Restless Leg Syndrome or RLS
Is Restless Legs a Real Disease?
Restless Legs Syndrome (RLS) is classified as a neurological disorder. It is most often described as an 'irresistible urge to move' one's body. As the name implies, it most often affects the legs, however the arms and torso of a smaller number of sufferers is also effected.
Unfortunately, these sensations are most pronounced when the patient is not moving and in a relaxed state. As a result, most people experience RLS sensations while trying to fall asleep, and in fact, these sensations will either keep the sufferer from being able to fall asleep easily or involuntary leg spasms often associated with RLS will wake them shortly after falling asleep. Patients often suffer from sleep deprivation, and it is the primary reason a patient will seek treatment for their restless legs.
Although observations and descriptions of 'restless legs' date back to the 1600's, as recently as 20 years ago a patient describing the symptoms to their family physician was likely to get any number of (usually wrong) diagnoses'. And, although recent studies estimate that somewhere between 3-10% of adults in the United States will suffer from RLS at some point in their lifetimes, with as many as 3 million classified as 'chronic' or 'severe' cases.
Part of the difficulty of arriving at a correct diagnosis is compounded by the fact that the symptoms often defy description. The following is a partial list of how a patient might describe the sensation of a restless leg syndrome attack:
- pins and needles
I personally describe it to non-sufferers as if someone is tickling your legs -- only on the inside of your legs, where the muscle meets the bone.
Mirapex - The Parkinson's Drug Used for RLS
Drugs for Restless Legs Syndrome
Recently Doctors, and the public at large, have become more aware of restless legs syndrome. I attribute this to the fact that it was discovered that Parkinson's medications will often times give RLS sufferers a modicum of relief. The drug companies realized that they could encourage 'off-label' uses of their existing Parkinson's medications for a potentially large and under-served market of desperate for relief.
Advertisements in magazines and television started educating the public. The ads would describe the symptoms of RLS, and previous sufferers who were unaware of what to call the uncomfortable sensations in their legs, were suddenly aware that it was a recognized 'syndrome'. The drug companies also used this as a way to do 'push' promotions. In other words, encouraging the public to talk to their doctors about prescribing one of the various Parkinson's medications to them for their RLS.
Some of the drugs currently on the market are as follows:
- Requip (Ropinorole)
- Mirapex (pramipexole)
- Sifrol (pramipexole)
- Mirapexen (pramipexole)
- Neupro (Rotigotine)
- Gabapentin enacarbil (Horizant, XP-13512)
- Carbamazepine (CBZ)
Unfortunately, most all of these drugs carry with them some unwanted 'side effects', including increased risk of cancer. However, possibly the most insidious side effect is in what is known as 'rebound' and 'augmentation'. Rebound and augmentation are complex medical terminology to describe the fact that the drugs will actually make the symptoms worse and more pronounced than before once the drug wears off.
In cases like my father's RLS, which is quite acute, his solution was to continue upping the dosage for years. While this was a boon for the drug companies, he was eventually forced to stop using the drugs due to toxicity in his liver. And, at this point his restless legs were so severe that he seldom got more than 2 hours a sleep a night.
Acupuncture for Restless Legs
Acupuncture and Chinese Medicine
Due to the failure of Western medicine, many have searched for alternative treatments to ease the suffering involved with having restless legs syndrome.
RLS is understood to be primarily a neurological condition, and due to the almost 'electric' sensations that restless legs can create, quite naturally many have tried to get relief through acupuncture.
So, can acupuncture help restless legs syndrome?
There are some patients that report a marked decrease in symptoms, but for me the answer was 'no'.
To be fair, I was faced with what many patients were faced with 20 or 30 years ago when trying to describe their symptoms to a healthcare practitioner who wasn't familiar with the disease. On top of that, I was dealing with a linguistic challenge in that my acupuncturist spoke only Chinese and I was having to ask someone to translate for who also had never experienced RLS.
Restless Leg Syndrome Acupuncture Points
I don't consider myself an expert, but from my reading, I believe most patients who are successful at treating their RLS with acupuncture focus their treatment on something called the bladder meridian.
The bladder meridian is a circuit of nerves, and theoretical 'chi' or energy that flows throughout the body. There is a cluster or 'nexus' of nerves which focus in the lower back and pelvis region.
While I still think that acupuncture is better suited to leg cramps or leg pain, it's undeniable that some have found it an effective restless leg syndrome treatment and something all suffers should explore before resorting to a lifetime of pharmaceutical intervention.
Restless Leg Syndrome Causes
The cause of RLS is not perfectly understood. However, most current research links restless leg attacks to a shortage of dopamine in the brain.
Dopamine is a chemical created and used by the brain to carry out signaling between nerve cells. The dopamine shortage itself can have many proximate causes, such as:
- a vitamin or mineral deficiency
- a drug interaction
- pregnancy (which probably triggers a vitamin or mineral deficiency)
- and, the most popular cause; genetics
The most common cause, genetics, can start to interrupt the sufferer's sleep as early as childhood, and one or both parents often suffer from RLS as well. For patients who have not suffered from restless legs and suddenly develop a case later in life, more attention should be given to changes in diet, lifestyle, pharmaceutical regimines or pregnancy.
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