normally acidic stomach. Using antacids or drugs to reduce stomach acid interferes with iron uptake and can lead to problems such as anemia or RLS.
The goal of wellness care is to heal the stress on the stomach, making the medications unnecessary, then the body can digest the iron more effectively. In a similar vein, there are ways to naturally improve brain chemistry, which can help patients whose RLS comes from this problem. Whether or not the patient improves enough to get off his or her medications, there may be enough improvement to ease the leg symptoms.
I have found acupuncture to be helpful in most RLS cases, regardless of the cause.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at firstname.lastname@example.org.