Restless legs syndrome

Encyclopedia of Medicine, Apr 06, 2001 by Ann M. Haren

• Acupuncture. Patients who also suffer from rheumatoid arthritis may especially benefit from acupuncture to relieve RLS symptoms. Acupuncture is believed to be effective in arthritis treatment and may also stimulate those parts of the brain that are involved in RLS.
• Homeopathy. Homeopaths believe that disorders of the nervous system are especially important because the brain controls so many other bodily functions. The remedy is tailored to the individual patient and is based on individual symptoms as well as the general symptoms of RLS.
• Reflexology. Reflexologists claim that the brain, head, and spine all respond to indirect massage of specific parts of the feet.
• Nutritional supplements. Supplementation of the diet with vitamin E, calcium, magnesium, and folic acid may be helpful for people with RLS.

Some alternative methods may treat the associated condition that is suspected to cause restless legs. These include:

• Anemia or low ferritin levels. Chinese medicine will emphasize stimulation of the spleen as a means of improving blood circulation and vitamin absorption. Other treatments may include acupuncture and herbal therapies, such as ginseng (Panax ginseng) for anemia-related fatigue.
• Late-stage pregnancy. There are few conventional therapies available to pregnant women, since most of the drugs prescribed are not recommended for use during pregnancy. Pregnant women may benefit from alternative techniques that focus on body work, including yoga, reflexology, and acupuncture.

RLS usually does not indicate the onset of other neurological disease. It may remain static, although two-thirds of patients get worse with time. The symptoms usually progress gradually. Treatment with Levodopa is effective in moderate to severe cases that may include significant PLMS. However, this drug produces significant side effects, and continued successful treatment may depend on carefully monitored use of combination drug therapy. The prognosis is usually best if RLS symptoms are recent and can be traced to another treatable condition that is associated with RLS. Some associated conditions are not treatable. In these cases, such as for rheumatoid arthritis, alternative therapies such as acupuncture may be helpful.

Diet is key in preventing RLS. A preventive diet will include an adequate intake of iron and the B vitamins, especially B12 and folic acid. Strict vegetarians should take vitamin supplements to obtain sufficient vitamin B12. Ferrous gluconate may be easier on the digestive system than ferrous sulfate, if iron supplements are prescribed. Some medications may cause symptoms of RLS. Patients should check with their doctor about these possible side effects, especially if symptoms first occur after starting a new medication. Caffeine, alcohol, and nicotine use should be minimized or eliminated. Even a hot bath before bed has been shown to prevent symptoms for some sufferers.

• Books
• The Editors of Time-Life Books. The Medical Advisor. The Complete Guide to Conventional and Alternative Medicine. Alexandria, VA: Time Life Books, 1997.
• Long, James W., and James J. Rybacki. The Essential Guide to Prescription Drugs. New York: HarperPerennial, 1995.
• Mills, Simon, and Stephen J. Finando. Alternatives in Healing. New York: New American Library, 1989.
• "Peripheral Neuropathies." In Mayo Clinic Family Health Book, edited by David E. Larson. New York: William Morrow and Company, 1996. Periodicals
• Montplaisir, Jaques, et al. "Clinical, Polysomnographic, and Genetic Characteristics of Restless Legs Syndrome: A Study of 133 Patients Diagnosed with New Standard Criteria." Movement Disorders 12 (1997): 61-65.
• O'Keeffe, Shaun T. "Restless Legs Syndrome: A Review." Archives of Internal Medicine 56 (Feb 12, 1996): 243-246.
• Silber, Michael H. "Concise Review for Primary-Care Physicians. Restless Legs Syndrome." Mayo Clinical Proceedings 72 (March 1997): 261-264. Organizations
• Restless Legs Syndrome Foundation. 1904 Banbury Road, Raleigh, NC 27608-4428. (919) 781-4428. http://www.rls.org.