Restless Leg Syndrome and Fibromyalgia
Restless leg syndrome is a condition that results from the urge to move the legs in order to stop unpleasant sensations. It most commonly occurs in middle-aged and older adults and appears to be made worse by stress. For most patients who have restless leg syndrome, the cause is unknown. Individuals with certain conditions or in certain situations may be at a greater risk of developing restless leg syndrome, including those with chronic kidney disease, diabetes, iron deficiency, Parkinson’s disease, nerve damage, pregnancy, those who consume caffeine or take certain medications, and those who are withdrawing from certain sedative medications. Restless leg syndrome can occur in families, however a genetic link has not been identified to date. The loss of sleep that frequently results from restless leg syndrome can lead to daytime sleepiness, depression, anxiety, decreased thinking ability and confusion.
The symptoms of restless leg syndrome are those of sensations between the knee and ankle, though sometimes the upper leg, feet, or arms may also be affected. The individual is made uncomfortable by these sensations unless he or she moves their legs. They typically occur at night while lying down but may occur during the day while sitting for a long period of time. Individuals with restless leg syndrome have described the sensations as “creeping,” “crawling,” “aching,” and “tingling,” among others. The sensations can last for up to an hour or longer and result in the irresistible urge to walk or move one’s legs, an action that unfailingly results in relief from the discomfort. Symptoms may also worsen during periods of extreme stress.
Unfortunately there is no definitive test for restless leg syndrome, other than to rule out peripheral nerve disease and iron deficiency anemia, and there are also no known cures. Treatments are designed to reduce stress and help muscles relax, and include gentle stretching exercises, massage, and warm baths. Some individuals get relief from certain medications – most notably Mirapex and Requip – and others who have severe sleep disturbances may require other medications such as gabapentin (an anti-seizure medication), pregabalin (a medication commonly used to treat nerve pain), or a tranquilizer such as clonazepam to help them sleep.
Folic acid (Botez et al. 1976), magnesium (Hornyak et al., 1998), and vitamin B12 (Benito-Leon et al., 2000) have all been investigated to determine their effectiveness in treating the symptoms associated with restless leg syndrome, however supportive evidence is lacking and additional studies are warranted.
Restless Leg Syndrome and Fibromyalgia
Many individuals with Fibromyalgia also have restless leg syndrome. The reasons why these two conditions frequently co-occur are not well understood, since there is no known definitive cause for either condition. It is likely that a common causal factor in the brain and or central nervous system is at work.
A 1996 study by Yunnus and Aldag investigated the prevalence of Fibromyalgia and restless leg syndrome and found that both the syndrome itself as well as leg cramps were much more prevalent in patients with Fibromyalgia than in normal control subjects (Yunus & Aldag, 1996). A 2008 study designed to evaluate the prevalence of restless leg syndrome in female Fibromyalgia patients also found a high prevalence, with 64% of the 332 Fibromyalgia patients studied having restless leg syndrome (Stehlik et al., 2009). This study also found that patients who suffered from both restless leg syndrome and Fibromyalgia experienced greater sleep disturbances and difficulty maintaining sleep than those who had only Fibromyalgia. Similar prevalence and sleep disturbance findings were also recently reported in a study by Viola-Saltzman et al. (2010).
The findings of an increased prevalence of restless legs syndrome and associated sleep disturbances among Fibromyalgia patients are important in that they can provide both patients and treating physicians with useful information that may improve both the sleep and quality of life for these patients.