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Restless Leg Treatment

Restless leg treatments are designed to manage symptoms. There are many different types and styles of RLS treatments.
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Restless leg is not a life threatening condition. But it is an incredibly disruptive condition.

Those living with restless leg often find themselves in dire need of standing up and moving around, often being forced to wake up in order to move around.

The stress from living with RLS has also been linked to a variety of potential long term health conditions, so while RLS itself may not be harmful to your health, it is possible that the lack of sleep and overall stress you experience creates health related problems in the future.

Treatment for Restless Leg Syndrome

All treatments start by ensuring there is no underlying medical condition.

RLS itself is its own medical problem, but in some cases restless leg may be caused by some type of underlying condition, such as diabetes.

Generally when this is the case, the doctor will focus their efforts on treating the underlying condition. That's why it's useful to go in for a full physical if you are living with RLS, to ensure that restless leg is not a secondary symptom to a different health problem.

Assuming you are in good health, however, then it is time to treat restless leg syndrome using RLS specific methods. Below, we'll explore some of the treatments currently available.

Medicines for Restless Leg

Easily one of the most common ways of treating restless legs is with medicines available via prescription.

Doctors are generally mixed on the types of RLS treatments to provide, but they usually fall under the following categories:

  • Parkinson's Medications
  • Epilepsy Medications
  • Sleep Medications

RLS is an interesting disease, because people often appear to respond differently to different types of medications. It's also possible for a medication to stop working or change the way your RLS manifests.

Parkinson's Medications for RLS

Parkinson's medications are designed to increase dopamine in the body.

They're often known as dopamine agonists, and despite being linked to such a terrible disease, those suffering from restless leg syndrome do not appear to be at greater risk for Parkinson's.

The reason these medications appear to work is because for many, restless leg syndrome corresponds to normal dopamine levels in the brain/body. Generally dopamine levels drop at night, which happens to be the same time that restless leg symptoms appear.

Mirapex and Requip are the most common, although it's possible for a dopamine agonist to be used off label.

Dopamine agonists are generally well tolerated, although they are not often used for more than 9 months and taken only before bed (meaning they may not help with daytime RLS symptoms). Although the risk of side effects is low, the types of side effects have caused a great deal of concern in the medical community.

In fact, one study found that many people developed unusual habits, including obsessive gambling. Others developed a strong sexual appetite or other forms of addiction. Many express concern that in addition to standard side effects (nausea, etc.), dopamine agonists may increase addictive behaviors.

In addition, your body has a tendency to adapt to dopamine agonists. Most RLS symptoms occur at night, but in several studies they found that those taking dopamine at night simply experience their symptoms earlier.

For these reasons, Parkinson's medications are generally only prescribed to those that absolutely need it, despite their apparent effectiveness. All other causes, as well as lifestyle changes and safer treatments, will usually be exhausted first.

Epilepsy Medications for RLS

Another interesting treatment for RLS is medication designed for treating epilepsy.

Once again, it's unclear what the relationship is or why these drugs are effective, but studies have shown that the drug is fairly well tolerated and appears to reduce restless leg symptoms. Though some with epilepsy do have restless leg syndrome, RLS itself does not appear to be a sign of epilepsy.

Its most likely benefit is that of an anticonvulsant. Since epilepsy is a seizure disorder that commonly causes convulsions, and RLS can create what appear to be convulsions in sleep, it's likely that this is the primary reason that these drugs are effective.

The most well known drug is Gabapentin Enacarbil.

There is reason to believe that despite being well tolerated, these medications have their own safety issues. Gabapentin Enacarbil, for example, was originally not approved by the FDA because of an apparent link to cancer. But approval has since taken place.

Sleep Medications and Muscle Relaxants for RLS

Medications used to promote sleep are also considered useful for dealing with RLS.

Sleep aids and sedatives may also be used to treat RLS. Each one comes with their own side effects, but benzodiazepines tend to be the most common.

Sleep aids don't necessarily affect RLS itself. Their goal is to promote better sleep in general, which controls the most disruptive symptom of restless leg – waking up in the middle of the night as a result of the disorder.

Many different types of sedatives or muscle relaxants may be used for RLS. Few of them have been tested for RLS specifically, but are often used "off label" and considered to be fairly effective. Sedatives are generally well tolerated, but do have side effects and some have dependency risk, so never take a sedative without doctor approval.

