Restless Leg Syndrome: Symptoms, Causes and Support Strategies
Restless legs syndrome (RLS) can significantly impact your quality of life. The National Sleep Foundation estimates that approximately one in every ten American adults suffer from RLS each year or roughly 11 percent of the general public (3). Still experts believe this neurological disorder is still being under-diagnosed.
A report by the Journal of Clinical Sleep Medicine finds that up to 25 percent of older adults are affected (5). Women of middle-age and those whom already passed menopause report symptoms of restless legs syndrome more than any other group of individuals.
There are four mandatory clinical features that are used by the International Restless Legs Syndrome Study Group to positively classify a RLS diagnosis. These include: (4)
- The urge to move legs because of an unpleasant or uncomfortable sensation
- Symptoms are partially or completely alleviated by movement
- Periods of inactivity such as sitting, lying or sleeping results in worsened symptoms
- Symptoms become worse in the evening or at night
Symptoms of Restless Leg Syndrome:
Symptoms of restless leg syndrome include an uncomfortable sensation in the legs and the constant urge to move them to relieve of pain and feelings of tingling. Generally, these sensations worsen at night causing insomnia and fatigue which is why restless leg syndrome is also referred to as a sleep disorder. Restless leg syndrome might feel like twitching or the feeling of jiggling. When it occurs at night it is associated with a higher dependence on caffeine, alcohol and sleep aids. (2)
Although these unpleasant feelings of bugs crawling under your skin are not dangerous problems, people who suffer from this condition experience a cycle of agitation and lack of quality sleep that increases stress and can lead to more devastating health consequences.
Fortunately, there are several treatment strategies that one can utilize in a multifaceted approach to healing. Experts believe that a healthy lifestyle can greatly help improve symptoms of restless legs syndrome. RLS is understood to run in families and is aggravated by poor dietary choices, increased stress and inflammation.
Causes of Restless Legs Syndrome:
Understanding the origin of the problem can help you overcome restless leg syndrome and maximize your quality of life again. Although some of the contributing factors are out of your control, many underlying problems can be fixed and in general symptoms can be reduced regardless of originating factors.
Genetics and gender are two influences which may increase your chances of having RLS. Some studies find that RLS is an inheritable condition citing that about 50 percent of people with restless legs syndrome have a family history. Women, unlike men are affected by different hormonal pathways which may explain why women are more likely than men to have RLS.
Underlying factors that may be more within your control however outnumber those influences you cannot change. Common factors that can increase the severity of symptoms are as follows.
Nutritional Deficiencies: Nutrient deficiency especially magnesium, iron, folate, vitamin B6, vitamin D and electrolytes critical to the function of the nervous system.
Varicose Veins: Varicose veins can break and leak blood into the legs making symptoms of RLS worsen. A study performed by the National Sleep Foundation found that the treatment of varicose veins using non-surgical sclerotherapy improved symptoms in 98% of patients affected by RLS (6).
Nerve Damage: Medical conditions which can cause nerve damage such as autoimmune disorders and diabetes can lead to RLS. These health problems are associated with malnutrition, anemia, kidney problems and neurological problems that contribute to RLS symptoms.
Medications: Estrogen containing medications such as hormone replacement therapy or birth control pills.
ADHD: Although not as common in children and teenagers, adolescents can still experience RLS. ADHD is a common contributing factor to an increased risk of RLS in both kids and adults.
Neuro Degenerative Disorders: Cognitive disorders such as Parkinson’s disease.
Electrolyte Imbalance: Overtraining or a diet low in electrolytes can cause RLS. Kidney, lung and other chronic diseases or disorders can contribute to an electrolyte imbalance increasing the severity of RLS.
Pregnancy: Pregnancy may increase the risk of having RLS with the greatest occurrence during the third trimester. Although symptoms disappear following deliver, 25% of women develop RLS during pregnancy.
Is it Restless Legs Syndrome or Sciatica?
Don’t confuse the pain found in sciatic nerve pain with restless legs syndrome. Sciatica pain generally runs from the lower back down through the legs and to the feet and is often caused by a herniated disc or pinched nerve.
Sciatica pain is unlike RLS because symptoms do not improve during the day and become more severe during the evening. Remedies that can improve RLS can actually make sciatic nerve pain worst. Coughing, sneezing, bending, and exercising can aggravate the sciatic nerve. (19)
Receiving the proper diagnosis is crucial to overcoming both RLS and sciatica as the approach for each are different. Treating sciatica involves using chiropractic care, massage therapy and therapeutic stretching. The following 7 tips provides a natural approach to finding relief from symptoms of restless legs syndrome.
Improving your diet is one of the single best fixes you can do to change your lifestyle and overcome health problems. Common underlying ailments that contribute to restless leg syndrome include nutrient deficiencies of both vitamins and minerals. Eating a nutrient rich diet that is low in carbohydrates and rich in good quality fats can help stabilize blood sugar preventing against other disorders like diabetes which can contribute to symptoms.
