Restless Legs Syndrome and Fibromyalgia

RLSRestless Legs Syndrome (RLS) pain is a common and sometimes devastating condition and is seen frequently in many chronic pain patients. In fact, it contributes to quite a bit of persistent pain, because of the difficulty it causes in terms of getting a good night’s rest.

Pain is broadly defined as “any unpleasant sensation with a negative affective component” and the symptoms of Restless Legs Syndrome meet that criteria. Besides RLS being rather painful, there are diseases associated with chronic pain, such as Fibromyalgia, that can result in so-called secondary RLS.

Restless Legs Syndrome pain results in sleep disturbances caused by rhythmic leg movements during sleep called Periodic Limb Movement Disorder (PLMD). The symptoms include burnining, tugging, creepey, crawly, achy, tingling sensations in the legs or arms that can last one or more hours. Walking or moving the legs may help to relieve the symptoms. The pain from RLS can range from mild discomfort to intense pain.and is aggravated by stress, anxiety and emotional upset, traits that also exacerbate Fibromyalgia.

Restless Legs Syndrome—a genetic link?

I remember after receiving a diagnosis of Fibromyalgia, of trying to fall asleep at night and my legs twitiching uncontrollaby. It was like tics that wouldn’t stop, and it would happen as I would lay down to rest for the evening. I was not aware that this anomaly had a name— Restless Legs Syndrome. My sister, who also lives with FMS, would tell me about feeling as if something was crawling on her legs at night, and having to “walk it off”, unable to go to sleep. Personally, I, too, thought it was “all in her head”  I plead guilty to that common but mistaken way of thinking!

I have since learned that Restless Legs Syndrome (RLS), also known as Willis-Ekborn disease, is a real affliction, and people living with Fibromyalgia are eleven times more susceptible to have it. It is one of the primary co-existing conditons of FMS and affects 10% of the population and has been shown to have a genetic pattern.

Diagnostic Criteria for Restless Legs Syndrome

It is estimated that thirty to seventy percent of of people living with Fibromyalgia also meet the diagnostic criteria for RLS.

The diagnostic criteria for Restless Legs Syndrome were established by the International Restless Legs Syndrome Study Group in 1995 and identify four essential components, along with several associated clinical features. The four essential components are:

  1. Urge to move the legs (This is usually accompanied by uncomfortable or unpleasant sensations in the legs).
  2. Onset or exacerbation with rest. (The urge to move becomes more pronounced during periods of inactivity such as sitting or lying).
  3. Relief with movement. (The urge to move and unpleasant sensations are diminished by activity for at least as long as the movement continues).
  4. Circadian Pattern (The urge to move is more pronounced in the evenings or night than during the day).

Medical Treatments for Restless Legs Sydrome Pain

Several prescription medications, most of which were developed to treat other diseases, are available to reduce the restlessness in your legs. These include:

  • Medications for Parkinson’s disease. These medications reduce the amount of motion in your legs by affecting the level of the chemical messenger dopamine in your brain.
  • Medications for epilepsy. Certain epilepsy medications may work for some people with RLS.
  • Opioids. Narcotic medications can relieve mild to severe symptoms, but they may be addicting if used in high doses.
  • Muscle relaxants and sleep medications. This class of medications, known as benzodiazepines, helps you sleep better at night. But these medications don’t eliminate the leg sensations, and they may cause daytime drowsiness.

It may take several trials for you and your doctor to find the right medication and dosage for you. A combination of medications may work best.

It is also important to be aware that anti-depressant drugs used in the treatment of Fibromyalgia can aggravate RLS symptoms in some patients, so a period of trial-and-error might be required to find appropriate therapies for an individual. In the past I have used a low-dose anti-depressant for sleep and pain control, it was a blessing at the time and I would not hesitate to use them again if needed, as a temporary solution.

Natural Solutions for Restless Legs Syndrome pain

Though there is no cure for RLS, reducing stress, anxiety and relaxing the muscles seem to be beneficial in relieving symptoms. Stretching exercises, such as Yoga, massage therapy and Chiropractic care may also help. If you are deficient in iron, check with your doctor about a supplement. Calcium, along with Magnesium, may also be used to treat RLS and Fibromyalgia. Hertbal medicine has also been used, with herbs such as valerian root for muscle pain and spasms.

Patients should have regular sleep and wake times and avoid activities which cause irritation immediately prior to sleep. A brief walk before bedtime can be helpful,


Epsom Salts Bath

An open pilot study published in the journal, Sleep, investigated the effectiveness of magnesium therapy for Restless Legs Syndrome. Six patients suffering from mild-to-moderate RLS were given oral magnesium (4.12 mmol) every evening over a period of 4-6 weeks. The results showed that the symptoms of RLS in all patients were significantly improved by magnesium supplementation. I, personally, soak in magnesium in a warm bath of epsom salts and try to include magnesium-rich foods in my diet.  Most dietary magnesium comes from dark green, leafy vegetables. Other foods that are good sources of magnesium:

  • Fruits or vegetables (such as bananas, dried apricots, and avocados)
  • Nuts (such as almonds and cashews)
  • Peas and beans (legumes), seeds
  • Soy products (such as soy flour and tofu)
  • Whole grains (such as brown rice and millet)
  • Blue-Green Algae

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I know how difficult it can be with the pain and the frustration of not getting that so-important restful sleep.  I hope this article has been helpful.  Always, confide with your Doctor whenever choosing a supplement or treatment plan.

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