Restless legs syndrome (RLS), as the name suggests is a condition where the person is forced by himself and his legs are voluntarily shaken or moved uncontrollably for a long time in a day. It is a nervous system disorder that causes an overpowering urge to move the legs. It’s also known as Willis-Ekbom disease. Symptoms commonly occur in the late afternoon or evening hours, and are often most severe at night when a person is resting, such as sitting or lying in the bed. They also may occur when someone is inactive and sitting for extended periods (for example, when taking a trip by plane or watching a movie). Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up. Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops.
SIGNS AND SYMPTOMS
Irresistible urge to move the legs
Uncomfortable sensations in the lower limbs
Pain and aches of muscles of lower limbs
Sleep disturbances
CAUSES
In most cases, the cause of RLS is unknown (called primary RLS). However, RLS has a genetic component and can be found in families where the onset of symptoms is before age 40. Specific gene variants have been associated with RLS. Evidence indicates that low levels of iron in the brain also may be responsible for RLS.
PATHOPHYSIOLOGY
Iron deficiency in the brain causes an abnormality in the dopaminergic system leading to manifestation of RLS. Genetic factors are also important in the development of RLS.
DIAGNOSIS
No specific test.
Clinical evaluation
TREATMENTS
Symptomatic treatment including
Lifestyle changes like proper exercise, sleeping habits etc
Iron supplements
Anti-seizure drugs
Dopaminergic drugs
Opiods
benzodiazepines
PROGNOSIS
RLS is generally a lifelong condition for which there is no cure. However, current therapies can control the disorder, minimize symptoms, and increase periods of restful sleep.
COMPLICATIONS
Poor quality of life
Irritability
Disease & Ayurveda
There is no single disease name that can be correlated with restless legs syndrome. But as all movements are attributed to the function of Vaatadosha, this condition can be correlated with Vaatavruddhi lakshana being kampa (jerking or shaking type of movements). As it mostly affects the hip and lower limbs, the sthaana(site) is Vaatika.
Nidana
Dhaatukshaya(degeneration)
Aavarana (obstruction to channels in the body)
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors Vaata gets vitiated and gets lodged in the lower limbs, especially nerves & muscles, causing the signs & symptoms.
Lakshana
Kampa – uncontrollable movements
Associated symptoms like pain in the calf muscles(pindikodweshtrana) and sleep disturbances can be due to Vaata dosha vitiation.
Divisions
Not mentioned
Prognosis
Saadhya when the disease is new
Krichrasadhya when the disease is chronic
Chikithsa
Samana
Lepana with soolaharadravyas
Parisheka with warm soolahara-sothahara dravyas
Upanaha with Vaataharadravyas
Sirodhara with Vaatahara taila
Sodhana
Sneha (Abhyanga)
Sweda (Potalisweda)
Vasti
Virechana
Raktamokshana
Daahakarma
Commonly used medicines
Sahacharadi kashayam
Aswagandhachoornam
Kapikacchu choornam
Guggulutiktakaghrutam
Brands available
AVS Kottakal
AVP Coimbatore
SNA Oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Medical professionals suggest the following to ease pain & other disturbances in the legs:
- Stop the activity that caused the cramp.
- Stretch and massage the muscle.
- Hold the leg in the stretched position until the cramp stops.
- Apply heat to muscles that are tight or tense.
- Use cold packs on tender muscles.
Diet
- To be avoided
Drink enough liquids. Ensure enough hydration.
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha and cause obstruction in channels
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from very hot & cold climates.
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid lifting heavy weights and other vigorous physical activities.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Yoga
Vigorous exercises are not allowed in painful conditions.
Only stretching, moderate walking, and mild cardio exercises are advised. Also, specific yogacharya including bhujangaasana, salabhasana, vajrasana is recommended. Caution must be there to consider the range of movement and flexibility.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Salabhasana
Vajrasana
Bhujangasana
Exercises For Leg Pain
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
DOI: https://doi.org/10.3122/jabfm.2011.04.100173
A double-blinded, randomized controlled trial was done to examine whether bupropion would improve the symptoms of RLS, or at least not exacerbate them. Twenty-nine participants with moderate to severe RLS received 150 mg sustained-release bupropion once daily, and 31 control participants received a placebo. Participants were followed for 6 weeks and completed standardized tools, including the International Restless Legs Syndrome Study Group (IRLSSG) severity scale.
Bupropion was more effective than placebo in the treatment of RLS at 3 weeks; however, the difference was not statistically significant at 6 weeks.
The study concluded that bupropion does not exacerbate the symptoms of RLS and may be a reasonable choice if an antidepressant is needed in individuals with RLS.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
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