Getting a leg up on Restless Leg Syndrome

For ten percent of the U.S. population, working long hours at a desk, sitting in traffic during the daily commute and simply resting at home can be unpleasant, irritating and nearly impossible. These individuals suffer from restless leg syndrome (RLS), which causes the individual to suffer from spontaneous, continuous leg movements accompanied by unpleasant sensations.

For those suffering from RLS, the sensations occur when they are at rest and seem to be only relieved by movement. These sensations usually occur in the calf area, but may be felt anywhere from the thigh to the ankle and can also be felt in the trunk or arms as well. People with RLS often experience chronic insomnia and sleeplessness due to the strong urge to walk or do other activities to relieve the sensations in their legs.

According to the RLS Foundation’s Web site, http://www.rls.org, extensive research into the cause of RLS has occurred worldwide. A single unifying cause has not been identified, but there are several known elements to RLS. For example:

•RLS often runs in families.

•RLS sometimes appears to be a result of another condition, which, when present, worsens the underlying RLS.

•Up to 25 percent of women develop RLS during pregnancy but symptoms often disappear after giving birth.

•Anemia and low iron levels frequently contribute to a worsening of RLS.

•RLS is very common in patients requiring dialysis for end-stage renal disease.

•Damage to the nerves of the hands or feet from any number of causes including diabetes can contribute to RLS.

•Attention Deficit Disorder (ADD) is common in children and adults with RLS.

A common misconception regarding RLS is that it only affects senior citizens. However, according to a study done by the RLS Foundation, in the United States alone, RLS is believed to afflict more than 10 million adults and an estimated 1.5 million children and adolescents. Although most research has focused on adults, RLS symptoms often begin during childhood or adolescence. About 35 percent of patients report RLS onset prior to age 20, and one in ten report that the syndrome appeared during the first decade of life.

Nancy Moramarco, a 79-year-old Rainbow resident, remembers suffering from restless legs as a young woman.

As a teenager, Moramarco's brother would ask her to pose as his model for drawings, but she could never sit for too long because of her restless legs.

“I would have to get up and stretch because my legs wouldn’t sit still,” she explained. However, the symptoms were infrequent, and flared up during Moramarco’s multiple pregnancies.

“I couldn’t keep still and always had to move around,” explained Moramarco. “None of that was as much of a pest as what I have felt in the past few years, though.”

Moramarco developed varicose veins, neuropathy in her feet, and adult onset diabetes. Because nerve damage contributes to RLS, her symptoms were severely aggravated.

“I would stay up at night, crying from frustration,” said Moramarco.

Doctor Richard Ferreras, a geriatrics specialist with Fallbrook’s Mission Family Care, has diagnosed several patients with RLS, and understands the discomfort that comes with RLS.

“It feels like a compulsion to constantly move your legs,” said Ferreras.

For his patients, Ferreras recommends a dopamine agonist such as Requip (ropinirole) or pramipexole (Mirapex).

According to the RLS.org, other medications that have served to help RLS include dopaminergic agents, sleeping aids, anticonvulsants, and pain relievers. In addition to medications, there are other options for those suffering with RLS.

“Combination therapy is often useful, and periodic changes in choice of medication to deal with tolerance are frequently necessary,” said Ferreras. “In some patients, additional doses of medication may be necessary during the day to manage diurnal symptoms.”

Individuals suffering with RLS can also take precautions to limit the symptoms they experience.

For example, they can check to see if there is an underlying iron or vitamin deficiency in their body, and then supplement their diet with iron, vitamin B12 or folate. Making sure their diet is healthy and balanced, while eliminating alcohol are also options recommended to help monitor RLS.

According to Ferreras, exercise can also help to relieve RLS symptoms.

“I recommend that my patients [suffering from RLS] walk at least four times a week for 20 minutes,” said Ferreras.

Other activities for dealing with RLS include stretching, taking a cold or hot bath, massaging, acupressure, or relaxation techniques.

Just as there are activities that could help relieve RLS symptoms, certain activities, habits and medication can have adverse effects on an individual with RLS.

Antihistamines that are found in cold and allergy medications, such as Benadryl; anti-nausea medications, such as meclizine and Compazine; antidepressants such as Elavil and Prozac; and psychiatric medications for bipolar disorders and schizophrenia, such as haloperidol, can all increase the effects of RLS.

Upon identifying the medications, habits and activities that cause more noticeable symptoms of RLS, the condition can become manageable. For certain individuals, it may mean that they have to stop drinking caffeine, for others, it may mean brisk walks in the afternoon or evening. For Moramarco, relief came in the form of active lipoic acid, which she had been taking for another condition.

“I had read that lipoic acid could regulate my glucose, and had taken it to my doctor to see if it could help,” said Moramarco. “Since then, I’ve been able to sleep.”

Working with a primary doctor can help understand if an individual has RLS, said Ferreras.

“It may not be diagnosed <as RLS> immediately, but working with a doctor to find what helps is best,” he said.

For more information on Restless Leg Syndrome, go to http://www.RLS.org.

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