Do you experience persistent sensations in your legs that keep you awake at night? Even when the rest of your body is aching to fall into a state of deep sleep, you repeatedly overcome by this need to keep moving your legs, tossing and turning until the break of dawn.
What makes this condition even more frustrating is that it is often shrugged off by those not suffering from it with a casual “it’s all in your head.”
Rest assured (no pun intended) that this seemingly strange condition is not psychosomatic. You may very well be afflicted by what is known as restless legs syndrome (RLS), a neurological disorder affecting an estimated 12 million Americans.
It causes an uncomfortable feeling in the leg, most notably when sitting or lying down, leading to an overwhelming desire to move the leg. Moving the leg relieves the discomfort temporarily, but it reappears after a short time.
Causes and Types of RLS
The exact cause of RLS is unidentified. However, it is sometimes associated with several medical conditions.
There are basically two types of RLS:(1)
- It’s more prevalent in younger people and the symptoms usually start to set in before the age of 40, sometimes even during childhood.
- It’s sometimes hereditary in nature and usually runs in the family.
- Symptoms can be intermittent or progress and worsen gradually.
- Primary RLS is a lifelong condition, which can only be managed but not cured.
Secondary RLS is a result of some separate underlying medical condition. It’s sometimes triggered by the use of certain drugs in some patients. The common features of secondary RLS are as follows:
- The onset of this type of RLS usually begins later in life, after the age of 45, and it’s not generally hereditary in nature.
- Its occurrence can be sudden and more severe in nature.
- The symptoms may disappear once the underlying medical condition is treated.
- Iron deficiency and pregnancy are known to be the major causes of secondary RLS.(4)
Other conditions known to cause the disease are:
- Obesity, smoking, and diabetes
- Kidney failure(5)
- High blood pressure and heart disease
- Parkinson’s disease(6)
- Thyroid dysfunction
- Autoimmune disease, peripheral neuropathy
- Alcohol or opioid withdrawal(7)
- Medications including certain antihistamines, antipsychotics, antidepressants,(8) anticonvulsants, and anti-nausea drugs, are known to trigger or worsen the symptoms of RLS.
Signs and Symptoms of RLS
- Symptoms of RLS come to the fore when the patient is in a position of rest. They tend to fluctuate in severity and are at their worst during the evening, especially with the onset of sleep.
- An irresistible urge to move the legs following unpleasant sensations such as throbbing, pulling, creeping, tingling, or strange crawling feeling in the legs are the hallmark symptoms of this disorder.(9)
- The intensity of these symptoms can range from uncomfortable to irritating to painful.
- There is persistent restlessness or urge to move in order to relieve the discomfort temporarily.
- The symptoms tend to get better during the daytime and might even disappear altogether.
- Long periods of inactivity or restrictive movement of the limbs due to confined space such as long flights, sitting in a movie theatre or in front of the TV, car trips, or immobilization due to a cast can also trigger the symptoms.
- The persistent discomfort at night causes sleep deprivation, which in turn results in exhaustion, daytime fatigue, and higher rates of anxiety or depression in patients suffering from RLS.
- Although these symptoms generally manifest themselves deep inside the leg, between the knee, and in the ankle, they can occur in the feet, thighs, arms, and hands as well.
- Furthermore, this condition most often afflicts both sides of the body rather than just one side.
- The symptoms may subside or show marked improvement during the initial stages of the disorder, but they will eventually reappear and exacerbate over time.
Prevention of RLS
- Cultivate healthy sleep habits that could help make up for the loss of sleep caused by this condition and help cancel out the detrimental effects of RLS to some degree.
- Because a deficiency of iron and other vital vitamins is often associated with RLS, it is advisable to consult your doctor about possible inclusion of the requisite supplementation of iron or vitamin D, C, or E in your diet.
- Going by anecdotal evidence, keeping your bedding loose can help by allowing your feet to rest in a natural position.
- Sleeping with your legs in an elevated position, generally with the help of a pillow, can work to reduce the symptoms of RLS.
- Caffeine, alcohol, and nicotine can aggravate the symptoms of RLS and thus should be kept at a minimum if not discontinued altogether.
- Engaging in miscellaneous activities that keep your brain preoccupied helps with the anxiety that often comes as part and parcel of RLS. Knitting, crossword puzzles and other games, reading, or just a deep meaningful heart-to-heart are just some of the ways you can keep your mind off your symptoms.
