Technical Meaning of RLS

Desc: Many people suffer with restless leg syndrome daily but what is restless leg syndrome and what can be done to treat the uncomfortable Itching, tingling sensation

What Is Restless Legs Syndrome?

Restless Legs Syndrome (Restless Leg Syndrome), also called Willis-Ekbom or Ekbom disease is a neurological disorder that affects an estimated 10% of the population. This disorder causes an uncontrollable urge to move the legs. The compulsion results from discomfort in the legs characterised by tingling, itching and burning sensations, along with the feeling of electric currents running through the limbs. The intensity varies greatly from person to person, with moderate to severe Restless Leg Syndrome affecting between 2-3% of adults in the United States. Women are almost twice as likely to develop Restless Leg Syndrome as men.

The majority of people with Restless Leg Syndrome (80%) also experience a condition known as Periodic Limb Movement Disorder, which is characterised by spasmodic limb movements during sleep which usually occur every 15 to 40 seconds and may last throughout the night.

The symptoms of Restless Leg Syndrome appear when the subject is at rest, sitting or lying down, especially in the evening and at night and disappear during movement: getting up, walking or on waking. Therefore it can be very difficult to just sit, or sit for prolonged periods when required, such as attending meetings or travelling by train or plane.

As the symptoms of Restless Leg Syndrome manifest during the resting hours slumber is more difficult. During sleep, the sensations are not perceived but involuntary movements persist to varying degrees. These movements may progress to contortions, and extreme morning stiffness can be felt in addition to chronic fatigue when the syndrome is severe.

Some people say that on waking they feel as though they have been walking all night. As the symptoms may disrupt sleep and impair the quality of life considerably, it is not uncommon for people who suffer Restless Legs Syndrome to also experience impaired concentration and memory loss. The evolution of the syndrome is unpredictable.

As the name indicates, Restless Legs Syndrome mainly concerns the lower limbs. However, in almost 50% of cases the upper limbs are also affected. Restless Legs Syndrome should not be confused with night cramps, as they are totally different.

In 2005, Allen and Walters published the findings of a general population study titled ‘Restless Legs Syndrome prevalence and impact: REST general population study. 15,391 fully completed questionnaires revealed that:

Restless Leg Syndrome, symptoms of any prevalence reported by 1,114 (7.2%).
For 773 (5.0%) respondents symptoms occurred at least weekly; occurrences of at least 2 times per week were reported as moderately to severely distressing by 416 (2.7%).
Of those 416 Restless Leg Syndrome sufferers, 337 (81.0%) discussed their symptoms with a primary care physician, and only 21 (6.2%) were diagnosed with Restless Leg Syndrome.
Sensory symptoms were reported by 88% (including inability to get comfortable, pain, urge to move)
Sleep-related symptoms were reported by 76% (including inability to fall asleep, interrupted sleep, insufficient sleep)
56% reported disturbance of daytime functioning (including fatigue/exhaustion, sleepiness, difficulty concentrating)
37% reported symptoms affecting movement (including twitching and jerky movements)
26% reported mood disturbance (including a tendency to become depressed/low)

Primary Causes of Restless Legs Syndrome

Restless Leg Syndrome affects millions of people who wish to get to the root of this frustrating condition. In the majority of cases, the primary cause remains unknown (idiopathic). Restless Legs Syndrome is commonly first seen in adults under the age of 45.

Scientists theorise that the condition may be caused by an imbalance of brain chemicals known as neurotransmitters, particularly one named dopamine, and an important chemical compound that allows the nerves to communicate with each other and regulate muscle movement. Another theory is that the syndrome is often familiar and frequently begins in early adulthood. Almost half the sufferers of Restless Legs report having a relative who is similarly affected.

Another cause of restless leg syndrome is believed to be the fact that, there are non-return valves in the veins in the back of each leg. The primary reason for these non-return valves is to reduce the pooling of blood. There is one in the back of the calf muscle, the other at the back of the knee. After 60 – 90 minutes of in-activity the valves would normally relax, reducing blood pressure.

