RLS and Increasing Circulation in Legs

Please share your experiences, successes, and failures in using non-drug therapies for RLS/WED (methods of relief that don't involve swallowing or injecting anything), including compression, heat, light, stretches, acupuncture, etc. Also under this heading, medical interventions that don't involve the administration of a medicine to the body (eg. varicose-vein operations, deep-brain stimulation). [This forum contains Topics started prior to 2009 that deal with Non-prescription Medicines, Supplements, & Diet.]
pamhb
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RLS and Increasing Circulation in Legs

Postby pamhb » Sun Sep 11, 2016 10:35 pm

I have had RLS for most of my life, and have been using dopamine agents for the last 18 years. I have gone from moderate to severe symptoms, which I believe are a result of augmentation, and which an upcoming washout will shed some light on. While I am currently on Neupro, I still have about 2 bad nights a week.

My new sleep specialist has suggested I pay more serious attention to the non-pharmacological options, in particular the pneumatic compression device and regular massage therapy. As I began to do my research, I came to realize that a lot of the strategies that we all use have the effect of increasing blood circulation -- hot baths, cold baths, exercise, stretching, foam rollers, etc. The other therapies that have been studied -- pneumatic compression devices, NIR light therapy, massage therapy -- have the same thing in common (increasing blood circulation), and have a measurable effect on symptoms for many of the patients in the studies.

I then came across this article http://onlinelibrary.wiley.com/doi/10.1111/pcn.12170/full, Reduced daytime intramuscular blood flow in patients with restless legs syndrome/Willis–Ekbom disease. It is a 2014 study in which indicates that blood flow to the tibialis anterior muscle found in the legs is lower for patients suffering with RLS than those without. Biopsies taken from this muscle tissue indicated that the lower extremities of persons with RLS are being affected by hypoxia.

I will likely start with a pneumatic compression device, but am also quite intrigued by the NIR light therapy. In the meantime, I have been working diligently at the ordinary things I can do to improve my circulation -- regular morning exercises and stretching, taking breaks where I am lying with elevated feet, being sure to vary my position during the day so that I don't sit, stand, or lie down for too long, a self-leg massage where I always have the pressure going up towards the heart and not down to the toes, and some brisk marching on the spot in my bathtub in cold water up to my calves, just before bed. So far it seems to be helping...

I shall keep you posted following my washout, as to how I manage with alternate therapies.

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Re: RLS and Increasing Circulation in Legs

Postby ViewsAskew » Mon Sep 12, 2016 12:28 am

Good luck with the washout!
Ann - Take what you need, leave the rest

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Re: RLS and Increasing Circulation in Legs

Postby badnights » Tue Sep 13, 2016 8:59 am

I also have been fascinated by the muscle hypoxia angle. If you plan on buying a pneumatic compression device, I hope you'll post which one you bought and the results? I have looked into these off and on for a few years now, but I just can't bring myself to fork over that much money for something sight unseen that may not even work. I would like to at least try it for a night first but I live in a remote area and it won't be easy to make that happen.

I also looked at buying the NIR wand or whatever it was but either you need a prescription for it or its really expensive.
Beth - Wishing you all restful sleep tonight
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pamhb
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Re: RLS and Increasing Circulation in Legs

Postby pamhb » Fri Sep 23, 2016 8:40 pm

I was able, through my doctor, to get a full copy of the journal article, "Pneumatic compression devices are an effective therapy for restless leg syndrome: a prospective, randomized, double-blinded, sham-controlled trial" by Lettieri CJ, CHEST 2009; 135:74-80. The study used an Aircast VenaFlow pneumatic compression device, programmed to inflate the leg wraps for 5 seconds every minute, at 40 cm H20 air pressure with each inflation cycle. Patients in the study used the PCD one hour per day, generally in the evening. All of the RLS patients using the device at the prescribed pressure experienced a relief in symptoms; the amount of relief varied. One third of the patients experienced total relief. Subjects with a longer history of RLS had less relief.

If I go the route of the PCD, I will certainly let you know how well it works for me.

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Re: RLS and Increasing Circulation in Legs

Postby ViewsAskew » Sat Sep 24, 2016 3:52 am

OK - slightly different, but here goes.

This afternoon, my friend went to get a mani-pedi and I went with. I decided to get a pedicure - since I'm in So Cal and am wearing a lot of sandals, I might was well have my feet free of calluses, etc, right? Besides, they massage your feet and calves for like ten minutes - what's not to like about that?

So, after they painted my toe nail, they told me to relax and I was sitting in a massage chair. The fit my calves into slot that surrounds each calf on 3 side - only the front of the calf is not surrounded. My friend declined this, but I thought I'd try it - I mean, who knows, it might help the RLS. It was around 3 in the afternoon and I'd been up around 5 hours. I'd already taken my first dose of meds.

Within 3-4 minutes, I felt a bit uncomfortable, but thought maybe it was just the pressure. About five minutes into it, I could feel the RLS starting - very mild, but it was there. I don't have RLS in my calves, rather it's in my thighs, but this set off the RLS in my thighs. I kept it up to see what would happen. By about 8 minutes, I had to ask them to stop it.

Not sure how much this would differ from pneumatic compression....just thinking that I'm not as curious as I was prior to this afternoon.
Ann - Take what you need, leave the rest



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Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

pamhb
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Re: RLS and Increasing Circulation in Legs

Postby pamhb » Sat Sep 24, 2016 12:32 pm

I have had a similar reaction to even simple massage given during a pedicure, where the pedicure is done later in the day. Now that I think more about it, I usually try and get my pedicures in the morning or early afternoon for that reason. It's like "Don't touch the legs, don't touch the legs!"

