You finally sit down to relax at night after a long day at work, and bam! No sooner do you settle into that easy chair that a tightening sensation crawls up your legs, making you get up again. How can you rest when your legs are urging you to move? Here are tips to ease the symptoms of restless legs syndrome, so you can get the relaxation you need…
It feels like your legs constantly want to do the cha-cha, but the cause of restless legs syndrome (RLS) may not be in the lower limbs at all. It actually may be in the brain.
Scientists have found that low levels in the brain of a crucial chemical, dopamine, and a mineral, iron, may trigger the torturous twitching, tingling sensation that’s a hallmark of the disease affecting 10% of Americans.
“Anything that affects the body’s metabolism of dopamine will affect RLS symptoms,” says William Anderson, M.D., an internist who practices sleep medicine at the University of South Florida in Tampa.
That’s one reason scientists recommend therapies that target the brain to ease RLS symptoms, from raising levels of dopamine and iron to distracting the mind.
Here are some tricks you can try ease your symptoms, settle down and relax.
1. Raise levels of dopamine
“The problem is usually the dopamine level in the nerves,” says Lorne Label, M.D., chief of staff at Los Robles Hospital and Medical Center in Thousand Oaks, Calif., and clinical professor of neurology at University of California, Los Angeles.Increasing dopamine will help ease symptoms, he says.
Drugs containing “dopaminergic agents,” such as pramipexole and ropinirole, largely used to treat Parkinson’s disease, increase dopamine and have been shown to reduce symptoms of RLS, according to the National Institutes of Health.
“Folic acid also helps improve production of the neurotransmitter dopamine,” says Suzy Cohen, Lifescript pharmacist, R.Ph., and author of The 24-hour Pharmacist (William Morrow).
She recommends 800 micrograms (mcg) twice daily.
2. Check your iron
Low iron can be the main cause of RLS symptoms, Dr. Label says.
“If your ferritin [the protein that stores the body’s iron] level isn’t above 50 nanograms per milliliter, it’s not high enough,” Dr. Anderson says.
But the problem may not lie just with low iron levels but rather with how your brain processes it.Iron may be poorly absorbed in the brains of restless legs syndrome patients, according to 2003 Penn State University College of Medicine research that showed poor iron uptake in the brains of autopsied restless legs syndrome patients.
The “iron isn’t being delivered to certain brain cells in an effective way,” explains James R. Connor, Ph.D., who led the study.
To check whether you need iron supplements, see your doctor for a simple blood test.
3. Boost your B vitamin intake
“Folate [a B vitamin] increases blood flow (circulation) and, therefore, could improve RLS,” Cohen says.
Folic acid can be taken as supplements or through foods, such as peanuts, garbanzo beans, lentils and spinach in its naturally occurring form, folate.
Another B vitamin, B12, has also been directly linked to RLS, according to Dr. Anderson.
The recommended dietary allowance of vitamin B12 is 2.4 mcg. Ask your doctor if you might benefit from more.
4. Use a sequential compression device (SCD)
A sequential compression device is a mechanical sleeve that fits over the leg and massages it by inflating and deflating with air (much like the armband used to measure blood pressure). It’s usually used to prevent blood clotting in hospital patients, and one small study has shown it may help RLS patients too.
All nine patients who wore a sequential compression device (SCD) for one hour before bedtime every night for three months reported improved social and daily task function and quality of life, according to a 2007 study by the Department of Medicine at the Walter Reed Army Medical Center in Baltimore.
It might work because “the body is capable of only appreciating a limited number of stimuli simultaneously,” the Restless Legs Syndrome Foundation states, implying the sensory impact of the SCD won out over RLS.
Working out may alleviate symptoms of restless legs syndrome, according to the National Institutes of Health. But don’t overdo it, cautions the RLS Foundation.
Mild exercise, such as walking, light jogging, or yoga, “may help RLS while vigorous exercise can trigger RLS symptoms in some individuals,” explains the RLS Foundation’s brochure, Triggers for Restless Legs Syndrome.