There is plenty of evidence that the discomfort of RLS starts after 60-90 minutes of in-activity. This causation is probably connected to the valves at the back of the knee, not relaxing after in-activity.

We discovered by placing one of our single negative enhanced products, to the back of the knee (over the non-return valve) immediately reduces the RLS symptoms. This was the confirmation needed that shows how our LegCare product has been relieving RLS symptoms for thousands for many years. The LegCare Product is wrapped comfortably around the leg below the knee & above the calf muscle,

This also confirms in our previous study at Bart’s that RLS is not connected to the systemic effect of improved blood viscosity. See: “Follow Up studies On The Effects of Leg Wraps on RLS Sufferers” below.

Secondary Causes of Restless Legs Syndrome

Symptoms of secondary Restless Leg Syndrome are usually due to an underlying medical condition and normally stop if the condition is suitably treated.

Pregnancy can also trigger Restless Leg Syndrome, especially in the last trimester, with up to 20% of women experiencing symptoms. However they tend to disappear within 2 weeks of delivery.

Iron deficiency anaemia is more common in people with Restless Legs syndrome, characterised by low haemoglobin levels in the blood. Iron tablets may resolve this deficiency.

Taking certain prescribed medications such as antidepressants, lithium, anti-nausea drugs, anti-psychotics, antihistamines, antidopaminergic, beta-blockers, steroids, dopamine antagonists and neuroleptics may exacerbate or trigger Restless Leg Syndrome.

The syndrome is also seen in patients suffering kidney disease and renal failure. Iron levels in blood fall when the kidneys fail to function, and Restless Legs can result. Chronic illness such as diabetes, fibromyalgia and rheumatoid arthritis may contribute to restless leg syndrome.

Peripheral neuropathy, identified as damage to the nerves in the arms and legs is also a secondary cause of Restless Leg Syndrome. Peripheral neuropathy is seen in a number of diseases such as alcoholism, diabetes, kidney failure, Parkinson’s, underactive thyroid and HIV infection.

Alcohol, caffeine and tobacco may also exacerbate or trigger Restless Leg Syndrome. Patients with multiple sclerosis, amyotrophic lateral sclerosis or migraine headache are more often affected. Obesity increases the risk slightly.

Symptoms of Restless Leg Syndrome

Restless Legs Syndrome is characterised by unpleasant sensations, sometimes painful, mainly affecting the lower limbs. These sensations are described as:

Itching, throbbing, tingling and burning
A feeling of ‘bubbling’ in the blood vessels in the legs
Cramping or electric shocks in the legs and/or calves
Symptoms experienced may be intermittent for some, while for others they may occur every day.
Just over 50% of people with restless legs syndrome experience bouts of lower back pain.
Symptoms are triggered when at rest – Restless leg symptoms start or worsen when sitting, relaxing, or trying to rest.
Symptoms worsen at night – Restless Leg Syndrome is exacerbated at night, particularly when lying down. In more severe cases, the symptoms may begin earlier in the day in more severe cases, but they intensify at bedtime.
Symptoms improve when walking or moving the legs – uncomfortable sensations are temporarily improved with movement, stretching or massaging the legs. Relief continues as long as movement is sustained.
Night time leg twitches – Many sufferers of restless legs syndrome also have sporadic limb movement disorder (PLMD), a sleep disorder that involves continual cramping or jerking of the legs, which further disrupt sleep.

Restless Leg Syndrome Diagnosis

There is no definitive test or Restless Leg Syndrome. It may take several doctor visits before diagnosis, and other causes of the symptoms may be ruled out with blood tests. Restless Legs Syndrome is diagnosed according to four basic criteria:

Medical and Family History – Most doctors diagnose a patient based on symptoms they experience and the history of their family, such as whether the patient may have any of the diseases or conditions that can trigger Restless Leg Syndrome. The most common type of Restless Leg Syndrome tends to run in families. Thus, the doctor may ask whether any relatives have Restless Leg Syndrome.

