Restless legs syndrome affects an estimated third of all fibromyalgia patients — even though the bizarrely-named condition that gives people the urge to move their legs uncontrollably is quite rare in the general population.
Restless Leg Syndrome: What is it?
Restless legs syndrome is — basically — exactly “what it says on the tin”; a condition in which patients are overcome by annoying feelings in their legs that in turn make them move their legs rather a lot. Restless legs syndrome frequently strikes during the night while you are resting.
If you suffer from restless legs syndrome, the following probably sounds familiar to you:
- You’ll start experiencing the feelings that “force” you to move your legs after you’ve been physically inactive for a while, either lying or sitting down. Think at an office job, on a bus, or during a lecture. Your symptoms tend to be worse at night.
- You briefly feel better immediately after you move your legs — by shaking, stretching, or kicking them, for instance. The sensation soon comes back, unfortunately!
The cause of restless legs syndrome remains a mystery, though it is clear that it is a neurological condition. It’s possible that it could be genetic, but it may also be linked to kidney failure, anemia, diabetes, pregnancy (particularly in the final trimester), Parkinson’s disease, and peripheral neuropathy. Lesions of the spinal cord have been associated with restless legs syndrome as well.
Fibromyalgia and restless leg syndrome: How are they linked?
The overlap between restless legs syndrome and fibromyalgia isn’t understood, at least partially because the two conditions share something we wish they didn't — their causes haven’t been discovered yet. They’re both believed to be neurological in nature, however, and both may also fall under the umbrella of central sensitivity syndromes, which means that the body becomes more sensitive to stimuli.
Restless legs syndrome can unsurprisingly interfere with sleep, and sleep deprivation is in turn likely to worsen your fibromyalgia symptoms. Luckily, there are some treatments that can help you feel better.
Medications to ease your restless legs symptoms
Boost your dopamine levels in the brain with these drugs
Pramipexole (Mirapex), rotigotine (Neupro) and ropinirole (Requip) boost your dopamine levels, and are all FDA-approved to relieve more severe cases of restless legs syndrome. Another way to raise your dopamine and possibly bring some "rest" to your legs is Sinemet, which is a mix of carbidopa and levodopa. Unfortunately, you may notice that the dopamine drugs don’t work any more after a while, or your symptom relief doesn't last as long. When this happens, it is time to explore other options.
Pregabalin (Lyrica), gabapentin (Neurontin) and gabapentin enacarbil (Horizant), have all been shown to relieve the symptoms of restless legs syndrome in some patients. They will sound familiar to many fibromyalgia patients, as the first two are also often prescribed to reduce the symptoms of this condition. The good news here is that you may be able to receive a double benefit from your medications.
Opioids are well-known to be addicting, especially when taken in larger doses for a longer period of time, and they'll be used as a last resort — if other medications do not bring you relief. When opioids are used, a combination of hydrocodone and acetaminophen (Norco, Vicodin), codeine, mixed oxycodone and acetaminophen (Percocet, Roxicet) and oxycodone (OxyContin, Roxicodone) are some examples of medications you may be prescribed.
Benzodiazepines — sleep drugs
Benzos will help you sleep better, though they stop you from having the strange sensations in your legs and may also make you feel tired and drowsy during the day. Some of benzodiazepines that may soothe your restless legs are clonazepam (Klonopin), temazepam (Restoril) and alprazolam (Xanax).
Alpha3 agonists work on your alpha2 receptors in the brain, activating neurons that regulate a part of your nervous system that manages involuntary muscle movements and sensations. As a result, your restless leg syndrome symptoms can be relieved significantly. One of these drugs, clonidine (Catapres), is not uncommonly prescribed for people with restless legs syndrom
Remember that a few of the drugs you take — antidepressants often used for fibromyalgia, but also something as innocent as cold medications — can actually aggravate the symptoms of restless leg syndrome. Talk to your physician about which drugs to take and what side effects they can give you.
Home treatments and lifestyle adjustments to treat fibromyalgia and restless legs syndrome
Several home remedies and lifestyle changes can help your restless legs. Some of these are:
- Work out! Exercising regularly but not too often can aid both your restless leg and fibromyalgia symptoms. Don't work out later in the day, because that can make your symptoms worse.
- Create a healthy sleep environment. You should ideally sleep in a peaceful, slightly cool, and noise-free room, as well as sticking to regular a bedtimes. Better sleep will help reduce both restless legs syndrome and fibromyalgia symptoms.
- Protein before bedtime. Guard against a sudden decrease in your blood sugar which can make your symptoms worse by eating proteins, like eggs, cheese and almonds, shortly before you go to bed.
- Consider massages and a hot bath. Soothe your muscles by bathing in a nice hot bath and massage your legs.
- No caffeine. Staying off caffeine could ease your restless legs, so try to go without coffee, chocolate, tea and energy drinks.
- Cold packs and hot packs. You might be able to get rid of that restless legs feeling by putting either warm or cool packs on your legs.
- Magnesium. Bathing in Epsom salts with magnesium can calm your muscles. You can experiment and add essential oil to your bath as well. This can help you rest well and lessen your symptoms, but if you have a magnesium deficiency, you will want to look into taking a supplement too.