September 2005

Restless Leg Syndrome: A chiropractic deficiency?

by Dr. Howard Loomis

Have you ever thought of Restless Leg Syndrome (RLS) as a chiropractic deficiency? By chiropractic deficiency do I mean a lack of chiropractic adjustments in the sufferer's life, or am I implying that patients are not aware that their doctor of chiropractic is quite capable of quickly correcting this very annoying symptom? Perhaps, I'm implying that our colleges have not adequately prepared their graduates to recognize the simple cause of this complex symptom. Actually, I believe all three causes are involved. Fortunately, however, the pharmaceutical industry has come to our rescue with an FDA‑approved prescription drug, even though they readily admit the cause of RLS is unknown and the condition is life long and cannot be cured!

My purpose in writing this month's column is to show that chiropractors have no competition in diagnosing and effectively treating this condition, relieving many patients of lifelong discomfort and frustration.

RLS is described as a sleep disorder in which a person experiences vague, unpleasant, seldom painful, but always very annoying, sensations in the legs such as creeping, crawling, and tingling. These sensations occur anywhere from the thigh to the ankle. One or both legs may be affected and, for a small percentage, the sensations may also be experienced in the arms. The symptoms usually occur when the person lies down or sits for prolonged periods of time, such as at a desk, riding in a car, or watching a movie.

People with RLS describe an irresistible urge to move the legs when the sensations occur. Walking, rubbing or massaging the legs, or doing knee bends can bring relief, at least briefly. This should be enough to suggest a pelvic or sacro‑iliac involvement.

RLS symptoms are often worse during periods of relaxation and decreased activity. This coincides with patient reports that they are bothered much more in the evening and during the night hours than during the morning hours. The symptoms make it difficult to relax and fall asleep and this produces a concomitant problem of sleep deprivation. Rest may not come until the end of the night or during the early morning hours, resulting in fatigue during the day. The net result is that RLS interferes with their work, social life, and recreational activities.

Cause

The exact cause of the syndrome is unknown, but the following factors are common to patients with RLS:

Pregnancy. Some women experience RLS during pregnancy, especially in the last months. The symptoms usually disappear after delivery, again suggesting a structural pelvic involvement.

Low iron levels or anemia. Persons with low iron levels or anemia may be prone to developing RLS. While the symptoms may improve once the iron level or anemia is corrected, this is actually a manifestation of a much larger nutritional problem, which is discussed in our seminars.

Chronic diseases. Kidney failure quite often leads to RLS. Other chronic diseases such as diabetes, rheumatoid arthritis, and peripheral neuropathy may also be associated with RLS. These diseases share obvious structural problems caused by muscle contractions related to the condition.

Diagnosis

There is no laboratory test that can make a diagnosis of RLS, and the condition cannot be diagnosed by medical physicians other than by symptoms reported by the patient. This strongly suggests a structural problem is the root cause and the chiropractic profession should be in the forefront of treatment, not the pharmaceutical industry.

The case history usually includes a description of the typical leg sensations that lead to an urge to move the legs or walk. These sensations are noted to worsen when the legs are at rest, for example when sitting (especially in a recliner or in an automobile) or lying down. Patients with RLS may complain about trouble sleeping or daytime sleepiness. In some cases, the bed partner will complain about the person's leg movements and jerking during the night.

Correction

Recognize that RLS is caused by a pelvic instability, with stress placed on the sacral base in an anterior direction and increasing the lumbo‑sacral lordosis.

***  Correction of lower extremity instability in the feet, ankles, legs, knees, and hips is mandatory.

*** Chiropractic therapy for pelvic and lumbo‑sacral instability.

*** Exercise. Specific exercises for strengthening the pelvis, lumbo‑sacral angle, and intervertebral discs are important. A regular program of walking seems to be most successful.

*** Leg stretches. Beginning and ending each day by stretching (hamstring shortening) the legs is helpful.

*** Avoid certain medications. Anti‑nausea drugs, anti‑psychotics, and some cold and allergy medications have been found to aggravate symptoms of restless legs syndrome.

Imagine what could happen if the chiropractic profession would address the cause of RLS with case studies that go beyond taking case histories and treating the non‑related conditions the way medicine is approaching the syndrome. What if our profession publicized an effective alternative to drug therapy, free of side effects, based on determining the exact cause of RLS for each patient?

It seems unlikely that a change will happen profession‑wide, so I'm suggesting that individual practitioners could specialize in the treatment of RLS and be quite successful. After all, there's nothing wrong with taking advantage of the current advertising campaign that extols the virtues of a new drug for a condition that has no known cause, no cure, and therefore must be tolerated for life!

(Dr. Loomis welcomes input on the subjects covered in this column. To make a comment, request a longer version of this article about RLS, or get information about upcoming Loomis Institute seminars, please contact Loomis Institute of Enzyme Nutrition online at www.loomisensymes.com, by phone at 800‑662‑2630 or by postal mail at 6421 Enterprise Lane, Madison, WI 53719.)