Restless Leg Syndrome

Restless Leg Syndrome (RLS) is surprisingly common. The prevalence of occurrence is approximately 10 percent of the “adult” population. The diagnosis is often vague, but essentially RLS is:

  1. Characterized by an irresistible urge to move the legs, particularly at night when lying or sitting down.
  2. May be accompanied by symptoms of “skin crawling,” tingling, or a sense of pressure in their calf muscles.
  3. Symptom relief when moving around
  4. Waking up in the middle of the night with these symptoms again.

If symptoms occur more than twice a week, and result in severe disruption of sleep patterns and marked daytime symptoms, the case is severe and requires immediate investigation and intervention.

The causes of RLS are varied. Often, the “cause” is a combination of two or more of the following components:

  1. Genetic, especially if appearing before the age of 30.
  2. Secondary variations that are reversible (pregnancy, kidney failure, and anemia’s).
  3. Associated conditions that exacerbate RLS and must be treated to resolve the condition (spinal cord compression, peripheral neuropathy, iron and B-12 anemia’s, kidney failure, iron deficiencies).

There are many lifestyle factors that make RLS worse. Central nervous system stimulants and depressants must be evaluated in a thorough history, and be reduced or eliminated for maximum recovery.

The mechanism of RLS is primarily a dysfunction of a part of the brain called the basal ganglia. It controls neurological output from the brain and allows our central nervous system to be calm relative to body movements. When the basal ganglion is not functioning properly, excessive movement while at rest occurs in the body. A very well known and severe manifestation of poor basal ganglia function is Parkinson’s disease. RLS is a less severe manifestation of the same brain dysfunction.

The medical approach is to treat with dopamine medications, to calm down the basal ganglia and benzodiazepines to keep the patient asleep. The approach is typically successful, but the side effects of long term use of these medications can often create psychiatric side effects and can damage internal organs.

There are other approaches. Functional medicine treats the body as a whole and evaluates all components–musculoskeletal, neurological (i.e. basal ganglia), and metabolic (i.e. anemia’s, iron deficiencies, diabetes, etc)–that contribute to destabilizing the basal ganglia itself and thus allowing the excess movements to occur. Neurologically, other parts of the brain (cerebellum and frontal lobes) “fire” on the basal ganglia and cause it to work properly. If they are not functioning correctly, they need to be and can be, “strengthened” through specific brain exercises. As they strengthen and function better, the basal ganglia calms down and can recover; so does the RLS.

The brain needs proper nutrients to function well. Those patients are evaluated metabolically for indicated nutritional and dietary changes, or herbal/botanical support that will allow the frontal and cerebellar lobes to function better, and do their job in correcting the basal ganglia and subsequently the RLS. The advantage of the functional model: no medications, no long term side effects, and an individualized operating manual for that patient to follow, to control the condition permanently.

It is a very effective approach for those individuals interested in non-drug, cause-based alternatives if the medications don’t work or if side effects, present, and future, are an issue.