A constant, irresistible urge to move the legs, often associated with paresthesias – abnormal sensations, tingling or pricking (pins and needles), caused primarily by pressure on or damage to peripheral nerves, or dysesthesias – abnormal and unpleasant sensations felt when touched, resulting from damage to peripheral nerves. Sensory symptoms that are precipitated by relaxation, rest or sleep, and are alleviated by movement, for as long as movement continues.

Symptoms that are exacerbated at night are absent or negligible in the morning.

Diagnostic Tests

Currently, there are no diagnostic tests specifically for Restless Leg Syndrome.

Blood Tests

If Restless Legs Syndrome is suspected the patient may be referred for a number of blood tests to confirm or exclude the possibility of secondary underlying causes. For instance, blood tests can rule out conditions such as diabetes or anaemia, and problems with kidney function.

Sleep Tests

Sleep studies are used rarely used in the diagnosis of Restless Leg Syndrome. Sleep studies measures the quantity and quality of sleep, and although Restless Leg Syndrome may disrupt sleep, this sign alone is not specific enough to diagnose the disorder.

If Restless Legs Syndrome is severely disrupting sleep a suggested immobilisation test (SIT) may be offered. Suggested immobilisation tests involve lying sill without moving the legs for a period of time, while involuntary leg movement is monitored.

Polysomnography may be recommended.

Restless Leg Syndrome Treatments

Life Style Changes

A warm shower or bath before bed will aid relaxation. Cold or warm compresses applied to the legs may distract the muscles from responding to the tingling sensations of Restless Leg Syndrome.

Stretch the legs before going to bed. Flexing the ankles to stretch the calf muscles will help release tension.

If sitting in a theatre or on a plane opt for an aisle seat. Make the most of it, stand up and move around frequently.

According to Vensel Rundo, massaging the legs works as stimulation against the sensations of Restless Leg Syndrome.

Review medications – certain allergy and cold medications, antidepressants anti-psychotic and anti-nausea drugs and may exacerbate Restless Leg Syndrome symptoms.

Being active is best for overall health but do not go overboard. With Restless Leg Syndrome, sudden changes in activity level should be avoided, such as suddenly training for a marathon or stopping the usual exercise routine.

Do not smoke

Give up caffeine – Cutting out chocolate, coffee and other caffeinated drinks and foods may help relaxation for better sleep.

Alcohol may help you fall asleep, but it is also a stimulant. Therefore it may also cause wakefulness during the night.

Establish a healthy diet. In some cases Restless Leg Syndrome is linked to iron deficiency. Iron supplements may be beneficial.

Establish a sleep routine. Go to bed at a set time every night and get up at the same time every morning. Do not eat 2-3 hours before going to bed, allow time for food to digest. Bedroom temperature should be ambient the room should be dark and conducive to sleep.

LegCare Leg Wrap

What is Leg Wrap?

LegCare Leg Wrap has been designed to apply a strong, static magnetic field around the leg. The LegCare Leg wrap contains powerful neodymium magnets. The small, potent therapeutic magnetic device works harmoniously with the body. The LegCare is fashioned to soothe and relieve the damaged or painful area.

There are several ways that magnetic fields have been reported to improve healing. Some studies propose that nerve signals be calmed, circulation may improve, and there may be changes in the behaviour of cells active in the healing process.

The LegCare Leg Wrap may in very high cases alleviate the suffering of arthritic knees, swollen legs and ankles, ankle pain, varicose veins, thread veins, Restless Leg Syndrome as well as reducing water retention without drugs.

LegCare has been used by more than 350,000 people many upon recommendation from family and friends. For maximum benefit the LegCare Leg Wrap must be fitted comfortably around the leg, below the knee and above the calf muscle (not under compression). The LegCare Leg Wrap is held securely in place by “hook and loop” fastening tape, and should be worn continuously (24 hours) including overnight for approximately three months, then overnight to stop recurrence.

It is reported that LegCare had a positive effect on 96% of the users. 84.5% of the users reported a reduction in knee and ankle pain. A significant number reported that they had stopped taking painkillers completely. 73% of those with swelling reported a marked reduction in that swelling. The LegCare Leg Wrap is registered as a Class 1 Medical Device.

