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Nerve Tension

Posted: Sun Dec 09, 2018 12:51 am
by XenMan
For anyone interested in physical treatment for RLS symptoms the following article is very interesting and explains the inconsistencies with treatment. I will list some extracts at the end of this post.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498562/

Nerve tension explains my experiences and those in other posts on this forum. My approach initially was with muscle tension treatment; which was frustratingly inconsistent. I’m happy to say I was wrong, with nerve tension being the explanation. Inflammation of the fibular nerve appears to be key to RLS symptoms in the calf muscle. This can of course extend to other parts of the body.

I would speculate that a large percentage of the population has RLS neurology, but there is a requirement for nerve tension for symptoms. I would also add that the RLS neurology promotes nerve tension to develop easily due to certain physiology such as a result of specific exercises, or lack thereof. I don’t see surgery as an option, but the identification of nerve inflammation treatment worth exploration. Anti-Inflammatory medication doesn’t appear to be an option, as over the counter ibuprofen and non-steroidal anti-inflammatory medicines are ineffective.

This explains my deterioration over the last year, and the challenges in treatment of symptoms. I now use a program of massaging tense muscles before bed, a plantar fasciitis sock on one leg and being woken by light periodic cramps on the other that are resolved by rolling my foot out and stretching. This leg then needs a compression wrap on the calf to stop aches.

I’m now exploring nerve flossing as a treatment, as well as monitoring if symptoms improve.

“Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis”

The main finding from this retrospective analysis is that surgical decompression of the common and superficial fibular nerves improved patient ratings of symptoms commonly associated with RLS…

The total change in VAS was negatively correlated with the total presurgical VAS. Therefore, those who presented with the most severe symptoms experienced the greatest improvement following nerve decompression.

Re: Nerve Tension

Posted: Sun Dec 09, 2018 2:28 am
by ViewsAskew
Looking forward to hearing how this works for you.

The description in the study: "Forty-two patients completed VAS scales (0–10) for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression."

This reinforces my belief that there are a minimum of two different disease states that fall under the RLS label. I have no pain, burning, numbness, weakness, balance issues, tightness, aching, pulling, throbbing, cramping, or even twitchy feelings. I have one thing only - a creepy crawly feeling that makes me HAVE to move.

But, it's clear that some DO have these. How it fits together remains to be seen. In the meantime, no wonder we respond to different treatments.

Re: Nerve Tension

Posted: Sun Dec 09, 2018 11:28 pm
by curqlink
I wonder if both kinds can be passed down? I also have no symptoms but the creepy crawlies. My father had the same. Nothing seems to improve my symptoms except Dopamine Agonists and opioids. I take Lyrica..but all that seems to be is an expensive sleep aid. It does nothing directly to help with my creepy crawlies.

Re: Nerve Tension

Posted: Mon Dec 10, 2018 4:34 am
by XenMan
The paper mentioned above indicates strongly that nerve sheath inflammation, restricting nerve movement and causing a blockage, is the mechanism for RLS symptoms. Nerve pressure in individuals is going to create a variety of responses. What surprises me is that the symptoms are so similar and not different in most people with RLS.

Also those symptoms are descriptions by the patients, not observations by physicians, so they could all have the ‘crawling’ sensation described by many, but expressed and interpreted differently.

I would challenge that there are different RLS condition, just different symptoms as you would expect with the varying physical make up of individuals.

The confusion with this condition is due to it being spread across multiple medical disciplines. It is dominated by the GPs and neurologists who think drugs only. Physios are useless, as I have experienced, but this due to lack of referral by GPs and money for research.

The paper above is disappointing on numerous levels. First it is a clear mechanism that hasn’t been explored as it took me a long time to find it. Secondly the paper, and my posts here, will have no impact on treatment. For the indefinite future, Parkinson’s drug and opiates will be seen as the best option despite augmentation and a total lack of options following that.

Re: Nerve Tension

Posted: Sat Dec 22, 2018 7:28 am
by srgraves01
But doesn't nerve tension also cause muscle tension? Also, could you explain nerve flossing?

Thanks

Re: Nerve Tension

Posted: Sat Dec 22, 2018 7:51 am
by srgraves01
Ann, Having multiple disease processes as part of RLS is a real possibility. One other possible way of looking at this is that some of these symptoms occur with a greater progression of the disease. I have had RLS for almost 40 years. I have only had pain in the last 5 years or so. I have only experienced cramps in the last two years. I have had twitchy muscles for about the last eight years and I have twitchy muscles in more places than I used to. I don't think I have weakness or numbness though. However based on my experience alone one can't really say whether one or the other explanation is correct, or whether it is some combination of the two.

