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Restless Legs

Strategies for a good night’s sleep

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Restless Legs

Twitching, crawling, creeping or burning are some of the words used to describe restless leg syndrome. Missing nutrients could be one of its causes.

Subtle yet maddening. It’s how people describe restless legs that keep them awake night after night. Modern medicine has found no specific cause or cure for restless legs syndrome (RLS); however, there are natural remedies to help calm those annoying legs and their relentless demands to keep on moving.

What does it feel like?

RLS sensations are extremely unpleasant, yet they seem to defy description. People describe twitching, crawling, pulling, aching, tugging, burning, creeping and throbbing with a strong desire to move or shake the legs and/or arms.

There are no tests for a clinical diagnosis. Physicians review sufferer complaints and classify the syndrome based on the following criteria:

  • symptoms are worse at night
  • the urge to move the limb(s) is overwhelming
  • symptoms are triggered by rest, relaxation or sleep
  • symptoms are relieved with movement and the relief lasts as long as the movement continues

About RLS

Restless legs syndrome (also known as Willis-Ekbom disease) is a neurological movement disorder that occurs at any age, even in childhood, but is generally an ageing-related issue. It is estimated that up to 10 per cent of us experience RLS. Women tend to suffer at a higher rate than men.

The cause is not known; however, research shows a genetic link. Fifty per cent of early onset (before age 40) sufferers have a family member who also suffers. It is also well established that RLS is associated with kidney failure, pregnancy, diabetes and iron deficiency anaemia. New research also shows associations with obesity, irritable bowel syndrome, coeliac disease and erectile dysfunction.

Quality of life

An RLS sufferer’s quality of life is deeply affected. They may avoid long performances such as movies or presentations, car trips, air travel and activities where opportunity for frequent movement is restricted.

Sleep deprivation is the biggest health concern. RLS is considered a sleep disorder. The compulsion to walk, stretch or shake the legs impairs the ability to get restorative sleep (for the sufferer and their sleep partner). This leads to a multitude of secondary problems, such as loss of memory, concentration and coordination.

As a result, people with RLS may experience

  • increased risk of car accidents
  • decreased job performance if alertness or coordination is required
  • higher incidence of anxiety and depression
  • exhaustion
  • chronic health issues that result from restriction of the body’s natural repair processes that occur during deep sleep

Treatment

Since the exact cause of RLS is unknown, Western medicine focuses on symptom reduction. A physician may look at medication triggers and suggest decreasing caffeine, alcohol and tobacco intake and maintaining a regular sleep pattern. Although dopamine-related drugs may help manage the symptoms in the short term, they can actually worsen the severity of symptoms over time.

Missing nutrients

“Patients with RLS often present with constipation,” says Dr Gary Kracoff, naturopath, pharmacist and educator. Constipation is a symptom of low magnesium, which all muscles need to relax. Kracoff suggests patients take a magnesium glycinate supplement as well as Cuprum metallicum, a homeopathic treatment commonly used for muscle spasms.

Naturopathic doctor Cammi Balleck supports the nervous system and neuromuscular system with choline and inositol supplementation. These help metabolise fat and open the blood vessels by relaxing the nerves. She also prescribes essential polyunsaturated fatty acids to transport calcium from the blood to the tissue.

Move more

“I also advise patients to exercise and stretch their leg muscles to help increase circulation,” says Kracoff. “Simple activities such as walking up and down stairs will help stimulate blood flow.”

Chiropractor Dr Greg MacLuckie also prescribes movement. “Low legs need to contract via the calf muscle pump that contracts around the veins to send blood back to the heart,” he says. “This is essential for normal circulation.” He prescribes a simple calf raise exercise for 20 repetitions twice per day.

Add some yoga

Research on women with RLS found improvements in sleep quality when yoga was introduced. “The legs can be a place of circulation challenges,” says yoga instructor Temani Aldine. She recommends a technique called toe tapping to increase circulation by stimulating the legs.

“Balancing the pelvis is an important part of reducing RLS symptoms,” says Jennifer Colletti, an Ayurvedic yoga specialist who works with students with RLS. She suggests anything that lengthens and extends the spine will in turn create balance in the pelvis.

For example, a gentle routine of cat to cow poses and then a gentle flow from child’s pose to downward dog pose. “If you could only choose one, legs-up-the-wall pose is the way to go,” she says. She recommends holding this pose for five to seven minutes, half an hour before bedtime.

There is hope for individuals seeking a whole person approach to managing and possibly eliminating restless legs. A multi-practitioner team may be required to get started; however, an ongoing strategy is relatively straightforward.

4 simple moves to calm restless legs

Cat to Cow Pose

  • Start on all fours.
  • Raise the head to gaze at the sky while arching the back downwards.
  • Reverse the movement by arching the spine towards the sky while drawing the chin to the chest.
  • Repeat 5 to 8 times.

Legs-up-the-Wall Pose

  • Lie on your back with the sits bones and back of your legs straight and up against a wall, feet up.
  • Hold 5 to 7 minutes.
  • Perform daily 30 minutes prior to bedtime.

Calf Raises

  • Stand next to a wall for support.
  • Lift heels off the ground, activating the calf muscles.
  • Repeat 20 times.
  • Perform twice per day.

Toe Tapping

  • From a seated position with legs stretched out and parallel, heels touching each other, repeatedly tap the bases and tips of the big toes together.
  • Do 100 repetitions.

Herbs and supplements for RLS

A natural health practitioner can help identify deficiencies and prescribe appropriate supplements to help manage restless legs by supporting the nervous, circulatory and muscular systems.

Supplement Benefits for RLS
calcium a magnesium/calcium imbalance can result from a low-nutrient diet and poor calcium absorption
choline an essential nutrient that supports messages from and to nerves and between nerves and muscles
folate an essential vitamin; a 2007 study showed folate supplementation improved all RLS symptoms
inositol affects nerve transmission and the transportation of fats throughout the body, widens blood vessels and has been shown to reduce symptoms of depression and anxiety
iron important for normal neurological function; brain iron deficiency is well established in RLS
magnesium low levels of magnesium have been found in RLS sufferers
polyunsaturated improves nervous system function; supports cells and calcium transport into tissues
essential fatty acids shown to reduce the severity of symptoms of RLS
St. John’s wort shown to improve symptoms of RLS and decrease daytime sleepiness
valerian taken together, shown to reduce the severity
vitamins C and E of RLS symptoms in hemodialysis patients
Cuprum metallicum a homeopathic remedy containing copper that is used to manage muscle spasms
water dehydration can exacerbate RLS
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