Physical helps for managing symptoms

[meyer]

I'm an infrequent contributor here but frequent visitor.
This site has kept me sane and hopeful for the last 6 years since
I discovered it. Now I am seeking some help.
I'm interested in what exercises, stretches,, baths, etc. that others have found helpful for controlling symptoms. I've had RLS for over 30 years that was controlled by walking until about 6 years ago when I had a heart attack. Shortly after that I was prescribed Requip which managed symptoms for about 2 years. I then went to a neurologist who added gabapentin which also helped for a few years. I became concerned about my long term use of Requip, fearing augmentation. I was taking levothyroxine at the time and had read that that drug can precipitate out RLS symptoms so got my primary to switch me to Cytomel and increase my iron. I have successfully weaned myself off the Requip and my ferritin was 154 on the last check. I am now taking gabapentin, 400 mg at 8pm and 11pm but cannot get the late night symptoms under control. I can fall asleep but wake after 1 1/2 hrs and struggle until 4 or 5am. I already walk 7000 steps per day, take a hot shower every night, use compression stockings and do a set of Pilates exercises prescribed by my physical therapist for chronic knee pain due to arthritis. I don't want to take any more medicine if I can help it.
Thanks for any ideas!

[TimG]

While general principles may apply, each of us is different. What tends to help me is (1) moderate exercise every day. If I miss a day, it tends to lead to RLS. (2) Stretching helps me keep limber, but also tends to reduce the intensity of RLS if it occurs. (3) I occasionally do a foot soak, which is relaxing and is neutral as far as I can tell for RLS. (4) I find that doing relaxing things like reading, listening to music, doing meditation or breathing exercises can be helpful in avoiding or reducing RLS symptoms.

[Polar Bear]

Many years ago I successfully used the cold water technique. A bucket of icy cold water and put your feet/legs into it. It'll feel almost painful at first but soon eases. Splash the water up your legs as far as possible and keep doing so. After about 15 minutes this started to sooth the symptoms and they'd gradually ease off. This gave me a window where I could usually get over to sleep.
Others suggest a cold or a hot shower on the legs.
I found the cold shower wasn't as cold as I could make the water in the bucket.

[XenMan]

Some people have a physical element to their RLS, and others don't seem to. Also, there are many conditions that are 'RLS' these days, when they have very different mechanisms and potential treatments.

RLS or Willis Ekbom Disease, is a sensorimotor condition. So if you want to treat your RLS using physical treatments, it really helps if you can establish that you have a sensorimotor condition and then understand how it works. When you know how it works, you then know how to break it, so your legs are no longer having the symptoms.

The bad news is that it takes some skill to do this, but the good news is that once you understand the principles, it can be very easy to get a good nights sleep. At other times, it is a full time job through the night. If physical treatments work, it also implies that you have something that is causing the physical trigger points. There is a long list, but I believe oxalate is the most frequent cause. If this is the case, it then means you now have two conditions to deal with. Some have oxalate issues easily resolved, or there are people like me for which it is an ongoing nightmare.

There is also cult like thinking on dopamine and iron, and the 'take a pill' to fix everything mentality, so there isn't much good research on using physical treatments.

As for the physical treatments, there is an almost endless list starting at stretching and going through to TENS/EMS and massagers. Exercise through the day can help, or make things worse. I'm currently not doing any leg exercises at all after a really bad run of symptoms.

The starting point is to find the trigger points, which is best done when you have symptoms by feeling all over your lower leg for sensitive points along the bones that then lead to sensitive muscles. Sometimes it is just a single muscle strand, or a point on it.

If you want some more details, let me know.

[Yankiwi]

Trigger points for me is life!