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Restless Legs Syndrome (RLS), also known as Willis-Ekbom disease, is a condition that can disrupt a person’s sleep leading to anything from frustration to exhaustion.

Symptoms of an unpleasant sensation in the legs drive a person to move the legs to temporarily relieve the discomfort.  This feeling can be experienced as ‘pins and needles,’ a deep itch, pulling, aching, or burning.  While the symptoms can occur with extended periods of sitting, they typically occur in the evening or at night.

RLS can be thought of as a hybrid condition of movement disorder and parasomnia.  A parasomnia is a sleep disturbance that may occur at the start of sleep, during sleep or during arousal from sleep, but does not include sleep apnea.

Western Medicine View

Western medical research posits that RLS may be due to iron and/or folate deficiency or an imbalance of the neurotransmitter dopamine which, among other things, affects muscle movement.  The syndrome may be hereditary as it has been found to run in families.  While RLs can occur at any age, it is more common in people over 40.  Women tend to be affected more frequently than men.

Interestingly, pregnancy can induce or worsen symptoms of RLS.  This typically occurs in the third trimester.  Luckily, symptoms usually dissipate by about a month after delivery.

While not usually related to serious health issues, RLS may be associated with peripheral neuropathy and diabetes, kidney failure, or spinal cord conditions.  In these cases, it is important to treat the underlying condition to optimize one’s health and thereby address RLS.  In addition, a doctor may review a patient’s medications and supplements to understand if the symptoms are perhaps an unwanted side effect.

Western medical treatment may involve medications of varying types from muscle relaxers to those that increase the level of dopamine in the brain to iron or folate supplementation.

Traditional Chinese Medicine View

If the above efforts do not provide enough relief, a combination of acupuncture, moxibustion, and Traditional Chinese Medicine (TCM) nutrition can be helpful.  In RLS, as in any condition, symptoms are seen as a manifestation of imbalance and a thorough intake will uncover the individual’s particular pattern of imbalance.  TCM recognizes various ‘Pathogenic Factors’ as pushing a person’s system out of its desired healthy state.  In the case of RLS, several Pathogenic Factors may be implicated and ‘Wind’ is a very important one.  It acts as wind does in nature, generating movement small and large – think of the branches of a sapling gently swaying in a spring breeze to the destruction wreaked by a tornado.  While Wind has other attributes in TCM, the important feature in this instance is its ability to generate movement.  If Wind is indeed present, it can be dealt with in several ways.

Acupuncture and Moxibustion

Acupuncture encourages the body to rely on its innate ability to heal itself.  It is a safe method of treatment that can be used in conjunction with other modalities, including Western Medicine.  Acupuncture points are chosen depending on the pattern of imbalance that is identified.  There are some specific points that can help ‘extinguish Wind’.  There are even some acupuncture points on the body that have Wind as part of their names, signifying their relationship to this Pathogenic Factor.

Moxibustion, a local heating treatment, involves the burning of a herb product near specific acupuncture points on the body.   It provides a gentle warming sensation and can be very soothing.   One of its many functions is to reduce Wind.

TCM Nutrition

According to TCM nutrition, there are certain foods which should be avoided if Wind is indeed affecting a person’s health.  They are eggs, crab and buckwheat.  Buckwheat is also called kasha and may be used as whole-grain porridge or ground into a flour for baking.  Soba noodles are made of buckwheat flour or a combination of wheat and buckwheat flours.  If you eat gluten-free baked goods, check the label for buckwheat flour.

There are also foods which counteract Wind.  They are categorized here as Cool to Cold, Neutral, and Warm to Hot, reflecting the influence the food has on a person.  People who tend to feel warmer than others, who find the heat of summer very taxing, and who prefer cool drinks should choose from the Neutral and Cool to Cold foods.  Those who tend to feel colder than others (especially their hands and feet), who find winter especially uncomfortable and who prefer warm drinks should choose the Neutral and Warm to Hot foods.

Cool to Cold Foods:  banana, barley, celery, eggplant, peppermint, water chestnut

Neutral Foods:  bass, black sesame seeds, black soybean, coconut, cold-pressed flaxseed oil, perch, pineapple, sage, sunflower seeds

Warm to Hot Foods:  anise, basil, caraway, cayenne, cherry, cinnamon, fennel, garlic, ginger, green onion, oats, pine nuts, rosemary, shrimp, thyme, turmeric

Lifestyle and Dietary Changes

Finally, both Western Medicine and TCM agree that certain lifestyle and dietary adjustments can help manage the symptoms of RLS.

Establish and maintain good sleep hygiene to optimize rest.   Include stretching and massaging the legs in a warm bath before bed.  Get regular moderate exercise (e.g. walking, yin yoga or TaiJi) earlier in the day.

Better sleep can be had by removing caffeine from the diet.  This is best done by tapering off gradually rather than stopping abruptly.  Reducing or eliminating alcohol and tobacco products can also improve the chances for a good night’s sleep.

References

Dharmananda, S. (2005, February).  Restless Legs Syndrome and Chinese Medicine.  Retrieved from   http://www.itmonline.org

Farrell, Y. (2019).   A Spirit at Rest, day 2 notes [PowerPoint Slides].  Retrieved from    https://www.prodseminars.net

Kastner, J. (2009).  Chinese Nutrition Therapy:  Dietetics in Traditional Chinese Medicine (TCM) (2nd ed.).  Stuttgart:  Thieme.

Pitchford, P. (2002).  Healing with Whole Foods: Asian Traditions and Modern Nutrition (3rd ed.). Berkeley, CA:  North Atlantic Books.

Restless Legs Syndrome (n.d.).  Retrieved from https://www.mayoclinic.org/diseases-conditions/ restless-legs-syndrome/symptoms-causes/syc-20377168