6. Adjust your medication
“Antipsychotics and antidepressants can worsen RLS,” says Winona Tse, assistant professor of neurology at Mount Sinai Medical Center in New York.
“They interfere with the body’s metabolism of dopamine.”
Any medication that blocks dopamine receptors, including anti-nausea drugs used to reduce vomiting, motion sickness and inner ear dizziness, can worsen symptoms of restless legs syndrome, according to the RLS Foundation. So can antihistamines, frequently used to treat colds and allergies.
If you experience an increase in RLS symptoms while taking other medications, see your doctor about alternatives, decreasing the dosage or possibly discontinuing the medication.
7. Don’t try melatonin
Though restless legs syndrome can disrupt sleep, this common over-the-counter sleep supplement won’t help, according to a 2004 Canadian study.
The naturally occurring hormone melatonin regulates your body’s internal clock, or circadian rhythms. Its levels typically increase at night and taper off toward daybreak.
Melatonin also inhibits the secretion of dopamine, which makes it bad news for restless legs syndrome patients. It might increase RLS symptoms in the evening and night, according to researchers at Sacre-Coeur Hospital in Montreal.
8. Take calcium and magnesium
Calcium and magnesium are minerals that aid in the functioning of muscles and nerves, so they may help RLS patients, Cohen says.
“If it’s low, then you definitely need to have your calcium and magnesium within the normal range,” Dr. Label says.
Cohen recommends a daily combination dose of 600 milligrams (mg) of calcium and 200 mg of magnesium.
“But if after 2-3 months there’s been no improvement, it’s not going to help,” Dr. Label warns.
9. Get a massage
Massaging legs before the onset of restless legs syndrome symptoms has been shown to be effective in a 2007 study published in the Journal of Bodywork and Movement Therapies.
It found that therapies such as deep tissue and sports massage for 45 minutes twice a week on the lower extremities reduced symptoms of RLS.
Symptoms were reported to decrease after two treatments and continued to improve over the following three weeks. 10. Run a warm bath (or cold shower)
“Taking a hot bath may relieve discomfort for a [short] time,” Dr. Label says.
However, once you get out of the bath, the symptoms will probably return, he says.
“Others say a cold shower is soothing,” says the RLS Foundation. “Ice packs and heating pads have also been used for relief.”
Whether hot or cold temperatures work depends on the individual, it says.
Other Coping Techniques
The foundation suggests other methods for coping with symptoms of restless legs syndrome in various situations. They include:
- Working the nightshift. Because RLS is tied to the body’s circadian rhythms and worsens at night, it may help to work during the wee hours. By staying active at night, there may be relief during the day.However, check with your health-care provider before changing your schedule: There may be other health consequences to staying up all night, the RLS Foundation says.
- Traveling in the morning. Because sitting still for long periods can be challenging for those with restless legs syndrome, plan a long car ride and air travel for the morning hours. This is especially key for overseas flights or trips that involve a change in time zone, factors that further complicate your body’s natural rhythms.
- Requesting a standing work station. Many variations are available to the standard desk. Many people now work standing, at a podium-like work station. This not only may help RLS, but it also improves circulation throughout the body.
- Staying engaged. Bringing snacks to work or on long trips can distract the mind from the onset of RLS symptoms. For example, eating one popcorn kernel or raisin at a time may be enough. Also be sure to pack enough activities and reading material to stay absorbed during a long trip.
- Quitting caffeine. Although no formal research exists that shows a reduction in caffeine intake can lessen the symptoms of RLS, several patients have reported that quitting the stimulant has helped.
“Caffeine has been linked to an increase in RLS symptoms,” the Restless Legs Syndrome Foundation states. “[It] is present in coffee, tea, chocolate, soda, and other common foods and beverages. Check ingredient listing carefully.”
By Sally Schultheiss, Lifescript