Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

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Symptoms include strange feelings in the legs such as "creepy, crawly sensations," feelings like tiny worms working through the leg muscles, numbness, tingling, pins and needles. Also, the person afflicted with this condition feels that they must walk, no matter how tired they are. Relief can only be obtained by walking, massaging, or stretching the muscles, using hot or cold compresses, doing deep knee bends, or working the legs in a bicycling fashion.

Leg twitches may occur every 20-40 seconds during sleep, and sometimes during wakefulness. Other signs are depression, muscle or intellectual fatigue, depressed ankle jerk, diminished vibration sense in the legs, stocking-type of reduced sensation, and long lasting constipation.-Modern Medicine, February 15, 1977, p.69.

Nearly five percent of the population is affected. [As of 2023, restless leg syndrome affects an estimated 5 to 10 percent of adults and 2 to 4 percent of children in the United States.] As many as a million [now more than 5 million] people suffer from a severe form of restless leg syndrome. A majority are middle aged, or older. Most of the victims have only a mild case. Persons may discover they have it only after their bed partner protests of being continually kicked. Evenings, or during the night, are the worst times. After lying down the symptoms worsen, or you become more aware of them.

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‍Causes

1. ‍‍Metabolic
2. Vascular
3. Neurologic factors

Triggering factors may be

• anemia
• circulatory problems
• diabetes
• alcoholism
• pregnancy
• antidepressants
• diseases of the kidneys
• nerves
• muscles
• the use of caffeine
• calcium challenge blockers
• several other types of drugs
• folic acid deficiency
• iron deficiency

The condition tends to run in families, and the familial types tend to be the worst cases.

Sudden remissions lasting months, or years, may occur, followed by relapses, many times without recognizable precipitating factors.

Drugs prescribed for the disorder are of little or no benefit, including aspirin, Ibuprofen, other painkillers, sleeping pills, tranquilizers, muscle relaxants, antidepressants (some of which aggravate, or even cause symptoms), vitamin or mineral supplements, quinine, and allergy drugs. People have tried hypnosis, deep massage, acupuncture, thermal baths, meditation, and an alarming array of drugs.‍

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Treatment

‍There is no known sure cure, but there are some helpful treatments. We suggest the following for the restless leg syndrome:

1. Be certain to sleep in fresh air, having a current of fresh circulating air in the bedroom at all times. Do not sleep in an electric field, such as in a waterbed, or under an electric blanket. The heating pad should be kept out of the bed, until it is needed. Simply turning electrical appliances off does not entirely stop the electrical field around the appliances, it only reduces it.
2. Do not take medication, as the condition is likely to be long-term, and none of the medications usually used for restless leg syndrome are without serious side effects. Try diligently to find some way, using physical therapy means, to control the uncomfortable sensations so that you can avoid the side effects of medicines.
3. During the day, keep your extremities, particularly the legs, very warm. This means that during cold weather you may need to wear from two to five layers of warm long-johns in order to keep your legs warm, especially the thighs must be kept warm. Then the feet may need only a single pair of socks or tights in order to keep them warm, as the blood coming down from thighs and legs will keep the feet warm, if the blood has warmth to impart.
4. Put a heating pad near your bed, so that when you have the waves of unpleasant sensations you can turn the heating pad on high. If you wear socks and pajamas to bed, the heat can build up substantially before the skin feels it has taken all the heat it can bear.
5. Before going to bed, take a neutral bath, putting the bath temperature at about 98 degrees, and sitting in it for perhaps 30-45 minutes. The neutral bath will do wonders for some people.
6. Some of the herbal remedies will be helpful to you, such as hawthorn berry, white willow bark, licorice root, and feverfew. Use one tablespoon of each of these herbs, and simmer them gently in one quart of water. Drink the quart throughout the day. Then, have an additional cupful beside your bed, so that you can take it during the night if you awaken.
7. Your regularity must be impeccable. You should arise at the same time each day, and go to bed at the same time each day. Schedule all fixed events of life at the same time: mealtimes, exercise times, study periods, daily devotionals, etc., so that the circadian rhythm can set itself.
8. There are some foods that have active properties in them, which may be helpful to you to activate certain neurotransmitters in the brain and nerve tissues. These include dark leafy greens, parsley, onions, applesauce, and beets.
9. Carefully perform an Elimination and Challenge diet (a diet eliminating commonly allergic foods). It is often a fact that much restlessness is associated with a food sensitivity. It may be that eliminating those foods to which you are sensitive may aid in helping you find how to treat the restless leg syndrome, without using medication.
10. Restless legs may result from a deficiency of folic acid. Foods containing folic acid and vitamin E are most helpful in preventing attacks. Folic acid is found in beans, potatoes, dark green leafy vegetables, asparagus, broccoli, lima beans, peanuts, beets, cabbage, lettuce, and avocados. Vitamin E is found in wheat, all whole grain breads and cereals, wheat germ, broccoli, leafy vegetables, and vegetable oils. Birth control pills and dilantin interfere with the utilization of folic acid.
11. Entirely eliminate all coffee and its relatives—tea, colas, and chocolate—even if decaffeinated. Avoid tobacco in all its forms, even secondhand.
12. Use a low-salt diet with no free salt being added to the diet—none at the factory, none at the stove, and none at the table.
13. Avoid overusing the legs. Daily regular exercise is helpful in building up the legs, so that overuse becomes less likely.
14. Proper foot and leg gear may prevent the stagnation of blood in the lower extremities. Avoid narrowly pointed toes and high heels, garters, and tight waist bands. Use elastic stockings, or ace bandages to prevent blood stasis in the leg veins. Do not cross the legs. Elevate the legs periodically during the day.
15. Rotating the feet at the ankles for a few minutes may relieve symptoms.
16. Cold sponging of the legs, using a coarse wash cloth, will often bring relief.
17. Knee socks help some people, and greatly annoy others.
18. When the legs are recognized as being restless, lying face down can enable the person to go to sleep in many instances.
19. In some cases, supplementation with zinc, 30-50 mg daily, has been of help.
20. Take 500 milligrams of rutin and 25 milligrams of vitamin B-2 each night at bedtime. For some people this simple supplemental routine has been curative.
21. A woman in her early fifties reported that she started taking 1200 units of vitamin E daily (400 units three times a day) and that her restless legs problem, along with burning feet went away The restless legs were completely healed in about three weeks of taking the large dose of vitamin E.
22. If you wake up during the night with restless legs and can't return to sleep, take some tryptophan capsules. You should be able to obtain tryptophan from a compounding pharmacist.
23. Take wild lettuce and catnip tea. Put one tablespoon of the wild lettuce and one teaspoon of the catnip herb in a cup. Pour one cup of boiling water onto the herb, and let it set 30 minutes. Drink the tea before going to bed.
24. In some instances, restless legs are due to a lack of potassium and magnesium in the diet. Supply this lack with bananas, and other high potassium and high magnesium foods.