Restless Legs Syndrome, an unpleasant sensation felt in the legs

Hello. This is Baekrokdam Korean Medicine Clinic.

"Why do my legs feel strange only at night?"

A woman in her late 50s has had days where it is difficult to fall asleep due to an unpleasant sensation felt in her legs every night since 3 to 4 years ago. This sensation is not pain, but is described as a feeling like insects crawling, a tightening feeling, or a burning feeling.

The symptoms worsen especially when lying down; moving the legs brings temporary relief, but it repeats upon lying down again, preventing deep sleep.

2 years ago, I was diagnosed with Restless Legs Syndrome (RLS) and have been taking prescribed dopamine-based medication, but the symptoms are gradually worsening. Due to difficulty sleeping, symptoms such as chronic fatigue, depression, and palpitations are accompanying this.

Moreover, recently their mother recalled memories of experiencing similar symptoms during childhood, and mentioned that she had been thinking, "Could it be that my mother also had Restless Legs Syndrome?"

Restless Legs Syndrome, What Is the Problem?

1. Characteristics of Restless Legs Syndrome

• It is characterized by discomfort in the legs that mainly worsens at night and is temporarily relieved by movement.
• It can interfere with sleep, leading to chronic fatigue, feelings of depression, and other issues.
• Genetic factors are strong, and there are often cases with a family history.

2. Cause

• Dopamine neurotransmission abnormality: Dopamine deficiency or imbalance is cited as a primary cause.
• Iron deficiency: Iron deficiency can affect dopamine metabolism and neurotransmission, potentially worsening symptoms.
• Stress and lack of sleep: Psychological and environmental factors also exacerbate the symptoms.

Taking dopamine-class medications; typically, the following medications may be prescribed.

1. Primarily prescribed medications

• Dopamine agonist
  • Pramipexole (product name: Mirapex):It is a 1st-line treatment that relieves symptoms by activating dopamine receptors.
  • Ropinirole (product name: Requip):It is similar to pramipexole and is widely used for restless legs syndrome.
• Iron supplements:If iron deficiency is confirmed, iron preparations are used in combination to improve neurotransmission.
• Benzodiazepine class (sedatives)
  • Clonazepam (Brand name: Rivotril): It calms the nerves to reduce symptoms and induce sleep.
• Neuralgia medication
  • Gabapentin (Brand name: Neurontin):It relieves nerve irritability to reduce symptoms.

2. Problems with drug treatment

• Development of tolerance:Dopamine-class drugs may lead to the development of tolerance, where the effect decreases over time or symptoms worsen.
• Side effects: Long-term intake may cause side effects such as nausea, dizziness, and palpitations.
• Medication may temporarily alleviate symptoms, but there are cases where symptoms do not completely disappear.

Oriental medicine treatment for Restless Legs Syndrome

For Restless Legs Syndrome, not only dopamine abnormalities but also the balance of the entire body, especially blood circulation, nerve stabilization, and the relief of mental stress, are important. Oriental medicine treatment can help resolve these issues comprehensively.

1. Herbal Medicine Treatment

Herbal medicine is prescribed with the following goals according to the condition.

• Improvement of blood circulation and nerve stabilization:It improves blood circulation in the legs and calms nerve hypersensitivity reactions.
  • Medicinal ingredients: Rehmanniae Radix Preparata, Angelicae Gigantis Radix, Chuanxiong Rhizoma, Paeoniae Radix Alba.
• Sleep improvement and psychological stability:It alleviates psychological anxiety and heart palpitations, and helps with deep sleep.
  • Medicinal herbs: Sanjoin, Longyanrou, Baihe, Licorice.
• Iron and energy supplementation:If iron deficiency is suspected, medicinal herbs with high iron content are used.
  • Medicinal herbs: Astragalus, Poria, Ophiopogon.

2. Acupuncture Treatment

Acupuncture treatment is effective in directly addressing the neurological and blood circulation issues of restless legs syndrome.

• Acupoint Stimulation: Reduces leg discomfort and calms the nervous system.
  • Main acupoints: Zusanli, Sanyinjiao, Taichong, Yinlingquan.
• Sleep improvement: It relieves stress and tension to induce deep sleep.
  • Main acupoints: Shinmun, Simsu, Bisu.

3. Lifestyle Management

• Thermal Therapy: Keep your legs warm before going to bed to help blood circulation.
• Iron Intake:Consume foods rich in iron, and iron supplements are recommended if necessary.
• Stress management:Restore psychological stability through meditation, yoga, etc.
• Regular exercise:Relax the leg muscles with light aerobic exercise.

Restless Legs Syndrome can be improved with Korean medicine treatment

Restless Legs Syndrome is not simply a problem of dopamine abnormality alone. Various factors such as blood circulation, nerve hypersensitivity, iron deficiency, and psychological stress act complexly to worsen the symptoms. Korean medicine treatment comprehensively addresses these causes to restore the balance of body and mind and fundamentally alleviate the symptoms.

Even in cases where symptoms do not improve with drug therapy, quality of life can be regained through Korean medicine treatment and constitutional improvement. Consider Korean medicine treatment for better sleep and health.