Welcome to Running: A FEVER. My name is Michael Davis, and this is a show about fitness, diet, and medicine. It’s all about livin’ long and lovin’ life, and my goal is to live a long, healthy, happy, active life right up to the very end.
I had heard about restless leg syndrome and never knew exactly what it was. Simultaneously, at least in recent times, I had been experiencing, sometimes, a hard-to-describe feeling when I was laying down. A sort of edginess that could only be relieved if I moved my arms or legs. Because it was so hard to describe, it was hard to self-diagnose. Turns out I have restless leg syndrome.
What is it exactly? According to the Mayo Clinic, restless legs syndrome (RLS) is a condition that causes a very strong urge to move the legs. The urge to move usually is caused by an uncomfortable feeling in the legs. It typically happens in the evening or at night when sitting or lying down. Moving eases the discomfort for a short time.
Restless legs syndrome can begin at any age and tends to get worse with age. It can disrupt sleep, which interferes with daily activities. RLS also is known as Willis-Ekbom disease.
Simple self-care steps and lifestyle changes may help relieve symptoms. Medicines also may help many people with RLS.
What causes it? Nobody knows. Some scientists believe it may be caused by an imbalance of dopamine in the brain, because dopamine sends messages to control muscle movement. Some women have RLS only during pregnancy, but it is temporary and usually goes away after the baby is born. It also may be genetic, especially if it starts before age 40.
Though they don’t know the cause, there are some risk factors associated with RLS. This is not believed to be because other conditions cause RLS, but some conditions seem to coexist with it.
- 1. Peripheral neuropathy, which is damage to nerves in the hands and feet, sometimes due to chronic diseases such as diabetes and alcoholism.
- 2. Iron deficiency. This can cause RLS or cause it to get worse. You may have iron deficiency if you have a history of a bleeding stomach or bowels. It can also affect women who have heavy menstrual periods or people who donate blood often.
- 3. Kidney failure. This is often associated with iron deficiency or anemia. The iron deficiency can cause restless leg disorder or make it worse.
- 4. Spinal cord conditions. Having a damaged or injured spinal cord may cause or worsen RLS. I wonder if my spinal stenosis has anything to do with this.
- 5. Parkinson's disease. This can also cause an increased risk of developing RLS.
One of the big problems with RLS is that it can make it hard to fall asleep. So not only are you having trouble sleeping at night, you may also not be able to take a nap to make up for it. Unless you can sleep standing up.
My inability to describe the feelings associated with my restless leg syndrome is not uncommon. People sometimes describe them as:
- 1. Crawling
- 2. Creeping
- 3. Pulling
- 4. Throbbing
- 5. Aching
- 6. Itching
- 7. Electric
I think I would describe it as, you know when people say something makes their skin crawl? That’s how I would describe it.
Some drugs can also worsen symptoms of RLS, including some antidepressants, antipsychotics, and antinausea medicines, and some cold and allergy medications.
Treatment
If you are iron deficient, fixing that by taking an iron supplement may make the RLS symptoms go away. You should only do so under the supervision of a medical provider. Another prescription method is using an electrical stimulation device on a nerve on the side of your knee.
If none of these are appropriate, there are some lifestyle changes you can make, which include reducing caffeine, alcohol, and nicotine, establishing a cool and dark sleep schedule, and engaging in moderate daily exercise.
There are some medicines that can help. Some affecting calcium channels, including gabapentin, gabapentin enacarbil and pregabalin. Be aware of the side effects such as dizziness, unsteadiness, mental fog and weight gain. My vet once prescribed gabapentin as a sedative for my cat pre-surgery.
Some medicines that increase dopamine levels may be helpful. Some examples are rotigotine, pramipexole, and ropinirole. These are probably the most risky and unreliable — as well as unpronounceable — treatments. So beware.
Occasional RLS may be treated with carbidopa-levodopa, but daily use can cause the spread of RLS to other parts of the body.
As a last resort, sometimes opioids are prescribed. In low doses, according to the Mayo Clinic, addiction is rare, though I would be wary of that. Some examples include oxycodone, hydrocodone, and buprenorphine.
As you can see there are many options for treatment, and you may have to go through several to find the right formula. I would try the lifestyle changes first, as you can do these without a doctor, and they don’t have side effects.
Well, I can tell you from personal experience, restless leg syndrome is kind of a pain, even if you’re not IN pain. But there are options to make it better, and hopefully some of this information will be helpful to you if you suffer from RLS now or in the future.
Until next time, if you’ve got the fever, keep it burning, and if you don’t, catch the fever, and I will talk to you next time on Running: A FEVER.