TREATMENT CONSIDERATIONS FOR RLS
If you think you have restless leg syndrome (RLS), here are some things to consider:
- Talk to your doctor! There are many medical issues that may worsen RLS symptoms including thyroid issues, anemia, pregnancy, and neuropathy.
- Certain substances – like caffeine, alcohol, and nicotine – worsen RLS. Try avoiding these substances to see if your RLS symptoms improve.
- Try stretching exercises throughout your legs and hips. Tight muscles and ligaments can contribute to that antsy, uncomfortable, or painful feeling.
- Try warm or cold compresses on the front of your leg. Everyone responds differently to head versus cold. For example, hot baths in the evening can help while others prefer cool compresses.
- Massage can be very helpful! Sensations tend to be most alleviated when addressing the anterior tibialis muscle of the leg (the tissue on the outer areas of the bone on the lower part of the leg), calf, and feet including the toes.
- See a sleep doctor to discuss diagnosis and treatment options – sleep deprivation can worsen RLS!
MEDICAL TREATMENT OPTIONS FOR RLS
Iron deficiency worsens RLS. Iron is a cofactor in producing dopamine, which is theorized to be the primary affected neurotransmitter involved in RLS. Even if you have an iron-rich diet, the stomach only absorbs a certain amount of nutrients from food alone. In order to increase the amount of iron storage in the body, iron supplementation or a vitamin containing iron helps. Taking too much iron can cause constipation and can also be toxic in certain blood conditions, so talk to your doctor before starting iron supplements.
Medication choices will depend on your symptoms, medical history, and possibly the kind of RLS symptoms you have. RLS often waxes and wanes on its own, so there may be times when behavioral treatments are enough – while other times, medications are needed. So keep in mind that medications may not have to be taken on a daily basis, and can even taken on an as-needed basis.
Muscle strain and tension can exacerbate RLS symptoms. Releasing tension in the muscles and ligaments of the affected limb (e.g. usually the legs) can help ease the RLS sensation. Use simple stretching techniques before you exercise, and be sure to stretch after you exercise too. Use caution – don’t overstrain! The goal is to be loose and limber. Try targeting the IT band, anterior tibialis, and the foot muscles.
A great massage releases muscle tension in the axial muscles (around your neck and the entire length of the spine). Be sure to ask for extra attention to the legs including the muscles and tendons that connect each of these muscle groups. If you prefer an at-home approach, personal electronic massagers can be used with relief – target the anterior tibialis muscles and ankle areas. There is an FDA-approved RLS massage mat that is available as well.
Exercise helps by increasing circulation to the affected muscle groups, and heat from the activity can loosen muscles. Make sure to warm up and cool down appropriately. Use stretching techniques to help further loosen the muscles, which can provide relief for RLS. Timing of the exercise can differ – in some people, morning exercise helps with nighttime RLS, while in others, evening exercise is more helpful. Try to identify how your RLS symptoms synchronize to your specific circadian rhythm.
Compressing the RLS-affected areas (e.g. legs) has variable effectiveness. While some respond very well to muscle support, others feel compression makes RLS symptoms worse. Compression stockings can achieve this affect but can also cause your legs to feel very warm. If you like the supportive sensation around your legs but the heat sensation makes it worse, alternatives include runner’s stockings, which are made specifically to support the muscles but the mesh materials allow for breathability. Be sure to take off these stockings during sleep – they are only meant to be used during the daytime hours unless your doctor specifically advises otherwise.
Heat and cold affect people with RLS differently. Some people love hot baths while others need cool cloths to alleviate their RLS symptoms. Compression blankets have been helpful in some individuals. Electric blankets are not generally recommended due to both safety issues and the potential of excess heat interfering with sleep consolidation.