There is a particular complaint I hear in the pharmacy that can be surprisingly difficult for people to describe.
“My legs just won’t settle.”
They are tired.
They have gone to bed.
They are comfortable.
But then the strange sensation starts.
A crawling feeling.
An ache.
A tingling.
Sometimes it feels almost as though something is moving underneath the skin.
So they move their legs.
For a few seconds, it feels better.
Then they stop moving.
And it starts again.
Some people get up and walk around the bedroom.
Others spend half the night kicking their legs underneath the duvet.
And eventually they say:
“I think I’m going mad.”
You’re not.
There is a recognised condition called restless legs syndrome, or RLS.
And it is much more than simply having restless legs.
The clue is what happens when you stop moving
The classic description is an uncomfortable or unpleasant sensation in the legs accompanied by a strong urge to move them.
The interesting thing is that it tends to happen when you are resting.
Sitting on the sofa.
Travelling.
Watching television.
Trying to fall asleep.
And it is usually worse in the evening or at night.
Moving the legs can temporarily relieve the sensation, which is one of the clues that separates restless legs syndrome from some other causes of leg discomfort. (nhs.uk)
That is why someone can spend an entire day walking around without much trouble, only to find that the moment they get into bed their legs decide they have other plans.
It can destroy a good night’s sleep
This is where I think people sometimes underestimate the problem.
If it happens occasionally, you may simply put up with it.
But if it happens night after night, getting to sleep can become a real struggle.
And even when you eventually fall asleep, repeated symptoms can leave you feeling exhausted the following day.
The NHS specifically recommends speaking to a GP if restless legs are stopping you sleeping or if the measures you have tried yourself aren’t helping. (nhs.uk)
I have had people tell me they have been living with it for years without ever mentioning it to anyone.
There is no prize for suffering in silence.
Sometimes iron is part of the story
This is one of the more interesting things about restless legs.
There is a recognised association between RLS and iron deficiency.
In some people, treating an underlying iron deficiency can improve the symptoms. (nhs.uk)
That doesn’t mean everyone with restless legs should rush out and buy an iron supplement.
It doesn’t.
Iron is a useful treatment when there is a reason for it, but taking iron unnecessarily isn’t something I would recommend.
If you have symptoms suggestive of restless legs, particularly if you also have symptoms that could suggest iron deficiency, it is worth discussing this with your doctor.
Iron deficiency anaemia can cause tiredness, lack of energy, breathlessness, palpitations and other symptoms, and a blood test can help establish whether anaemia or another problem is present. (nhs.uk)
Your medicines may also be involved
This is where I put my pharmacist hat on.
Whenever somebody tells me about a new or worsening problem, I want to know what medicines they are taking.
Some medicines can make restless legs symptoms worse.
These include certain antidepressants, some antihistamines, some medicines affecting dopamine, and some other medicines used for different conditions. (NHS Inform)
That doesn’t mean you should stop taking them.
Quite the opposite.
Never stop a prescribed medicine suddenly because you think it might be responsible.
The sensible approach is to ask your pharmacist or doctor to review the medication.
Sometimes there is an alternative.
Sometimes the medicine isn’t actually responsible.
And sometimes the benefits of the medicine outweigh the side effect.
It needs looking at as a whole.
And then there is the evening cup of tea
This one can be difficult for some people.
We are a nation of tea and coffee drinkers.
For some people with restless legs, however, caffeine can make symptoms worse.
The NHS recommends avoiding caffeine, including tea, coffee and energy drinks, after midday if you are experiencing restless legs. (nhs.uk)
That doesn’t mean everyone has to give up their morning coffee.
But if you are drinking several cups throughout the afternoon and evening and then wondering why your legs won’t settle at bedtime, it is a fairly easy experiment to cut back and see whether it makes a difference.
Alcohol close to bedtime may also be unhelpful.
What can you do when it starts?
There isn’t one magic trick that works for everyone.
But movement often helps.
Get out of bed and walk around for a few minutes.
Try gently stretching the legs.
Massage the affected muscles.
A warm bath or heat applied to the legs may also help.
Regular daytime exercise and a consistent sleep routine can be useful too. (nhs.uk)
The important word is daytime.
I wouldn’t recommend doing a hard workout immediately before bed in an attempt to exhaust your legs.
That can sometimes make sleep more difficult rather than easier.
Don’t automatically call it restless legs
This is important.
Not every aching or uncomfortable leg is restless legs syndrome.
Leg cramps, nerve problems, circulation problems and other conditions can cause symptoms that may initially sound similar.
Restless legs has a fairly characteristic pattern — an urge to move, symptoms when resting, worsening in the evening or night and relief, at least temporarily, with movement. (nhs.uk)
If you have persistent pain, swelling, numbness, weakness or other unusual symptoms, don’t simply assume it is RLS.
Get it assessed.
So what would I do if someone came into my pharmacy?
I’d start with some fairly simple questions.
When does it happen?
Is it worse when you are sitting or lying down?
Does moving your legs make it better?
Is it mainly at night?
How badly is it affecting your sleep?
What medicines are you taking?
How much caffeine and alcohol are you having?
And, depending on the circumstances, I would suggest speaking to the GP about whether an underlying problem such as iron deficiency needs investigating.
Because sometimes the answer isn’t another sleeping tablet.
Sometimes the answer is finding out why the legs won’t settle in the first place.
Don’t just accept another sleepless night
There is nothing particularly dangerous about the occasional restless night.
But if your legs are repeatedly keeping you awake, don’t simply decide that this is something you have to live with.
There are things that can be changed.
Your medication can be reviewed.
Possible underlying causes can be investigated.
Iron deficiency can be identified and treated where appropriate.
And simple changes to caffeine, alcohol, exercise and sleep habits may help.
So if you find yourself lying in bed tonight thinking:
“Why won’t my legs just stay still?”
You may have more than an annoying habit.
And it is worth talking about.
Until next time, look after yourself.
This article is for general health information and is not intended to replace individual medical advice.
The Daily Durian (zaynp100@yahoo.com) is a content creator under the Newswav Creator programme, where you get to express yourself, be a citizen journalist, and at the same time monetize your content & reach millions of users on Newswav. Log in to creator.newswav.com and become a Newswav Creator now!
The User Content (as defined on Newswav Terms of Use) above including the views expressed and media (pictures, videos, citations etc) were submitted & posted by the author. Newswav is solely an aggregation platform that hosts the User Content. If you have any questions about the content, copyright or other issues of the work, please contact creator@newswav.com.