Physiotherapy for Restless Leg Syndrome

Original Editor - Peace Samuel Top Contributors - Peace Samuel and Kim Jackson

Introduction[edit | edit source]

Restless Leg Syndrome (RLS) manifests as an irresistible urge to move one's leg. It is also known as Willis-Ekbom disease. The term RLS was introduced by Karl-Axel Ekbom who encountered a number of outpatients complaining of peculiar and tormenting paraesthesias deep in their lower legs which he had never heard of before. [1] It is considered a condition of the nervous system that leads to a movement disorder that causes discomfort during sleep or relaxation. Mostly idiopathic in nature, Restless Leg Syndrome (RLS) has been managed over the years with medical / drug interventions. Recent research interventions aimed towards the management of RLS include exercise training, transcutaneous spinal direct current stimulation (tsDCS), pneumatic compression devices (PCDs), light therapy, repetitive transcranial magnetic stimulation (rTMS), or acupuncture for the treatment of primary RLS, exercise training for the treatment of uremic RLS, and endovenous laser ablation (ELA) for the treatment of RLS with superficial venous insufficiency (SVI). [2]

Causes of Restless Leg Syndrome[edit | edit source]

RLS is mostly idiopathic. This means that in most cases, the cause is unknown. It often runs in families and specific gene variants have been associated with the RLS condition. Low levels of iron in the brain also may be responsible for RLS and may be related to a dysfunction in a part of your brain that controls movement. [3] Other conditions that could be linked to the cause of Restless leg syndrome are:

  • Chronic diseases.
  • Medications.
  • Pregnancy.
  • Lifestyles like lack of sleep or other sleep disorders like apnea. Also, intake of alcohol, tobacco, and caffeine use. [1]

Symptoms of Restless Leg Syndrome[edit | edit source]

People who have Restless leg syndrome usually experience the following:

  • Irresistible urge to move the legs.
  • Uncomfortable sensations in the leg inform of aching, throbbing, pulling, itching, crawling, or creeping.

These symptoms can further lead to one experiencing the following:

  • Mood Changes.
  • Sleep disorders.
  • Concentration issues.
  • Impaired memory.
  • Decreased activities of daily living or productivity.
  • Depression and anxiety. [3]

Diagnosis of Restless Leg Syndrome[edit | edit source]

Restless Leg Syndrome doesn't have a single test for its diagnosis. A diagnosis is usually made based on your symptoms, medical history and family history, a physical examination, and test results. [1]

Management of Restless Leg Syndrome[edit | edit source]

There is no cure for Restless Leg Syndrome. Symptoms are usually managed as first line of action and the underlying medical condition like lack of iron, chronic diseases etc that leads to Restless leg syndrome can bring relief when treated. Some Medications are also used to relieve the symptoms as well and they include:

  • Dopaminergic drugs, which act on the neurotransmitter dopamine in your brain.
  • Carbidopa/levodopa (Sinemet) usually used to treat Parkinson's disease.
  • Benzodiazepines - may help with sleep.
  • Narcotics pain relievers
  • Anticonvulsant or anti-seizure drugs such as carbamazepine (Tegretol), gabapentin (Neurontin), gabapentin enacarbil (Horizant), and pregabalin (Lyrica). [1]

Physiotherapy Management of Restless Leg Syndrome[edit | edit source]

Recent research has proved that physiotherapy is effective in relieving symptoms of RLS. [4]

Effective results are obtained through various specific exercise programs like:

  • Traction straight leg raise. [5]
  • Reflexology,
  • Electrical stimulation,
  • Stretching exercises, and
  • Workout plans like strength training, and aerobic exercises.
  • Near Infrared therapy. [2]

The video below shows some practical exercises to try out. [6]

Conclusion[edit | edit source]

People may be experiencing symptoms of Restless leg syndrome before they start thinking about getting a diagnosis. Poor sleep habits, extreme fatigue and abnormal sensations in the legs are usually the first indicators. The first line of management goes to drug interventions but it's been proven that mild to moderate exercises can help relieve RLS Symptoms.

Engaging in different specific but not high-intensity exercises as discussed in this article is encouraged as it provides relief without dealing with any form of side effects as against when drugs are used to relieve the symptoms of RLS.

References:[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Ekbom K, Ulfberg J. Restless legs syndrome. Journal of internal medicine. 2009 Nov;266(5):419-31.[1]
  2. 2.0 2.1 Ratnani G, Harjpal P. Advancements in Restless Leg Syndrome Management: A Review of Physiotherapeutic Modalities and Their Efficacy. Cureus. 2023 Oct 10;15(10).
  3. 3.0 3.1 Manconi M, Garcia-Borreguero D, Schormair B, Videnovic A, Berger K, Ferri R, Dauvilliers Y. Restless legs syndrome. Nature reviews Disease primers. 2021 Nov 3;7(1):80.
  4. El-Gendy SR, Alkhateeb AM. Effect of stretching, strengthening exercises and walking on the management of restless legs syndrome: A cross sectional study. SPORT TK-Revista EuroAmericana de Ciencias del Deporte. 2022 Feb 26:8-.
  5. Dinkins EM, Stevens-Lapsley J. Management of symptoms of Restless Legs Syndrome with use of a traction straight leg raise: a preliminary case series. Manual therapy. 2013 Aug 1;18(4):299-302.
  6. Ask Dr Jo