- Incorporating moderate exercise in your daily routine can help relieve RLS symptoms and can help induce better sleep. However, it is essential that the exercise should not put undue strain on any points of pain and discomfort.
Risk Factors Associated with RLS
- RLS affects people of all ages, and usually, the condition deteriorates with age.
- Women appear to be more susceptible to RLS than men.
- Although the disease affects the person psychologically, it is not a serious disease itself.
- RLS is often indicative of some ongoing abnormal or serious latent medical condition such as diabetes, end-stage kidney disorder, anemia, and spinal cord injury.
Diagnosis of RLS
Diagnosis of RLS is largely based on the presence of RLS symptoms and ruling out other medical conditions. Results of a physical and neurological exam, the symptoms described by the patients, and their sleep patterns, medical history, family background, travel history, and lifestyle give crucial clues to the General Practitioner (GP).
The GP will assess the patient for the signs and symptoms of some other underlying medical conditions causing the issues. Certain blood tests are done to rule out pregnancy, kidney failure, diabetes, or anemia.
When to See a Doctor
People suffering from RLS often underestimate their symptoms and avoid visiting the GP. The condition continues to worsen over time to a stage when managing it becomes increasingly difficult.
The sleep deprivation and the resulting exhaustion, anxiety, and depression can have long-standing effects on the quality of the affected person’s life.
Moreover, RLS is often rooted in some underlying medical condition that might be serious. Thus, it’s always a good idea to consult with your healthcare provider if you have symptoms of restless leg syndrome, especially if you are over 45.
Prescription medication may help treat the problem, but you can also keep symptoms at bay with home remedies that can calm your legs and help you get a good night’s sleep.
The length of time needed for these remedies to work varies depending upon the severity of your symptoms.
Remedies to Manage Restless Leg Syndrome at Home
Here are some home remedies for RLS.
1. Hot and Cold Foot Soak
Alternating use of warm and cold soaks for your leg muscles can help reduce cramping and can ease the pain associated with RLS. The heat stimulates blood circulation, whereas the cold helps curb inflammation.(10)
- Fill one bucket with cold water and another with bearable hot water.
- Put your feet in the hot water for 3 minutes.
- Then, dip them in the cold water for 10 to 60 seconds.
- Repeat two or three times.
- Follow this regimen twice daily for effective results.
2. Take Epsom Salt Bath
An Epsom salt bath right before turning in can help you sleep better through the night. The high amount of magnesium sulfate present in Epsom salt helps soothe sore muscles and calm the nerves.(11)
- Pour 1 cup of Epsom salt into warm bath water. Use your hands to stir the water to help the salt dissolve better.
- Soak in the bath for at least 30 minutes.
- Do this daily.
3. Drink Tonic Water
Tonic water is a carbonated soft drink containing quinine, a compound that can help settle the nervous system and provide relief from various symptoms of RLS. It acts as a muscle relaxant and improves blood flow to the muscles.(12)
- Drink 1/4 cup of tonic water before going to bed each night. Sip it slowly so the body has time to absorb the quinine.
4. Sip on a Cup of Chamomile Tea
- Enjoy a warm cup of chamomile tea to relieve tension and stress in the nerves and muscles. Drink this tea 1 to 2 hours before bedtime.
- Alternatively, massage your legs with chamomile oil for a few minutes before going to bed.
5. Blackstrap Molasses can Help
Blackstrap molasses is rich in iron, which is believed to be beneficial in treating various symptoms of RLS.(14) An integral component of hemoglobin, iron helps transport oxygen from the lungs to different cells of the body. Iron is also indispensable for energy production and metabolism.
In addition to iron, blackstrap molasses also contains other minerals including calcium and potassium. Blackstrap molasses is available at most health or natural food stores.
- Stir 1 tablespoon of blackstrap molasses into 1 cup of water.
- Drink this solution half an hour before retiring to bed.
- Do this daily for best results.
You can also drink a combination of 1 tablespoon each of blackstrap molasses and apple cider vinegar mixed in 1 cup of water.
6. Reap the Benefits of Peppermint
Peppermint has high menthol content that can help numb the restless feeling in your legs and provide pain relief to aching muscles.(15)
- Drink a cup of peppermint tea before going to bed to relax the muscles and promote restful sleep. In fact, 3 to 4 cups of peppermint tea in a day is considered healthy.
- Alternatively, apply peppermint oil directly on the legs and then gently massage your legs for 5 to 10 minutes. This will help relieve tension.
