Electricity May Help with Restless Legs Syndrome
Restless Legs Syndrome Is Uncomfortable
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
Imagine lying down to sleep, and instead of comfortably drifting away, you feel creeping, crawling, drawing, pulling, itching, aching, pain and other uncomfortable and often nondescript sensations in your calves and thighs. In order to relieve these sensations, you feel compelled to move your legs. But relief is ephemeral, and in no time, you're back to feeling uncomfortable. As anyone can imagine, such bedtime discomfort makes going to sleep difficult, the effects of which roll over into your daytime activities and leave you feeling exhausted and fatigued.
For an estimated 5 million Americans with restless legs syndrome (RLS or Willis-Ekbom disease) such misery is an unfortunate reality. Treatment for this disease is symptomatic and many patients have experienced initial relief with dopamine agonists like levodopa (which is also used to treat Parkinson's disease). But most recently, dopamine agonists have been shown to cause "augmentation" or an increase in restless legs symptoms over time.
Promisingly, researchers in Germany have demonstrated that transcutaneous spinal direct current stimulation (tsDCS) or application of electrical current to the spine may be helpful with relieving short-term symptoms caused by restless legs syndrome.
What Is Restless Legs Syndrome?
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
Restless legs syndrome is a movement disorder that results in discomfort and delay of sleep and is diagnosed by clinical history. (Of note, Parkinson's disease is another movement disorder.) Typical symptoms of RLS affect the legs and occur when a person is relaxed and lying down to fall asleep. They include the following:
Such sensations are accompanied by an irresistible sensation to move your legs which provides only fleeting relief. Restless legs syndrome leaves your calves and thighs feeling weak and results in next-day fatigue and exhaustion.
To make matters worst, more than 80% of people with restless legs syndrome also experience a condition called periodic leg movements of sleep which causes repetitive movements of the legs and feet that occur every 20 to 90 seconds and result in either microarousals or full arousals. In other words, such movements may not fully wake you and only be noticed by your bed partner.
The etiology or cause of restless legs syndrome is unknown, but it has been associated with iron-deficiency anemia, low ferritin levels, thyroid disease, pregnancy, uremia, and antidepressant or antihistamine use.
Treatment of restless legs syndrome is symptomatic and can include the following:
tsDCS and Restless Legs Syndrome
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
In a small randomized controlled trial which involved 20 research participants with restless legs syndrome, researchers showed that the application of low-level current using spinal electrodes (transcutaneous spinal direct current stimulation or tsDCS) may be help with short-term symptoms of the disease--namely, the discomfort and desire to move your legs.
Participants in the study discontinued RLS medications at least 24 hours prior to treatment with tsDCS.
They then reported on pain at three time intervals before, during and after tsDCS treatment (the span of this reporting lasted less than an hour). Participants who received tsDCS reported a decrease in RLS symptoms after receiving tsDCS treatment as compared with those participants who received sham treatment. (Interestingly, researchers also noted a decrease in the amplitude of the soleus Hoffmann-reflex which is normally increased in the symptomatic RLS patient.)
Researchers conjecture that RLS causes an increase in spinal excitability and treatment with electrical current helps mitigate such excitability in the short term and thus relieve symptoms.
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
If you or someone you love suffers from restless legs syndrome, the emergence of tsDCS as a possible therapeutic intervention augurs well. Current pharmacologic treatment of RLS is complicated by numerous adverse effects. For example, as previously discussed, dopamine agonists can cause augmentation or worsening of symptoms in the long run, and drugs like opioids can lead to substance dependence.
Because tsDCS is noninvasive, nonpharmacologic and has proven effective in relieving symptoms of other chronic pain symptoms, it holds promise as a possible future therapeutic intervention. Nevertheless, further testing and research needs to be done in order to develop this treatment modality.
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
“Effect of Transcutaneous Spinal Direct Current Stimulation in Idiopathic Restless Legs Patients” by AC Heide and colleagues and published in Brain Stimulation and published in 2014. Accessed from PubMed on 10/29/2014.
LeBlond RF, Brown DD, DeGowin RL. Chapter 14. The Neurologic Examination. In: LeBlond RF, Brown DD, DeGowin RL. eds. DeGowin's Diagnostic Examination, 9e. New York, NY: McGraw-Hill; 2009.
Accessed October 28, 2014.
Ropper AH, Samuels MA, Klein JP. Chapter 19. Sleep and Its Abnormalities. In: Ropper AH, Samuels MA, Klein JP. eds. Adams & Victor's Principles of Neurology, 10e. New York, NY: McGraw-Hill; 2014. Accessed October 28, 2014.
Welsh CH, Welsh CH. Chapter 29. Evaluation of Sleepiness & Sleep Disorders Other Than Sleep Apnea: Narcolepsy, Restless Leg Syndrome, & Periodic Limb Movements. In: Hanley ME, Welsh CH. eds. CURRENT Diagnosis & Treatment in Pulmonary Medicine. New York, NY: McGraw-Hill; 2003. Accessed October 28, 2014.