Other Drugs for RLS

Opiate narcotics may also be prescribed to those that have restless leg syndrome.

Drugs with codeine and oxycodone when combined with acetaminophen do appear to reduce the signs and symptoms of restless leg as well. But this treatment for RLS isn't generally recommended because these drugs have a high dependency risk.

Medical marijuana may also be used for RLS.

Depending on the state, medical marijuana may still be illegal. There are also risks and precautions that would need to be taken regarding whether or not the drug is laced with any other drugs or medications, or grown in a healthy environment. Side effects of the marijuana delivery system can also be a problem. Nevertheless, this drug is popular in some circles and may treat restless leg.

Over the counter painkillers may also be used. Ibuprofen is a successful muscle relaxant, and muscle relaxants have been show to treat RLS. Generally these would be most effective for those with only mild restless leg syndrome, however.

Herbal Treatments for Restless Leg Syndrome

Because restless leg is not a life threatening disease, many people prefer the idea of using herbal supplements rather than medicinal treatments.

It's not fair to say that herbal supplements come without side effects. Many do have side effects. But for those that are looking for long term management of their RLS, an herbal remedy may seem like a better idea, as they are often available without a prescription and generally not as harmful as many pharmaceutical medications.

There are not a great number of herbal options available specifically for restless leg syndrome. However, there are some recommended supplements worth trying. These include:

Herbal Treatments for RLS

Valerian Root - Valerian root is a natural sleep aid. Like most herbs, it's not used for restless leg. Rather, it's used for providing a better night's sleep. A study at the University of Pennsylvania found that patients with restless leg that used Valerian root for 8 weeks experienced significant improvement not only in their quality of sleep, but also in their daytime sleepiness. Subjective reporting revealed that valerian appeared to improve quality of life scores as well.

Passionflower – It's unclear whether or not passionflower has an effect as a treatment for restless leg syndrome, but many in the herbal medicine community hail passionflower for its sedative effects. It's often used to treat mild anxiety, but the same properties should allow it to treat RLS as well. More research is needed to confirm or deny passionflower as an herbal remedy. All known reports are that passionflower is well tolerated.

Kava – Kava is also an anti-anxiety herb that may be an effective treatment for RLS. Once again, research in this area is slim. Kava is one of the few herbs that has received considerable research for its anti-anxiety and sleep aid properties, but a health scare with the kava herb essentially stopped all research, so it's unknown whether it would be beneficial for RLS. Nevertheless, some people do use kava to control their RLS symptoms.


Currently there is not a great deal of research into RLS in general, and even fewer studies promoting the idea of herbal supplements.

However, since most treatments for RLS are also treatments for other disorders (such as benzodiazepines, anticonvulsants, sleep aids, etc.), those that prefer herbal medicine to pharmaceutical medicine may wish to try an herbal version of the above list of medications, and see if it has any effect.

As usual, it's recommended that you talk with your doctor before starting any diet or medicine routine, including herbal medicine.

Vitamin Treatments for Restless Leg Syndrome

One of the most interesting aspects of RLS is that it is often linked to vitamin deficiencies.

In addition, it is believed that many of those that have the "correct" amount of various vitamins in their body may be in need of more of these vitamins than the average human being.

That is why vitamin supplementation is arguably one of the most common ways of treating restless legs.

You should talk to your doctor before starting any vitamin supplementation, even though these vitamins rarely have side effects. However, it is likely your doctor will recommend vitamin supplements first to combat the main causes of the disorder, and see if they have any effect before putting you on a stronger medication.

Vitamins that have been linked to RLS include:

Iron

Iron deficiency is by far the most commonly linked vitamin to RLS. Many of those that have RLS appear to be low in overall iron levels (anemic) when compared to the general population.

Not all of those suffering from RLS are low in iron, but some have posited that, since all bodies are different, those that suffer from restless leg may need more iron than average in order to function.

It's for these reasons that iron is often one of the first vitamins that many doctors will recommend, possibly before prescribing any type of medication or alternative treatment.

Calcium and Magnesium

Both calcium and magnesium play an essential role in nerve functioning, so deficiencies in either of these two vitamins may also contribute to restless leg.

Calcium deficiency is a common problem in those that don't get enough dairy. Calcium supplements are becoming more and more common in communities that are low in dairy intake.

