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Restless Legs Syndrome

Discussion in 'Opiate addiction' started by G_nome, Jun 29, 2009.

  1. G_nome

    G_nome Palladium Member

    Reputation Points:
    Sep 8, 2007
    Male from U.K.
    Thought I'd post this, since this is what my Monkey is finding the most annoying and frustrating, after being 5 days clean from poppy pods, after a year of use.
    Monkey finds that hot baths with essential oils like black pepper and chamomile deffo help!
    My Monkey's also lucky to have a mother who is an holistic therapist, he got a massage off her today, worked a treat!

    Hope it's some use to some other swimmers.

    [h1]Restless Legs Syndrome (RLS)[/h1]
    Finding relief for RLS symptoms and choosing treatment

    If you find that strange sensations in your legs keep you from sleeping or cause you to jump up and move around to relieve the discomfort, you may have Restless Legs Syndrome (RLS). RLS is a central nervous system disorder that can interfere with resting or falling asleep.
    Various treatments help with RLS. For some people, self-help tips decrease the discomfort, and for others, more treatment is necessary. Regardless, you can find relief.

    Signs and symptoms of Restless Legs Syndrome (RLS)

    Jamie was feeling frustrated and exhausted. Lately, whenever she sat down to relax, and especially when she tried to sleep at night, her legs felt twitchy and uncomfortable. Often, the irritating sensations became so great that she could not sit or lie down. Instead, she had to stand up and pace back and forth to feel better. The issues with her legs were making it almost impossible for her to rest.

    Although the symptoms are distinctive, many people dismiss the feelings as muscle aches or restlessness, and do not suspect that they have RLS. Thus, RLS is frequently misdiagnosed and often left untreated, resulting in restlessness, insomnia, and daytime sleepiness.
    [h3] What does Restless Legs Syndrome (RLS) feel like? [/h3]
    Many people have difficulty describing the sensations of RLS, although they may agree on an overwhelming urge to move the affected limbs. Some of the common descriptions of the feeling are:

    • Creeping
    • Crawling
    • Tingling
    • Pulling
    What parts of the body does RLS affect? Most people feel RLS sensations in their calves, but some people also feel them in the upper legs, feet, arms or hands.

    Common Symptoms of Restless Legs Syndrome (RLS) Irritating sensations
    Sensations can be painful or just uncomfortable and are often described as a general urge to move the legs (or other affected limbs).
    Urge to move
    Getting up and moving around seems to relieve discomfort.
    Evenings and nighttime are worse
    Discomfort tends to increase during the evening or night.
    Rest or stillness brings on the symptoms
    Sitting or lying down seem to trigger the restlessness in the legs.
    Visible movements in toes or feet
    Your feet or toes may move slightly or jerk when you are sitting still or resting.
    [h3]Children and RLS[/h3]
    Many people diagnosed as adults with Restless Legs Syndrome look back upon childhood hyperactivity or “growing pains” and realize that these were actually symptoms of RLS. Sometimes a child is misdiagnosed with Attention Deficit Hyperactivity Disorder, when the true diagnosis is Restless Legs Syndrome.
    Causes of Restless Legs Syndrome (RLS)

    Restless Legs Syndrome is a central nervous system disorder (a disorder based in the brain or spinal column). It may have a genetic basis (meaning it sometimes runs in families), or be related to an imbalance of dopamine in the brain. Levels of dopamine, a brain chemical that affects movement, naturally fall at night, which could be why RLS symptoms often get worse late in the day and at night. Additionally, iron is important to the production of dopamine, which may explain why low iron levels are often linked to RLS symptoms.
    Psychiatric conditions or stress may exacerbate RLS, but they do not cause RLS.
    Primary RLS
    Primary RLS seems to occur without cause and often first affects people when they are young. Mild symptoms may start in early adulthood and then increase with age. After age 50, the symptoms often increase in severity and significantly disrupt sleep. Primary RLS does seem to run in families.
    Secondary RLS
    Secondary RLS is usually caused by or linked to other conditions, including:

    • Iron poor blood (anemia)
    • Kidney disease
    • Parkinson’s disease
    • Pregnancy (RLS often goes away after pregnancy)
    • Thyroid problems
    • Neurologic lesions (spinal cord tumors, peripheral nerve lesions, or spinal cord injury)
    • Sleep apnea or narcolepsy
    • Varicose veins or trouble with the nerves in the hands or feet
    • Alcoholism
    Medications including tricyclic antidepressants, anti-nausea and anti-seizure drugs, selective serotonin reuptake inhibitors (SSRIs), lithium, and some cold and allergy drugs may increase or trigger RLS symptoms. In addition, withdrawal from sedatives may trigger RLS.
    Treating Restless Legs Syndrome (RLS)

    Although no cure exists for Restless Legs Syndrome, different types of treatment can be used to manage the condition and relieve discomfort. If your symptoms are mild, self-help may be sufficient treatment. If your Restless Legs Syndrome is caused by an underlying condition, treatment of the underlying condition often cures the RLS.
    [h3]Self-care for RLS[/h3]
    Your RLS symptoms may respond to changes in your daily behaviors and habits. .
    Self-help tips for Restless Legs Syndrome (RLS) During the day At bedtime
    • Exercise regularly.
    • Wrap your legs in ace bandages, or wear compression stockings or tight pantyhose.
    • Take iron supplements for low iron levels. Be sure to get tested first.
    • Stand up – Elevate your desk or stand at work if possible.
    • Reduce caffeine, alcohol, and tobacco use, particularly in the evenings. These substances often increase symptoms.
    • Keep a regular sleep schedule.

    • Pace, walk, or jog for a few minutes to relieve discomfort.
    • Stretch your legs, do knee bends, or rotate your ankles.
    • Massage your legs.
    • Relax with meditation, yoga, or deep breathing.
    • Apply heat or cold. Take a bath or soak your feet in hot water, briefly use a heating pad or cold compresses, or apply a hot water bottle.
    • Lie on your side with a pillow between your knees to initiate sleep.
    • Get up – Fighting the urge to move might make the feelings worse.
    Coping with RLS can be especially difficult if you feel like others can’t relate to the problem. Sharing information with family, friends and coworkers can help them understand why you need to stand up and walk around often. It might also be helpful to find a support group and talk with others who know firsthand about RLS and who can support and encourage you in a search for a solution.
    [h3]Transcutaneous Electric Nerve Stimulation (TENS) [/h3]
    Applying electrical stimulation to feet and legs reduces nighttime leg jerking in some patients who have severe RLS. Using a portable, bedside TENS unit, you apply electrical stimulation for 15 to 30 minutes to your legs.
    [h3]Seeking medical treatment for RLS[/h3]
    If self-help doesn’t relieve your RLS symptoms, a doctor or sleep specialist might be helpful in exploring alternative treatments. No laboratory test can confirm a diagnosis of RLS, so the condition is often overlooked. To diagnose RLS, your doctor will request:

    • A medical history
    • A familial survey to see if anyone else in your family has similar symptoms
      Interview about other medical conditions you have
    • A blood test for low iron levels
    Keeping a sleep diary is helpful if you suspect you have RLS. Recording changes in your diet, lifestyle, sleep habits and routine might help you and your doctor make helpful changes.

    Medications for Restless Legs Syndrome (RLS)

    Medications are a common treatment for RLS. However, no single drug works for everyone with the condition. The medications prescribed for Restless Legs Syndrome are frequently “off-label” uses of the drugs, meaning they are not specifically intended for RLS, but have been found to help with symptoms. The dosage given for RLS is usually much less than the dosage for the intended condition.
    Common medications prescribed for RLS include:

    • Dopaminergic agents (Examples: Ropinirole, Pramipexole) - Often, this is the first line of treatment for RLS. Normally used to treat Parkinson’s Disease, these medications increase dopamine, a neurotransmitter that regulates muscle movements.
    • Benzodiazepines - These are sleep medications, or central nervous system depressants, which also suppress muscle contractions.
    • Non-benzodiazepine sedatives - Short-acting hypnotic agents, or sleeping pills. These may be helpful for mild RLS that occurs primarily at bedtime.
    • Opiates / narcotics (Examples: low-potency Darvon, high-potency Percodan) - Pain-killing and relaxing drugs can suppress RLS in some people. Addictive and should be used only in low dosages.
    • Anticonvulsants (Examples: Gabapentin, Neurontin) - normally used to prevent seizures, and reduce muscle contractions for some people.
    • Hypertensive medications – Generally prescribed for high blood pressure.
    [h3] WARNING[/h3]
    Be cautious with your use of drugs for treatment of RLS. Drug ads may make sleep medications seem effective and safe, when in reality they often work only slightly better than a placebo, and cause more side-effects. Many drugs are approved based on very short-term studies, even though the medication may be prescribed for the long term. Additionally, some medications may actually increase RLS symptoms in certain cases.

