There’s news for people who lie awake in bed at night suffering from restless legs syndrome (RLS). A new study published in the October issue of Journal of Clinical Sleep Medicine showed a strong link between RLS and fibromyalgia (FMS). In fact, the overlap of these two conditions is so strong that people with fibromyalgia are 11 times more likely to have RLS than people in the general population.
Both fibromyalgia and restless legs syndrome tend to keep sufferers awake at night. Restless legs syndrome is a neurological disorder characterized by creepy sensations running through the legs and accompanied by an uncontrollable urge to move the legs to get some relief. Individuals affected with the disorder describe the sensations as burning, tugging, or feeling like insects are crawling inside their legs. The sensations range in severity from mere discomfort to considerable pain. In contrast, fibromyalgia is a tricky condition with a varied set of symptoms. Until recently, many in the medical establishment viewed people with the condition as hypochondriacs. As with RLS, the causes are unknown. FMS symptoms include multiple tender areas (muscle and joint pain) on the back of the neck, shoulders, sternum, lower back, hips, shins, elbows, and knees; fatigue; sleep disturbances; body aches; reduced exercise tolerance; and chronic facial muscle pain or aching. About 85 percent of fibromyalgia cases occur in women.
The link between fibromyalgia and RLS was discussed in a Journal of Clinical Sleep Medicine study that followed 172 people suffering from fibromyaglia. Of these, 93 percent were female. This group had a mean age of 50. They were compared to a control group of 63 people who did not suffer from pain and fatigue and whose mean age was 41. The researchers found that 33 percent of the fibromyalgia group also had RLS as compared to only 3.1 percent of the control group.
Contributing author Nathaniel F. Watson, MD, Associate Professor of Neurology at the University of Washington in Seattle, said in a news release, "Sleep disruption is common in fibromyalgia and often difficult to treat. It is apparent from our study that a substantial portion of sleep disruption in fibromyalgia is due to restless legs syndrome."
The medical establishment typically treats RLS with drugs, hoping to improve sleep and thus improve the overall condition of those who also suffer from fibromyalgia. This approach dates back to a study published in 1996, which also found a connection between fibromyalgia and RLS. Back then, the suggested regimen was to prescribe the drugs clonazepam, carbamazepine, or levodopa to get the RLS under control. But these drugs are such side-effect whoppers that if you were diagnosed with RLS in the 90s, you might have been better off suffering with it. The side effects of clonazepam, for example, include drowsiness, dizziness, blurred vision, muscle pain, excessive hair growth or loss, change in sexual desire, weight change, increased saliva production, sore gums, depression, suicidal thoughts and attempts, and other mood disorders. Carbamazepine has caused rare cases of skin reactions so severe that they have been fatal. It has also caused severe reduction in bone marrow function, plus all of the side effects we just listed for clonazepam.
And then there is levodopa. According to Medicinenet.com. "Most patients receiving levodopa-carbidopa experience side effects, but these are usually reversible. Occasional involuntary movements are the most common of the serious side effects of levodopa-carbidopa therapy. These may include chewing, gnawing, twisting, tongue or mouth movements, head bobbing, or movements of the feet, hands, or shoulder." Sometimes I think doctors should have to take the drugs themselves they prescribe, but don’t get me started on that topic. In any event, it’s hard to justify taking a medicine that stops leg twitching in exchange for gnawing, gnashing, and head bobbing.
The current drugs of choice for RLS are dopaminergics, which act like the neurotransmitter dopamine. One of these is mirapex, which has a list of side effects longer than a twitching leg. Among the many delightful experiences you might have are sleepiness, nausea and vomiting, constipation, dry mouth, chest pain and compulsive behaviors. If you don’t like how that sounds, there are always the benzodiazepines, which include Valium and Xanax. Or else there are opiates like Darvon and Percodan. Of course, both of these categories are highly addictive. And finally there are the latest and greatest of the anti-convulsants, like Nuerontin and Tegretol. The latter is a carbamazepine which I mentioned above and the former has a long list of side effects that include drowsiness, dizziness, unsteadiness, fatigue, vision changes, weight gain, nausea, dry mouth, constipation, and more rarely suicidal ideation, depression, and on and on.
While RLS causes patients considerable distress, there are more benign and effective approaches to decrease or control the symptoms of this condition. As I’ve reported in the past, RLS is very responsive to dietary and lifestyle changes, detoxification, programs that balance out hormones, and massage and physical therapy. And the side benefit is that the dietary and lifestyle changes and detoxes will also help with fibromyalgia. But it should be noted that FMS is a systemic condition and can’t be effectively dealt with unless you treat it as such.
You might well ask why anyone would subject him or herself to a side-effect laden pharmaceutical approach? Partly because doctors tend to think like pharmaceutical companies when it comes to conditions like these. They ask, "What drug can I dispense to push these symptoms out of sight?" And as long as doctors think about symptoms rather than about the patients manifesting those symptoms, patients will be advised to try expensive treatments replete with side effects, rather than treatments focused on deep, systemic healing.
I probably should point out that several years ago, my wife, Kristen, developed severe RLS that totally disrupted her sleep patterns. She got significant relief when she added bio-identical estriol crème to her regimen, but it wasn’t until she added a form of deep muscle massage called BioSync that she got complete relief. From the very first session of BioSync she received, she has not had one single further incident of RLS for some five years now. And yes, she continues to get Biosync work approximately once a month. Unfortunately, BioSync is not widely available, but I would guess that any deep muscle work would prove helpful.