Re: Nerve Tension

Posted: Sun Dec 23, 2018 2:08 am
by XenMan
Yes, if there is nerve tension that is going to be expressed as muscle tension. It is easy to find by exploring for tight and sensitive areas in your relaxed calf muscle. I have tender areas all along my tibial nerve and some branches caused by pronated ankles.

Nerve flossing is a range of exercises that move or free nerves inside the nerve sheath. I thought I had blockages but that is not the case, just tension. Nerve flossing inflamed nerves is not a good idea.

Because this is ‘diagnosis by testimony’, the term RLS is detrimental to any recovery. It is like calling regular headaches ‘Sore Head Syndrome’ and then treating the pain with drugs. The alternative is to determine if the headaches are from dehydration, neck problems, migraines or a brain tumour, and then treating the condition; not the symptoms.

Re: Nerve Tension

Posted: Sun Dec 23, 2018 8:20 pm
by ViewsAskew
srgraves01 wrote:Ann, Having multiple disease processes as part of RLS is a real possibility. One other possible way of looking at this is that some of these symptoms occur with a greater progression of the disease. I have had RLS for almost 40 years. I have only had pain in the last 5 years or so. I have only experienced cramps in the last two years. I have had twitchy muscles for about the last eight years and I have twitchy muscles in more places than I used to. I don't think I have weakness or numbness though. However based on my experience alone one can't really say whether one or the other explanation is correct, or whether it is some combination of the two.


The problem is that we cannot tell if these are some progression or multiple issues occurring. Pain, numbness, and cramps are all things that occur with great frequency without RLS, too. Not saying it isn't, just as I don't think we can say it is.

Re: Nerve Tension

Posted: Sun Dec 23, 2018 11:28 pm
by Rustsmith
XenMan, I think that it is important to remember that a medical syndrome is a collection of symptoms that may or may not be due to the same cause and our frequent mantra of "we are all different".

Up until earlier this year I was a competition class runner. I was constantly in training for one competition or another for over 20 years. My RLS suddenly went from an occasional mild annoyance to severe issues every night during the middle of this. It is also important to understand that my training included weekly massages of my both hamstrings and calves. Sometimes I had pain in my calves following very fast workouts, but generally my calf muscles were relaxed and there were no painful areas (unlike my hamstrings). Also, my RLS is also not limited to my legs, but also includes my arms and abdominal muscles and it was the abs that were most bothersome as the only non-drug way to manage them was to do crunches every few minutes while I was trying to go to sleep.

I am therefore glad that you are finding a way to treat your RLS, but keep in mind that what works for you may not be applicable to others.

Re: Nerve Tension

Posted: Mon Dec 24, 2018 12:27 am
by XenMan
You are absolutely correct with the variations experienced by individuals. Of course I present my view from a personal perspective and don’t wish to offend others by presenting my view as the only one. This is seen by a few that insist that only one thing causes or cures RLS; I don’t wish to present this.

I have read numerous papers, web opinions, forum posts and importantly fought an interesting battle against RLS. What I have gathered from this of most interest is the variability of symptoms from not only night to night, but also deterioration and improvements of the condition.

These changes can’t be explained by simple neurological changes. The brain tends to be rather stable with its chemical balance as seen in mental health treatment. For such extreme and at times rapid changes of RLS symptoms, if purely neurological, should express themselves as deterioration of cognitive or overall physical condition as seen in MS, Parkinson’s and mental health issues.

What is left is an extra element being the physical condition that is part of the feedback system that results in RLS symptoms. There is a lack of exploration of the role physical conditions play due to numerous reasons including that that they occur at times of sleep and are almost impossible to diagnose based on physical observation by a physician.

A balanced approach to management would benefit with recognition of the role the physical element contributes. For some this may be zero, at the other extreme it may be a 100% of symptoms. This would still leave the majority of those with RLS symptoms a missed opportunity to relieve, if not eliminate, symptoms through a sustainable physical approach.

Re: Nerve Tension

Posted: Thu Jan 24, 2019 8:17 am
by srgraves01
ViewsAskew wrote:
The problem is that we cannot tell if these are some progression or multiple issues occurring. Pain, numbness, and cramps are all things that occur with great frequency without RLS, too. Not saying it isn't, just as I don't think we can say it is.


I agree.