7. Lavender Oil can Give You Relief
Lavender oil is often used as a relaxant and thus can help reduce symptoms of RLS. Additionally, the aromatic scent of the oil has a calming effect that can lull you to a good night’s sleep.(16)
- Simply rub a few drops of lavender oil on the bottom of each foot before getting into bed each night.
- Alternatively, add a few drops of lavender oil to a small tub of lukewarm water. Soak your feet in this water for 10 minutes before going to bed each night.
Anecdotal Remedies for Restless Leg Syndrome
Camphor has therapeutic and antispasmodic properties, which make it a go-to product for relieving inflammation and alleviating RLS symptoms.
- Gently rub a small amount of camphor oil on your legs before going to bed. Within minutes, the tingling sensation in your legs will go away. Do this daily.
- You can alternatively use camphor cream for the same effect.
A leg massage with coconut oil can have a mitigating effect on the uneasiness caused by RLS. It works by improving blood circulation and relaxing the nerves to help you sleep soundly at night.
- Slightly warm some coconut oil and then massage it all over your legs.
- Rub the oil in your legs using circular motions of the hands, moving upward from the ankles.
- Do this daily to relax your muscles.
You can also use warm mustard oil as a suitable alternative.
RLS is considered to be beyond cure, and its symptoms may gradually worsen with age, which is usually faster in the case of secondary RLS. Because secondary RLS is often traced back to some other medical conditions, current treatments more or less focus on treating the underlying disorder and managing the symptoms to improve the quality and duration of sleep. In some patients, remissions were reported, where the symptoms disappeared for days or even months but eventually reappeared.
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- Sales S, Sanghera MK, Klocko DJ, Stewart RM. Diagnosis and treatment of restless legs syndrome. Journal of the American Academy of Physician Assistants. https://utsouthwestern.influuent.utsystem.edu/en/publications/diagnosis-and-treatment-of-restless-legs-syndrome. Published June 14, 2016.
- Shiyi G, Jinsha H, Jiang H, et al. Restless Legs Syndrome. Front. Aging Neurosci. https://www.frontiersin.org/articles/10.3389/fnagi.2017.00171/full. Published May 16, 2017.
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- Winkelman JW, Chertow GM, Lazarus MJ. Restless legs syndrome in end-stage renal disease. Plum X Matrix. https://www.ajkd.org/article/S0272-6386(96)90494-1/abstract.
- Piao, Ying-Shan, et al. “Restless Legs Syndrome in Parkinson Disease: Clinical Characteristics, Abnormal Iron Metabolism and Altered Neurotransmitters.” Researchgate, researchgate.net/publication/319491303. Published September 2015.
- Mackie, Susan E., et al. “Prevalence of Restless Legs Syndrome during Detoxification from Alcohol and Opioids.” Journal of Substance Abuse Treatment, Academic Press, sciencedirect.com/science/article/pii/S0740547216301386. Published October 6, 2016.
- Kolla, BP, et al. “The Influence of Antidepressants on Restless Legs Syndrome and Periodic Limb Movements: A Systematic Review. ”Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, ncbi.nlm.nih.gov/pubmed/28822709. Published April 2018.
- Muth, Christopher C. “Restless Legs Syndrome.” JAMA, American Medical Association, jamanetwork.com/journals/jama/fullarticle/2603932. Published February 21, 2017.
- Nordlander NB. Therapy in Restless Legs. Journal of internal medicine. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.0954-6820.1953.tb07042.x. Published April 24, 2009.
- Bartell, S, and S Zallek. “Intravenous Magnesium Sulfate May Relieve Restless Legs Syndrome in Pregnancy.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, ncbi.nlm.nih.gov/pubmed/17557494. Published April 15, 2006.
- Brasić, J R. “Should People with Nocturnal Leg Cramps Drink Tonic Water and Bitter Lemon?” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/pubmed/10335049. Published April 1999.
- Abdullahzadeh, Mehrdad, et al. “Investigation Effect of Oral Chamomilla on Sleep Quality in Elderly People in Isfahan: A Randomized Control Trial.” Researchgate, researchgate.net/publication/317612406. Published June 2017.
- Connor, James R., et al. “Iron and Restless Legs Syndrome: Treatment, Genetics and Pathophysiology.” NeuroImage, Academic Press, sciencedirect.com/science/article/pii/S1389945716302544. Published November 10, 2016.
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