An Integrated Approach towards Restless Leg Syndrome

An Integrated Approach towards Restless Leg Syndrome

Restless Leg Syndrome (RLS), also known as Willis-Ekbom Disease, is a sleep and movement disorder characterized by an irresistible urge to move the legs. This urge is accompanied by unpleasant and uncomfortable sensations often described as tingling, crawling, creeping, or aching. While RLS is most likely to impact the legs, for some people these sensations can also extend up into the arms, torso, or face.


RLS can pose challenges for individuals in various aspects of their daily lives; Some examples of activities that may prove difficult include:



  • Sitting Still: in work, school, travel, or social environments
  • Maintaining Focus and Concentration: at work or with life tasks when symptoms are heightened
  • Relaxing and Sleeping

In this article, we explore the signs and risk factors of RLS as well as offer insights on variables to consider when seeking relief. We’ll not only cover the typical protocols such as what vitamins help RLS and restless leg syndrome physical exercise recommendations, but we’ll also offer the perspective of why improving biomechanics, how your body moves and maintains balance, is a critical component that should not be overlooked.

 

RLS Common Signs and Risk Factors


There are several common characteristics of RLS, including:

  • Sensations that begin after rest
  • Relief of discomfort with movement: this may include the need to pace the floor or constantly move your legs while sitting or lying down
  • Symptoms worsening at night with a symptom free time period in the morning

These symptoms can be overwhelming and contribute to experiences of changes in mood, exhaustion and daytime sleepiness, problems concentrating, impaired memory, decreased productivity, as well as depression and anxiety. 


While the exact cause of RLS is not fully understood, some considerations regarding potential causes and risk factors are:

  • Genetic Factors
  • Neurological Factors: Changes in neurotransmitter levels, particularly dopamine, may play a role in RLS. Dopamine is a chemical messenger in the brain that helps regulate movement
  • Vitamin Deficiencies: Low iron, vitamin D, magnesium, and vitamin B12 may be correlated to RLS symptoms. Looking at these levels may be useful when considering what vitamins help RLS
  • Pregnancy: RLS is more common during pregnancy, especially in the third trimester. Hormonal changes and increased blood volume during pregnancy may be contributing factors. 
  • Other Medical Conditions: Some conditions such as peripheral neuropathy, kidney failure, and diabetes may increase the risk of RLS
  • Medications: Some medications, including certain antipsychotics, anti nausea drugs, and antidepressants, may worsen or trigger RLS symptoms
  • Lifestyle Factors: Factors like smoking, excessive caffeine or alcohol consumption, and a sedentary lifestyle may contribute to the development or worsening of RLS

Neurological Disorders: Why Addressing Mechanics is Key


Neurological disorders are medically defined as disorders that affect the brain as well as the nerves found throughout the human body and the spinal cord. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms.”(1)


RLS is considered to be a neurological disorder, which means that in order for someone to improve their condition, structural, biochemical, and electrical components need to be addressed.(2) This is where human biomechanics, the study of the mechanical aspects of human movement, and mechanotransduction, the cellular process that involves the conversion of mechanical signals or force into biochemical responses within the cells, becomes really important. These mechanical forces can also lead to changes within the electrical properties of the cell membrane.


We know these are big words but here’s the takeaway:


Mechanical signals have the ability to influence structural, biochemical, and electrical properties of the body, all challenges associated with neurological disorders. 


In order to improve mechanical signals you need to improve your movement. 


With this in mind, let's look at some common structural and mechanical issues that may pose a problem for people with RLS:

  • Poor Posture: Which can affect blood flow and nerve function throughout the body, and increasingly in the legs when sitting 
  • Muscle Imbalances: From weak or tight muscles 
  • Joint Dysfunction: Misalignments and dysfunctions in the spine or pelvic areas may contribute to RLS affecting nerve signaling and blood circulation
  • Foot and Ankle Problems: Flat feet, as one example, which can impact the alignment of the lower extremities
  • Fascial Adhesions: Which can cause movement to become restrictive
  • Peripheral Neuropathy: Nerve damage which can result from issues named above and also become a contributing factor to RLS

An interesting further note is that mechanotransduction is also involved in many cellular activities such as gene expression. There is evidence to suggest that some people may have a gene for RLS; However, we know that just because someone has a gene doesn’t mean that the gene will be turned on or expressed. Could improving biomechanics make it more likely to prevent or limit the expression of a disordered gene? While we won’t speak in certainties, it’s worth considering that it is in the realm of possibility that improving mechanics may increase the probabilities that those who have this gene are less likely to have it expressed.

