Restless.

I'm a leg bouncer. You know that person sitting next to you that will not, can not stop shaking or bouncing her leg. For me, it's not a nervous twitch, it's Restless Leg Syndrome, which is actually categorized as a sleep disorder.

The hallmarks of RLS are:

- a strange discomfort in the legs usually between the knees and ankles,

- symptoms that occur at rest, mostly in the evenings or while sleeping,

- symptoms are only transiently improved by moving the legs, hence my constant twinkle toes.

The pathology is not well-understood although it seems to be related to abnormal chemicals and reduced iron stores in the brain fluid. But it also may be caused by abnormal blood flow and lower oxygen levels in the legs. Of course RLS has to be differentiated from other conditions that cause leg movements like tics, leg cramps or one of the many other causes of leg pain.

The leg bouncing is the least concerning effect of RLS. Disordered sleep can lead to serious secondary consequences such as extreme daytime fatigue, lack of concentration, anxiety, depression, high blood pressure, obesity and headaches. Interestingly though, some sleep medications, antidepressants and antihistamines like Benadryl can make symptoms worse!

As with most medical conditions, regular exercise is part of the prescription to control RLS. Reducing caffeine and alcohol and avoiding those medications that cause RLS are also some behavioral techniques that may help. Osteopathic manipulation treatments can help improve blood and lymphatic circulation and normalize the autonomic and peripheral nervous system impulses. Anecdotally, I use topical arnica cream and peppermint oil as a topical nerve-calming toner. And for severe cases that are refractory to lifestyle changes, pharmacologic treatments are available such as neuromodulating medications or iron supplementation (if your iron stores are low).

As always, check in with your doctor to find out if you have RLS and which therapies and treatments might work best for you. In the meantime, keep up your regular exercise and stretching and maybe get a loved one to give you a nice massage!

xo,

Dr. Lex