Restless Leg Syndrome- New Data on Causes and Solutions

Restless Leg Syndrome (RLS) is a debilitating condition in which individuals experience an intense sensation causing them to have to- or want to- move their legs at inappropriate times- like at night when in bed. Often times RLS sufferers have to get up and move around to stop the unwanted movement, an action which ultimately prevents them from getting any sleep as this sensation mostly occurs at night.

In this article we will present new data regarding RLS, its causes, and new non-drug treatment options.

First lets- in a very simplistic manners- describe the mechanism within the brain. That’s right- the brain- that when interfered with- causes RLS.

When your brain wants you to move a body part, your leg for example, it issues the command to move that body part. This command from the brain cortex to create movement in the leg traverses through a deep structure in the brain on its way to activate the muscles in the leg. This structure is called the basal ganglion. The command circuits are well mapped out circuits. In RLS this circuit breaks down in the basal ganglion, a structure which regulates movement and whose breakdown is involved in other movement syndromes such as Parkinson’s and Huntington’s disease.

The basal ganglion is regulated by sensory (touch, temperature, pressure, joint motions, muscle stretch, pain) feedback impulses from all joints and muscles in the body. These feedback impulses must be present to stimulate the basal ganglion to work properly and prevent us, as human beings, from experiencing uncontrolled and non-self directed movement. When this feedback mechanism is interfered with you get RLS, Parkinson’s and Huntington’s disease- all characterized by various types of tremors.

The newly investigated and understood causes of this pathways breakdown are:

1. The condition Peripheral Neuropathy (PN)- a significant percentage of PN sufferers also experience RLS. Why? Because the PN sufferers are experiencing damage to the nerves in their hands and feet causing numbness, burning, tingling, cramping etc. This damage and pain symptoms shuts down the necessary sensory feedback mechanisms vital to good basal ganglion function and often causes RLS.
2. Iron deficiencies- recent studies have confirmed that when brain iron load is low it directly effects the production of dopamine production. Dopamine is a brain chemical (neurotransmitter) that primes the basal ganglion. That’s why Parkinson’s patients who also suffer from basal ganglion dysfunction due to inadequate dopamine production are given drugs that increase dopamine. For RLS sufferers low iron= low dopamine = problems in the movement command center and frequently= RLS.
3. Low back nerve irritation – People who fit the criteria for low back surgery (ie disc problems and pinch nerves that have not responded to conservative therapies) can have this as a cause of RLS. The pinches nerve or compromised spinal cord acts as interference to the stimulation required from structures in the legs and feet to stimulate the basal ganglion.

These newly acknowledged mechanisms of RLS stand in stark contrast to the current paradigm of the causes simply being “to little dopamine” which is addressed only with drug oriented solutions (Requp, Miropax, ets.) In fact the above mentioned causes can almost always be regulated without medication. In general the solution is:

1. Improve Sensory feedback from the feet and legs back to the basal ganglion and ultimately to the area of the brain that controls the feet. This is accomplished with various electrical stimulations applied to the organ of the affected nerve pathways in the feet or by removing the cause of the low back dysfunction
2. Simultaneously correct all metabolic issues that can create iron dysfunctions or peripheral neuropathy. This list is long and includes immune deficiencies, diabetes, food sensitivities, cancer, vitamin deficiencies and over loads, a host of GI conditions and of course low iron. You must correct the metabolic issues for any hope of a long term solutions to RLS.

Utilizing this new data in clinical practice allows for a consistently successful approach to RLS. It is our hope that this information gives some hope and solace to you of you or a loved one suffers from this potentially maddening condition.

References:

1. Altered Brain iron homeostasis and dopaminergic function in Restless Legs Syndrome (Willis-Ekbom Disease).

Earley CJ, Connor J, Garcia-Borreguero D, Jenner P, Winkelman J, Zee PC, Allen R.

Sleep Med. 2014 Jun 16. pii: S1389-9457(14)00237-8. doi: 10.1016/j.sleep.2014.05.009. [Epub ahead of print] Review.

PMID: 25201131 [PubMed – as supplied by publisher]

2. Gray matter alteration in patients with restless legs syndrome: a voxel-based morphometry study.

Chang Y, Chang HW, Song H, Ku J, Earley CJ, Allen RP, Cho YW.

Clin Imaging. 2014 Aug 2. pii: S0899-7071(14)00178-8. doi: 10.1016/j.clinimag.2014.07.010. [Epub ahead of print]

PMID: 25176196 [PubMed – as supplied by publisher]

3. Effect of sensory stimuli on restless legs syndrome: a randomized crossover study.

Rozeman AD, Ottolini T, Grootendorst DC, Vogels OJ, Rijsman RM.

J Clin Sleep Med. 2014 Aug 15;10(8):893-6. doi: 10.5664/jcsm.3964.

PMID: 25126036 [PubMed – in process]