These days, most people know to get more calcium, but magnesium has been essentially wiped out of most modern diets.

Some people have linked magnesium deficiency to serious issues like depression. Others note that calcium alone can be toxic to the brain if there isn't enough magnesium in the body. The two need to be in the correct balance in order to help your body function.

That's why calcium and/or magnesium may both be beneficial as part of a treatment for RLS.

Vitamin B12

Vitamin B12 deficiency has also been linked to restless leg.

Low levels of B12 are responsible for a type of anemia that may also lead to RLS, much like what occurs with iron deficiency.

Combined with Folic Acid, B12 has been known to cure or reduce some forms of RLS.

Folic Acid

Finally, folic acid deficiency is also believed to be a cause of RLS, so folic acid may be used to treat RLS.

A very small study in the 1970's looked at six women that were suffering from neurological issues.

They appeared to have RLS, intellectual fatigue, and an assortment of other symptoms. Three had severe folic acid deficiency.

They gave those three individuals folic acid supplements. All three reported significant symptom improvements, indicating to the researchers that low folic acid counts may be responsible for a variety of neurological issues, including restless leg.

Additional Methods of Treating RLS

Those looking for some type of medicinal or supplementation RLS treatment may turn to any of the above tips and strategies, all of which are believed to help those with RLS – especially those that don't have any underlying disease that may contribute to restless leg.

It's always a good idea to talk with a doctor and make sure that you're healthy enough for any of the available RLS therapies.

Many doctors also recommend lifestyle changes to help treat RLS. They've found that patients that are willing to perform certain activities may reduce their restless leg symptoms, and possibly prevent them altogether.

Some of these include:

Lifestyle Changes for RLS

Healthy Eating/Hydration – Poor eating habits and dehydration may all contribute to some of the issues leading to restless leg. There are many that theorize that alcohol, smoking, and possibly caffeine all contribute to restless leg symptoms, although it's not clear the mechanism with which this occurs. Generally RLS is already present, but those drugs have a tendency to make the symptoms worse. Good eating habits and keeping properly hydrated are very important.

Exercise – Exercise has also been shown to decrease symptoms of restless leg syndrome. In addition, a large scale study found that those considered obese were also more likely to suffer from RLS, so it's possible that exercise helps provide additional tools to treat restless leg syndrome. 

Decrease Stress – Stress also has a tendency to exacerbate RLS. In the case of stress (as well as exercise and some dietary changes), decreasing your stress won't cure your restless leg. What it will do is ensure that the stress isn't making the symptoms worse, and that you're able to get more overall rest.

Massage/Stretching – Anecdotally, many people have found that stretching and massaging the legs can help provide treatment for restless leg. Presumably this occurs because the body is able to experience more movement during the day, so the legs feel less jumpy. Many also use this technique when suffering from RLS symptoms but in an environment where standing and walking may not be possible, such as in the car or on a plane.

Acupuncture – Many of the benefits of acupuncture have not held up against formal review. Research often finds that acupuncture is not that much more useful than a placebo. In the case of RLS, acupuncture is widely regarded as an effective treatment, and many point to studies that confirm this benefit. However, a systematic review of all available studies (14 at the time of the review) found that 12 of them had serious methodological flaws, leaving only two to be analyzed for efficacy. Of those two studies, only one showed any improvement, and only when combined with medicine for RLS. Still, acupuncture remains a very popular RLS treatment.


These represent just a few of the ways that those living with restless leg syndrome treat their condition.

Some believe that taking hot or cold baths also helps, while others switch back and form between heat and ice packs. Both of those appear to be effective for some people.

Finding the Right Restless Leg Syndrome Treatment

One of the issues with RLS is that, although RLS is its own disorder, it's possible that it has different causes for different people.

Some people may simply have the neurological problem with no clear cause. Others may have a vitamin deficiency. Others may have something more hereditary.

Because of all of these causes, treatment for RLS is generally about finding the one that works best for your needs. Often it's best to start with the easiest and safest treatments and work your way towards the riskier medications and treatment options, but in general its best to try the safest RLS treatments first, and continue to look for others if they prove ineffective.

The good news, however, is that RLS is both not life threatening and can be treated successfully, so finding relief is real option. 

Sources


http://www.health.com/health/condition-article/0,,20188872,00.html

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006457.pub2/abstract

http://journals.lww.com/

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