It could be that we are sitting when we get a pedicure, which in itself can impede circulation if we sit for too long. Or that whatever the device was doing to your leg, it was not helpful to good circulation. I wonder if it would trigger the same reaction if your legs were raised?

Good observation and information to think about!

Precise
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Re: RLS and Increasing Circulation in Legs

Postby Precise » Mon Dec 12, 2016 3:52 am

I tried the lowest force compression socks available. Withing minutes my legs hurt terribly. I do not comprehend how compression would mitigate poor circulation. I think compression must reduced circulation.

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Re: RLS and Increasing Circulation in Legs

Postby Stainless » Wed Mar 15, 2017 3:38 pm

I never get RLS when I am distracted so it is hard to tell what might work. I bought a $3000 massage chair because it made my RLS go away when I was suffering while walking through a mall. Great chair but did not continue to help RLS.

Hypoxia in muscles should be easy to test in hyperbaric chambers. There are many hospital based chambers where you could safely put a sufferer on three atmospheres of pure oxygen for long periods. In these chambers the patient sit or lay down which typically brings on most of our symptoms. It would be expensive for an individual but not a researcher. I'm no doctor but would think this would settle the hypoxia hypothesis.

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Re: RLS and Increasing Circulation in Legs

Postby badnights » Thu Mar 16, 2017 6:29 am

It's an intriguing idea but there might be design problems. It's possible to have hypoxic muscles in the legs while not being hypoxic in general. For example, the 2014 study cited at the beginning of this thread found decreased circulation in at least one leg muscle of WED/RLS patients, and confirmed hypoxia in that muscle by biopsy, but presumably the patients weren't gasping for breath. Putting us in a hyperbaric chamber might not be enough to overcome the leg-circulation problem is, so the study would tell us nothing if it was designed to test for disappearance of symptoms in a hyperbaric chamber.
Beth - Wishing you all restful sleep tonight
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Re: RLS and Increasing Circulation in Legs

Postby Stainless » Thu Mar 16, 2017 7:19 pm

Pushing oxygen is exactly what hospital based chambers are for, improving circulation for issues like burns, cancer, etc. I'm no doctor but would think RLS would be little lower oxygen delivery, not a significant reduction that would cause tissue damage. If you just to breath pure oxygen long enough, 5 times as much would reach the muscle eventually reach the mussel. In a chamber three times that much. I'm sure any doctor studying this seriously is aware of hyperbaric medicine and these that facilities are common now.

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Re: RLS and Increasing Circulation in Legs

Postby Stainless » Thu Mar 16, 2017 7:28 pm

Someone talked about the tiny bit lower pressure in an airliner triggering RLS (lower oxygen). I know getting on a plane always triggers mine but I never thought that could be the cause. I always chocked it up to being in a constrained position.

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Re: RLS and Increasing Circulation in Legs

Postby badnights » Fri Mar 17, 2017 5:42 am

Other people have problems with altitude, probably for the same reason.

Have you thought about emailing some researchers about your idea? The first author of the 2014 paper, for one.
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Re: RLS and Increasing Circulation in Legs

Postby Rustsmith » Fri Mar 17, 2017 12:35 pm

There have been studies that correlate RLS with altitude, but I know that for me, although there may be a correlation that increased altitude does not actually work as a trigger. I lived for a number of decades at sea level and now live at 4500ft. I have not noticed much difference. I have also spent what seems like a lifetime on board airplanes. Some flights are shear torture and on other flights I don't have any problems. And there doesn't seem to be a time of day when I have problems and when I don't. So, I have always considered the confinement and inability to move my legs to be the trigger and not altitude.

And if you do decide to propose the research idea, be aware that anything above 2 atm of pure oxygen has a significant potential to cause convulsions that can be fatal. During hyperbaric treatments where the go to 3 atm, they use normal air and not pure oxygen. So, the partial pressure of oxygen in these treatments is about 0.6 atm. They do this because the lungs are more efficient with normal air, so the body actually gets more oxygen than by breathing pure oxygen at 1 atm.
Steve

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Stainless
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Re: RLS and Increasing Circulation in Legs

Postby Stainless » Sun Mar 19, 2017 4:24 pm

I don't know what levels they use in hospitals. I think in absolute pressure so we are already at 1 ata. I worked in the diving industry and a typical bends treatment would be 60 feet of seawater (3 ata) breathing 30 minutes of oxygen followed by 15 minutes air repeated however long the doctor said. Forty years ago it was common to go 165 feet on air for an embolism but now they use less pressure and more oxygen.

I just seemed funny to me that they were using listening to Doppler bubbles but not addressing does RLS go away given enough oxygen. And one last thing, my RLS now seems to be in my thighs way more than my calfs as I remember it feeling forty years ago. What the heck is that about. Seems to be more about the brain and maybe circulation is a trigger.

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Re: RLS and Increasing Circulation in Legs

Postby ViewsAskew » Sun Mar 19, 2017 8:26 pm

Stainless wrote:And one last thing, my RLS now seems to be in my thighs way more than my calfs as I remember it feeling forty years ago. What the heck is that about. Seems to be more about the brain and maybe circulation is a trigger.


Mine was always in my thighs...and I remember reading about people with RLS in calves when the internet first started to have such info and wondering -how can that be????? One doctor wrote it could only be in you calves - that was my first taste of how narrow some views were of this disease. It has moved into hands, arms, shoulders - but not calves. No idea why.

Related to this topic, how could the oxygen be limited to a specific part of the body. Fascinating disease - would find it much more fascinating if I did not have it, though!
Ann - Take what you need, leave the rest



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Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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