Monday, June 28, 2010

Restless Leg Syndrome (RLS)

Although there is a growing number of individuals who suffer from Restless Leg Syndrome, research on the topic is limited and there seems to be a number of proposed mechanisms ... explaining why what works for you, may have no effect on another individual with the same problem. Restless Leg Syndrome (RLS) is described by those who suffer from it as an odd sensation or pain that usually travels through the leg. This sensation causes a need to move the affected limb in order to stop the sensation from occurring, even if only temporarily. The pain or uncomfortable sensation, often described as a burning, itching or electrical sensation, is more often experienced at night and although typically in the legs, some individuals can experience it in their arms or torso. RLS can begin in childhood, and may be associated with what many call growing pains throughout childhood and adolescence. It most commonly begins around the age of 40-45 years old. Its known as a spectrum disorder, as it ranges from severe pain to a minor nuisance that occurs only occasionally. What most patients seem to find most intolerable is the degree to which RLS affects their sleep. Many patients will not go to their doctor until they are suffering significant insomnia. The National Institute of Health has defined RLS by the following criteria: 1) an urge to move the limbs with or without sensations 2) improvement with activity 3) worsening at rest 4) worsening in the evening or at night There are two types of RLS. Primary RLS is considered idiopathic, meaning there is no known cause. It typically develops slowly and gets progressively worse as a person ages. Secondary RLS usually begins suddenly and the intensity does not seem to change. It is important to note that RLS can be a sign of an existing health problem, such as nutritional deficiency or disease. Treating the symptomology as well as the root may significantly decrease symptoms or cause them to disappear altogether. Although the causes of Restless Leg Syndrome are still only proposed, the majority of studies are focusing on a combination of iron and dopamine deficiency. 20% of RLS cases are caused by low iron. It is strongly recommended that you have your iron tested, as a blood ferritin below 50 micrograms/L could be responsible for symptoms. In a matter of months, supplementing with iron and increasing iron stores can cause a significant reduction in pain. Many prescription medications are also based on increasing dopamine stores and production in the brain. As dopamine is a chemical messenger that controls muscle movement, a deficiency in this neurotransmitter may play a significant role in RLS. Other conditions associated with RLS include varicose veins (or venous insufficiency), Parkinson’s disease and other nervous system disorders, and peripheral neuropathy, which is common in unmanaged diabetes. There are a number of prescription medications that may cause side effects very similar to RLS sensations. Inform your doctor of the medications you are currently taking. Obesity and poor diet, smoking, stress and pregnancy, particularly in the 3rd trimester are all also highly associated with RLS. There also seems to be a genetic component in its development. Over 50% with RLS report a family member with the same condition. Given the many proposed causes of RLS, there are many lifestyle suggestions that can help to alleviate symptoms and help sufferers to get some well deserved sleep. At the top of the list is exercise. Aiming for 30 minutes to 1 hour daily serves to reduce stress, shed extra pounds and improve sleep. Sitting at work for hours on end can also decrease blood flow to the arms and legs. Taking regular stretch breaks and even sitting with your feet above your heart for 15 minutes daily can help to increase blood flow and venous return in the lower extremities. Alternating hot and cold packs or hot and cold water in the shower, as well as dry skin brushing can also reduce sensations. We all know the importance of a good night’s sleep. Sleep deprivation can lead to serious illness, including heart attack, stroke, obesity, depression, memory and cognitive impairments. Although RLS makes it difficult for some individuals, adequate sleep is essential and will serve to decrease pain. Aim for 7-9 hours a night. Smoking, alcohol and caffeine can all aggravate RLS symptoms, as can fluctuations in blood sugar caused by a diet high in refined sugars. Eating small frequent meals also helps to stabilize blood sugar. As always, a diet high in whole grains, vegetables, fruit and lean protein is recommended to provide the essential vitamins and minerals needed to maintain healthy nerves and muscles. Supplementation with iron, magnesium and B vitamins, as well as herbs to aid in sleep, may all be necessary in addition to these lifestyle suggestions, if symptoms are severe enough and an individual is finding it difficult to find relief with lifestyle changes alone. Iron - Dose: 15 mg daily for premenopausal women, 10 mg for postmenopausal women and men. Ferrous fumarate and ferrous gluconate forms of iron do not cause constipation. Iron is also more easily absorbed when taken with a vitamin C supplement. As many individuals with RLS are iron deficient, supplementation can help to decrease symptoms. Be sure to have your iron levels checked before supplementing, as too much iron can also have side effects.

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