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
Imagine lying down to sleep, and instead of comfortably drifting away, you feel creeping, crawling, drawing, pulling, itching, aching, pain and other uncomfortable and often nondescript sensations in your calves and thighs. In order to relieve these sensations, you feel compelled to move your legs. But relief is ephemeral, and in no time, you're back to feeling uncomfortable. As anyone can imagine, such bedtime discomfort makes going to sleep difficult, the effects of which roll over into your daytime activities and leave you feeling exhausted and fatigued.
For an estimated 5 million Americans with restless legs syndrome (RLS or Willis-Ekbom disease) such misery is an unfortunate reality. Treatment for this disease is symptomatic and many patients have experienced initial relief with dopamine agonists like levodopa (which is also used to treat Parkinson's disease). But most recently, dopamine agonists have been shown to cause "augmentation" or an increase in restless legs symptoms over time.
Promisingly, researchers in Germany have demonstrated that transcutaneous spinal direct current stimulation (tsDCS) or application of electrical current to the spine may be helpful with relieving short-term symptoms caused by restless legs syndrome.
What Is Restless Legs Syndrome?
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
Restless legs syndrome is a movement disorder that results in discomfort and delay of sleep and is diagnosed by clinical history. (Of note, Parkinson's disease is another movement disorder.) Typical symptoms of RLS affect the legs and occur when a person is relaxed and lying down to fall asleep. They include the following:
- creeping feelings
- crawling feelings
- aching sensations
- formication (medical jargon for the sensation that "worms" are crawling all over your legs)
- "coldness"
- an "itch" you can't scratch
Such sensations are accompanied by an irresistible sensation to move your legs which provides only fleeting relief. Restless legs syndrome leaves your calves and thighs feeling weak and results in next-day fatigue and exhaustion.
To make matters worst, more than 80% of people with restless legs syndrome also experience a condition called periodic leg movements of sleep which causes repetitive movements of the legs and feet that occur every 20 to 90 seconds and result in either microarousals or full arousals. In other words, such movements may not fully wake you and only be noticed by your bed partner.
The etiology or cause of restless legs syndrome is unknown, but it has been associated with iron-deficiency anemia, low ferritin levels, thyroid disease, pregnancy, uremia, and antidepressant or antihistamine use.
Treatment of restless legs syndrome is symptomatic and can include the following:
- dopaminergic agents like levodopa, pramipexole and rotigotine
- anticonvulsants like gabapentin
- benzodiazepines like clonazepam and diazepam
- opioids like oxycodone and codeine
- iron supplementation
- exercise
- massage
- avoidance of drugs, alcohol and tobacco
tsDCS and Restless Legs Syndrome
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
In a small randomized controlled trial which involved 20 research participants with restless legs syndrome, researchers showed that the application of low-level current using spinal electrodes (transcutaneous spinal direct current stimulation or tsDCS) may be help with short-term symptoms of the disease--namely, the discomfort and desire to move your legs.
Participants in the study discontinued RLS medications at least 24 hours prior to treatment with tsDCS.
They then reported on pain at three time intervals before, during and after tsDCS treatment (the span of this reporting lasted less than an hour). Participants who received tsDCS reported a decrease in RLS symptoms after receiving tsDCS treatment as compared with those participants who received sham treatment. (Interestingly, researchers also noted a decrease in the amplitude of the soleus Hoffmann-reflex which is normally increased in the symptomatic RLS patient.)
Researchers conjecture that RLS causes an increase in spinal excitability and treatment with electrical current helps mitigate such excitability in the short term and thus relieve symptoms.
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
If you or someone you love suffers from restless legs syndrome, the emergence of tsDCS as a possible therapeutic intervention augurs well. Current pharmacologic treatment of RLS is complicated by numerous adverse effects. For example, as previously discussed, dopamine agonists can cause augmentation or worsening of symptoms in the long run, and drugs like opioids can lead to substance dependence.
Because tsDCS is noninvasive, nonpharmacologic and has proven effective in relieving symptoms of other chronic pain symptoms, it holds promise as a possible future therapeutic intervention. Nevertheless, further testing and research needs to be done in order to develop this treatment modality.
Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.
Updated November 19, 2014.
“Effect of Transcutaneous Spinal Direct Current Stimulation in Idiopathic Restless Legs Patients” by AC Heide and colleagues and published in Brain Stimulation and published in 2014. Accessed from PubMed on 10/29/2014.
LeBlond RF, Brown DD, DeGowin RL. Chapter 14. The Neurologic Examination. In: LeBlond RF, Brown DD, DeGowin RL. eds. DeGowin's Diagnostic Examination, 9e. New York, NY: McGraw-Hill; 2009.
Accessed October 28, 2014.
Ropper AH, Samuels MA, Klein JP. Chapter 19. Sleep and Its Abnormalities. In: Ropper AH, Samuels MA, Klein JP. eds. Adams & Victor's Principles of Neurology, 10e. New York, NY: McGraw-Hill; 2014. Accessed October 28, 2014.
Welsh CH, Welsh CH. Chapter 29. Evaluation of Sleepiness & Sleep Disorders Other Than Sleep Apnea: Narcolepsy, Restless Leg Syndrome, & Periodic Limb Movements. In: Hanley ME, Welsh CH. eds. CURRENT Diagnosis & Treatment in Pulmonary Medicine. New York, NY: McGraw-Hill; 2003. Accessed October 28, 2014.
Source...