One well researched cause of RLS is an iron deficiency (18). The central nervous system requires iron to promote dopamine function which affects sleep. Supplement iron rich foods into your diet and foods containing B vitamins with B6 and folate to improve your symptoms.
Foods high in iron and B vitamins include leafy greens like spinach and kale, organ meats including liver, sardines, grass-fed beef and lamb. If needed, consider talking with your doctor about the benefits of taking a high quality B-complex supplement to boost your overall levels.
Vitamin D deficiency has also been shown to increase the severity of RLS symptoms (16, 17). Optimal vitamin D levels should fall within the range of 60-100 ng/mL. Aside from receiving plenty of sun exposure daily, bring up your vitamin D levels by consuming foods like salmon, cheese from grass-fed sources and eggs from pasture raised chickens. Taking a supplemental vitamin D is often necessary and warranted.
Another nutrient deficiency that can make RLS symptoms worse is magnesium. Not receiving adequate amounts of magnesium in today’s fast paced and stressed out world is easy to do and afflicts many people. Read on to learn more about why increasing your magnesium levels can improve your symptoms.
2. Support Electrolytes:
Start by making the majority of what you are consuming plant sourced foods. Foods high in electrolytes including potassium, calcium, and magnesium can improve the nutrient deficiency your body is combating. Electrolytes provide a substance that regulates your body’s fluid levels supporting muscle contraction, blood pressure, cellular hydration, nerve impulses and metabolism.
The balance of these electrolytes in your body is critical as a deficiency in any one substance can create problems for concern. Vice versa, the over consumption of too much of any one critical nutrients essential for muscle strength is also problematic.
For instance, one of the most overly consumed electrolytes that may be contributing to your RLS symptoms is salt. An over consumption of salt will lead to a deficiency in potassium creating a pro-inflammatory state of stress and nerve damage. (7, 8)
Incorporate These Foods Into Your Diet:
The best way to make sure you are receiving adequate amounts of these minerals is to add foods containing potassium, calcium and magnesium to your diet (9). Avoiding taking over the counter supplements without consulting a doctor may not only not improve your electrolyte imbalance but may result in toxic side effects.
Good Quality Fats: Avocado, wild caught fish like salmon and sardines, olive oil, coconut oil, organic and pastured sourced dairy products like kefir and yogurt, nuts including almonds and Brazil nuts and various seeds such as chia, flax, hemp and pumpkin seeds.
Vitamin Packed Fruits & Veggies: Dark leafy greens like swiss chard, spinach and bok choy, sweet potato, cruciferous vegetables such as Brussel sprouts and broccoli, cantaloupe.
Healthy Proteins: 100% grass-fed meat such as beef and lamb, lentils, beans, wild caught fish and pasture-raised poultry and eggs.
Low Carbohydrates: Swap your white pastas, whole wheat breads and starchy white potatoes for healthier options like quinoa, wild rice, amaranth, and ancient grains. Even better, avoid all grains and stick with lots of good fats, vegetables and healthy proteins.
Foods to Avoid:
The following foods contribute to symptoms of restless leg syndrome by interfering with optimal nutrient absorption and promoting blood sugar imbalances. Avoid:
- Caffeinated beverages including alcohol
- All refined oils and trans fats
- Processed carbohydrates
- Artificial sweeteners
- White table sugar and high fructose corn syrup
3. Good Hydration:
Healthy cellular function and the prevention of muscle cramps is reliant on proper hydration. Hydration promotes natural detoxification processes and is naturally energizing.
Drink purified water to avoid introducing more toxins to your body and try sipping on lemon water. Mineralized water with lemon oxygenates cells, purifies the blood, strengthens the immune system, balances pH and produces overall feelings of rejuvenation
Suffers of RLS can reduce symptoms of can significantly improve symptoms by hydrating with purified water, mineralizing water and may especially benefit from the anti-inflammatory effects of electrolyte rich coconut water as well.
4. Essential Oils:
The use of essential oils is a long withstanding human practice that has been used throughout history. Aromatherapy is a practice that can be used to calm the nervous system alleviating stress, anxiety, aid in restful sleep, ease sore muscles and has been an alternative form of medical practice for thousands of years. In fact, various studies report that the use of essential oils has immunomodulation effects that can benefit individuals suffering from restless legs syndrome (10, 11).
Apply essential oils to the affected areas on your legs to provide the soothing comfort of pain relief. Massage oils with antispasmodic properties into your skin to alleviate muscle cramps and spasms. Some of these oils include peppermint, rosemary, lavender, cedarwood and cypress essential oils. Treat yourself to a professional massage or perform your own massage therapy on your muscles before bed to help get a better night’s rest.
Aromatherapy options for essential oils that can help treat anxiety and restlessness includes vetiver, frankincense, bergamot, sandalwood and marjoram (12). For more info on how to use essential oils read this article.
