Many patients come into our clinic unaware that there actually are ways to treat restless leg syndrome. That irritating twitch of the legs that keeps a person up at night is something that can be significantly lessened through either conservative or progressive treatments.
What is Restless Leg Syndrome (RLS)?
Restless Leg Syndrome is actually a description of symptoms rather than a formal diagnosis. The symptoms are often described as an abnormal sensation that causes the legs to continuously move at night. This condition makes falling asleep extremely difficult.
Restless Leg Syndrome is primarily a neurological disorder that can result from a metabolic disease such as diabetes or thyroid malfunction, or from toxin exposure that causes damage to the nerves.
What we know about RLS:
- RLS is a neurologic condition because the symptoms of RLS are related to nerve function.
- There are a lot of variabilities as the severity of RLS symptoms varies from patient to patient.
- RLS is quite common: studies indicate 4-14% of the population suffer from RLS to some degree and the frequency often increases with age.
- RLS is associated with many diseases including iron deficiency, poor kidney function, low thyroid function, depression, fibromyalgia, and diabetes. Interestingly, all of these conditions are also associated with poor nerve function.
What are some home remedies for RLS?
To treat Restless Leg Syndrome at home, try taking a Vitamin-D supplement, take an iron supplement, sleep with a weighted blanket (this releases serotonin and melatonin, which have a calming effect, and decrease cortisol levels, which is a stress hormone), and/or exercise (stretching, walking, riding a bike, and practicing yoga have all shown to be helpful).
How do we treat RLS?
Moving around or walking tends to make the symptoms less intense but treatment with dopamine agonists (dopamine-like drugs) is the most common remedy. These include medications like Apomorphine (Apokyn), Pramipexole (Mirapex), Ropinirole (Requip), and Rotigotine (Neupro). Other medications that can help with Restless Leg Syndrome include gabapentin, pregabalin, and opioids.
What if your RLS doesn’t improve?
We have observed in our clinic that about 50% of patients with restless leg syndrome also demonstrate symptoms consistent with nerve entrapment. Oftentimes, these nerve entrapment sites are either unknown or unrecognized by other doctors, but they are part of the standard examination for patients with neurologic symptoms at the Next Step Foot and Ankle Clinic. Proper clinical examination and a patient’s response to injection can lead to a definitive diagnosis. We have had many patients come to our office with neurologic symptoms and restless leg syndrome and we’ve treated these patients with various treatment options, including surgical decompression of the nerve.
A study done in 2017 by James Anderson revealed a substantial improvement of Restless Leg Syndrome symptoms after nerve decompression surgery. The table below was a retrospective review of 42 patients that had Restless Leg Syndrome, 15 weeks after nerve (common and superficial nerve) decompression surgery:
As you can see, there was a substantial decrease in RLS symptoms within this group of patients. Our clinic has observed similar results from our patients after surgical decompression of the common fibular nerve.
What is nerve decompression surgery like?
Not everyone who has Restless Leg Syndrome is a candidate for Common Fibular Nerve Decompression but a plurality of patients are. Deciphering who will benefit best from this procedure is the trick and having a surgeon who knows how to effectively perform the surgery is critical.
The procedure is a relatively easy surgery to recover from. Our clinic recommends our patients lay down for three days with the foot elevated above the head. After these initial three days, the patient can do most daily activities within reasonable limits. The surgical area is still recommended to be wrapped to prevent swelling, and icing and elevation after activity would still be a good idea for 1-2 weeks. If you’d like to hear a patient’s experience with this surgery, CLICK HERE. Thankfully, this surgery has an impressively high success rate, which is why it is one of the most rewarding surgeries we perform.
If you suffer from Restless Leg Syndrome, we highly encourage you to make an appointment with one of our specialists to discuss what options you have for treatment.
To get a copy of this month’s Patient Newsletter featuring Restless Leg Syndrome, CLICK HERE.