 

A Function Patterns Approach to Addressing Restless Leg Syndrome

Demonstrations of postural corrective techniques. For more specifics on Restless Leg Syndrome physical exercise ideas check out the 10 Week Online Program

There are many recommendations available for how to go about addressing RLS, some of which are useful and others that, while not necessarily wrong, are incomplete. Here’s our take on how to approach RLS in a more comprehensive way:

  • Restless Leg Syndrome Physical Exercise Protocol: While restless leg syndrome physical exercise recommendations are plentiful, just telling someone to “stretch and be more active” does not account for postural and movement imbalances that can lead you down the path of worsening symptoms in the long haul. Instead of needing compression garments for improved circulation or lymphatic drainage, tap into the human body’s natural abilities for these processes by learning to train your body as a system.
    • Myofascial Release: Utilize self-massage practices to reduce tightness and restrictions in your tissues in lieu of stretching. Not sure why? Check out this demonstration.
    • Posture Training: Improve your posture by training your body as a system. Here’s how.
    • Do Corrective Exercises: Learn to move in ways that prioritize improving fundamental human movements of standing, walking, running, and throwing. Here’s why

Restless Leg Syndrome, pain reduction, and overall quality of life improvements achieved through implementing FP Corrective Exercises 

[Witness this client’s progress showcased by HBS Dario Improta here]

  • What Vitamins Help RLS: With regards to nutrition and supplementation, many people ask what vitamins help RLS. RLS symptoms can be triggered by inadequate levels of iron, vitamin D, magnesium, and vitamin B12. While in some cases supplementation in the form of pills may be necessary, we recommend focusing on nutrient dense dietary options (such well sourced meat, organs, shellfish, eggs, bone broths, dairy products, ripe fruits, etc as tolerated) and optimizing Vitamin D synthesis through adequate sun exposure.
  • Sleep hygiene: Work on creating a comfortable sleep environment and routine. For many people a dark, quiet, and cool environment can be useful. Aim to avoid stimulating habits such as looking at screens before bed.
  • Get out in nature: Aim to get sun in your naked eye in the morning and in your eyes and on your skin throughout the day. Time in nature can help you improve your circadian rhythm and help calm the nervous system
  • Avoid stimulants: Aim to cut out tobacco and alcohol and eliminate/limit caffeine.
  • Consider the Potential Impact of Prescription Medications: This article is not medical advice telling you to stop taking medications but it may be worth talking to your doctor to see if drugs that you are taking could be causing adverse side effects. If working to lessen the need for prescription drugs is something you aim to do, there are many examples to demonstrate how improving mechanics through Functional Patterns protocols can lessen, or eliminate, the need for reliance on these drugs.

Erica, age 63, Peripheral Neuropathy Improvements with HBS Neil Bortolus

Through following FP protocols Erica was able to get off all opioid painkillers, benzodiazepines, antidepressants and anxiety medication

 

If it’s determined that medication for RLS is presently needed, let it be considered a tool in your toolkit.  However, we know that medications can have side effects and typically they’re just helping you get by, rather than addressing the problem at the source. Whether you decide you need them or not, the probabilities are good that the above protocols will be of great use on your path to not only reducing RLS symptoms but also with improving your quality of life as a whole.

 

Conclusion

 

While RLS can be overwhelming to endure, it does not have to be a life sentence. On your path to seeking relief we suggest a comprehensive approach that prioritizes improving biomechanics coupled with the aforementioned additional protocols including a look at nutrition, sleep hygiene, increasing time in nature, and avoiding stimulants that can make your symptoms and overall health worse. 

 

As you work to improve your movement and change some of these habits, here are some additional resources that may be useful for you to consider:

 

 

REFERENCES

 

  1. Montana Department of Public Health and Human Services (2023) Neurological Disorders https://dphhs.mt.gov/schoolhealth/chronichealth/neurologicaldisorders
  2. National Institute of Neurological Disorders and Stroke (2023) Restless Leg Syndrome https://www.ninds.nih.gov/health-information/disorders/restless-legs-syndrome
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