5. Regular Exercise:
Clinical studies support that regular exercise can help restless legs syndrome sufferers reduce symptoms. A 2006 study revealed that individuals who participated in exercise no less than 3 times per week involving lower-body resistance training and moderate exercise experienced significantly reduced RLS symptoms. The majority of the patients found to have lowered pain severity by 50% over six weeks’ time. (1)
Receiving regular exercise alone is not the only improvement you can make to your new fitness level. Performing stretching exercises is also critical to avoiding overstrained, tight muscles and increase blood from building up and becoming stagnant in the lower extremities. Avoid working your muscles out too hard or too often and be sure to rest muscle groups. Incorporate the following stretches into your daily agenda to improve restless leg syndrome symptoms: (2)
- Place your foot up against a wall and gently bend the toes and foot back towards your body until you feel a stretch in your heel.
- Perform calf muscle stretches by completing a runner’s lunge
- Bend the upper half of your body towards the floor and try to touch your toes to stretch hamstrings.
- Stretch your quad muscles by standing on one leg (leaning up against a wall if needed) while bending the other leg back so that the heel of your foot is reaching towards your butt.
- Sit on the ground. Bend your knees so that the heels of your feet touch each other like butterfly wings and allow your knees to fall to the floor while stretching the hip.
Our bodies were not meant to live a sedentary lifestyle. Move often and avoid sitting for long periods of time.
6. Dry Brushing and Epsom Salt Baths:
An Ayurvedic practice that has been used to boost circulation and therefore also help with lymphatic flow and the stagnant build-up of blood in the legs is dry brushing. Other benefits of dry brushing include improve nervous system function, heightened energy, and a strengthened immune response which can reduce symptoms associated with restless legs syndrome. Use the following recommendations for receiving the benefits of dry brushing:
- Using a natural bristle brush, brush skin in the direction of the heart
- Brush skin when dry, preferably before a warm shower to help eliminate dead skin cells and open up pores for detoxification
- Never dry brush before bed to avoid interference with sleep
You may wish to follow up your dry brushing with a bath. Epsom salt baths have been traditionally used to treat muscle spasms, pain, bruises, and tingling by increasing magnesium absorption into the body. Epsom salts are an alternative healing mechanisms with anti-inflammatory properties due to the high rate of Epsom salt (in the form of magnesium sulfate or MgSO4) into magnesium, sulfur and oxygen.
Epsom salt baths are easy and affordable. Set aside 40 minutes of relaxation as your body will work to remove toxins the first 20 minutes and secondly to absorb the minerals the 2nd half of your treatment. Consider adding a few drops your favorite essential oils to help with your symptoms. The following concentrations of Epsom salt are recommended:
Individuals between 60-100 lbs: Add 1 cup of salts to a standard sized bath
Individuals between 100-150 lbs: Add 1 1/2 cup of salts to a standard sized bath
Individuals between 150-200 lbs: Add 2 cups of salts to a standard sized bath
*For every 50lbs more: add in an additional 1/2 cup of salts.
7. Food Sensitivities:
Recent research links restless legs syndrome with gastrointestinal disorders. In one study, patients with irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) were found to have a higher occurrence of restless legs syndrome than their opposing healthier subjects. Individuals with SIBO had the highest association with restless leg syndrome of which 69% of RLS patients were also diagnosed with SIBO. This clinical study recognizes that gastrointestinal health is a primary concern for treating RLS. (13)
Researchers believe there are three possible reasons regarding the relationship between food sensitivity affecting gut health and RLS.
- Gastrointestinal disorders lead to autoimmune abnormalities resulting in neuropathy.
- Individuals with RLS have weakened immune systems which predisposes them to gut dysfunction.
- Inflammation from gastrointestinal complications increases the malabsorption of iron by the central nervous system.
Therefore it is critical for RLS patients to quickly act on identifying any food sensitivities that may impair the health of the gut. Common food allergies including gluten, milk, nuts, eggs and shellfish can not only trigger a life threatening reaction but can lead to chronic inflammation and gut dysbiosis (14). As a result a spiral of worsening health effects contributes to nutrient deficiencies, nerve damage and severe symptoms of restless legs syndrome (15).
Clinically, I use an elimination diet in order to help people discover and overcome food sensitivities that they may or may not have been aware of. You can learn how to follow an elimination diet in this article.
Research has been coming out indicating restless leg syndrome and dopamine and serotonin imbalances (20, 21). Dopamine and serotonin play a large role in overall nerve impulses and muscle movement. Extreme dopamine deficiency causes Parkinson’s.
Restless leg syndrome is now being thought to be a similar kind of movement disorder related to Parkinson’s, however, there is no research that indicates RLS increases the risk of developing Parkinson’s later in life.
Dopamine agonists are being shown to help relieve the symptoms of RLS as well as Parkinson’s. These medications, do deplete B6 levels long-term which can cause much further problems.To support the dopamine pathways I use a variety of strategies as explained in this article