4UlcerCare (a similar device) has been found to accelerate healing of chronic leg ulcers (Eccles & Holinworth, 2005) and also to prevent their recurrence (Eccles, 2006).

The Daily Mail’s Static Magnetic Leg wrap Device Study

In 2006, 459 subjects with a diagnosis of Restless Leg Syndrome responded to an advert in the Daily Mail newspaper, which offered a free trial of the LegCare Leg Wrap static magnetic device. There were no exclusions in the study, although respondents had to have a diagnosis of RLS. Patients were instructed to wear the wrap 24 hours a day, for the duration of one month. Two LegCare devices were supplied with instructions to wear one continuously on each leg.

Subjects were asked to complete a questionnaire that requested them to report the duration of symptoms and to then rate their symptoms on a scale both prior to and after using the device.

Respondents were also asked about their previous experiences with other treatments for RLS, both conventional and unconventional.

Results of the Daily Mail Leg Wrap Device Study

Out of the 459 subjects who responded, 310 were female and 148 were male.

The results of the study were thus:

Previous Treatments – Pharmaceutical Treatment
58% (193 subjects) had tried some type of drug treatment, The most common treatments were

Quinine – 25 subjects,
Amitriptyline – 17 subjects
Co-codamol/Co-proxamol – 8 subjects
Ropinirole – 5 subjects

Previous Treatments – Non-Pharmaceutical Treatment
32% (145 subjects) had tried some type of non-pharmaceutical treatment, most commonly:

Magnesium – 24 subjects
Massage with creams or gels – 22 subjects
Acupuncture – 10 subjects
Herbal remedies – 15 subjects.

Pain symptoms before and after LegCare

The data suggested up to 75% relief of pain symptoms.
The data suggested 60% relief of symptoms of tingling after using LegCare.
Sleep disturbance after LegCare – This data suggests 50% less sleep disturbance.

Scores for Quality of Life before & after LegCare

The greatest disturbance of quality of Life is indicated by a higher score: the results were as follows:

Quality Of Life scores

Before (median 6, IQR 5-9)
After LegCare (median 4, IQR 2-6).

After using the LegCare Leg Wrap the median score for Quality Of Life is statistically significantly lower (p<10-5, Wilcoxon signed-rank test), indicating an improvement in Quality Of Life.

The data suggests an overall 50% reduction in Overall Symptom scores before and after LegCare.

Conclusion of the Study

From outset, 85.4% of subjects had overall symptom scores greater than 5 (on a 10-point scale). After one month of wearing Legcare, the proportion of subjects experiencing symptoms at this level was reduced to 30.9%. After LegCare treatment just under two-thirds of subjects were withdrawn from the greater symptom bracket.

We have received a massive amount of positive feedback from Many Thousands of people saying how much LegCare has helped them over the past Twelve years.

This valuable feedback from People has always encouraged us to try to discover the mechanism of action of how they are helping!

Follow Up studies On The Effects of Leg Wraps on RLS Sufferers

Following the success of the initial trials of RLS sufferers and the effects of leg wraps on symptoms, A separate trial was set up in the Scientific Department at Bart’s Hospital London.

Full examination and blood test were recorded on six volunteers suffering with RLS in both legs. They were then given one single LegCare to be worn continuously around one leg.

Results of the Examination and Blood Tests After One Month of Wearing Leg Care

The following results were gleaned from the tests and examinations on LegCare wearers before and after wearing the LegCare continuously for month one month.

Although the blood is systemic, all of the participants who took part in the study reported alleviation of discomfort only in the leg on which the LegCare wrap was worn. This means that RLS must be something other than improved viscosity of the blood itself.

Furthermore, the Blood test did show something quite remarkable. Not only did the participants, after only one month of wearing the LegCare wrap, display improved blood viscosity. It also showed that five out of the six participants with un-diagnosed mini blood clots present before using LegCare, had been completely dispersed.

Relief of Restless Leg Syndrome Symptoms With LegCare

77.8 % of subjects had improvement greater than 20%, 66.1% of subjects had improvement greater than 30%, and 45% of subjects had improvement in symptoms of 50%.

References

What Is Restless Legs Syndrome?