    Periodic Limb Movement Disorder (PLMD)

    Periodic Limb Movement Disorder (PLMD) is very similar to RLS. While RLS is a sensation in the legs and subsequent voluntary movement to avert the sensation, PLMD is involuntary, rhythmic limb movements, either while asleep or when awake. RLS disrupts sleep by delaying sleep; PLMD can disrupt sleep because of the constant limb movements. Many people with PLMD are not even aware of their symptoms until a bed partner brings it to their attention.
    Do people with RLS also have PLMD? Most people who have Restless Legs Syndrome also have PLMD. However, the reverse is not true - only some people with PLMD also have RLS. See the resources below for more information about PLMD.
    PLMD can be primary (with no known cause) or secondary (caused by an underlying medical condition). Primary PLMD might be caused by an abnormal regulation of nerves traveling from the brain to the limbs. Secondary PLMD is associated with many of the same conditions as RLS, including spinal cord injuries, sleep apnea, diabetes, and iron deficiencies.
    Last edited by a moderator: Jun 29, 2009
  2. Dickon

    Dickon Newbie

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    Oct 17, 2008
    Male from U.K.
    This is interesting information. One thing I wonder is if the "restless legs" of opiate withdrawal and restless leg syndrome are the same thing. My intuition, and let me stress this is pure speculation, is that it is a somewhat different beast. My cat does not have RLS in normal life, but he will kick and spasm out his legs in opiate withdrawal, as I imagine nearly everyone does "kicking the habit".

    I would like to know if anyone has had any success using any of the substances described above in withdrawal, especially the "weirder" ones. Please post if you have tried any of the above. The non-pharmacological approaches described above all seem pretty sensible. Again any successful methods used to combat painful legs or general restlessness would be very helpful information.

  3. Leftöver Crack

    Leftöver Crack Newbie

    Reputation Points:
    Mar 31, 2009
    38 y/o Male
    in response to the "weirder" ones, swim didn't actually read the whole first post so he doesn't know if it's in there, but he used a bar of soap.

    while detoxing this most recent time swim had RLS badly and researched cures on the monkey box. most of the cures was stuff you have to get in advance, but swim said "well the bar of soap looks rediculous, but i have soap here, so why not give it a try". i put it by my legs under the covers, and lo and behold it worked. swim is almost sure it was in his head as he can't come to a logical conclusion as to why a bar of soap works.

    btw dr. drew is on tv talking about MJ's death as i type this and just said "once an opiate addict always an opiate addict". ;)
  4. OhCasey

    OhCasey Palladium Member

    Reputation Points:
    Apr 26, 2007
    Male from U.S.A.
    Ive had RLS since I was a child, it runs in my family, and its exactly like the ones I experienced during a kick just not near the severity and long lasting duration but they used to keep me up all night. One thing that helped me is using a TENS unit which is a electrical stimulation unit. Ive had it for years to help with pain and I know its fairly common among chronic pain patients. I just hooked the four pads up to my calves and turned it up and it let me fall asleep a lot easier than without it. People may want to look into magnesium any supplements like calms forte but if someone had access to dr prescribed mediction then the one that worked the best for swim was Lyrica (Pregabalin) it blew all other meds out of the water including benzos and it had a lot fewer rebound symptoms than any benzo.
  5. psychedelaholic

    psychedelaholic Silver Member

    Reputation Points:
    Nov 2, 2005
    Male from england
    I've had RLS for most of my life. Is so annoying, haven't had it much recently but now seem to be getting the same symptoms in my arms.
  6. oxynomo

    oxynomo Silver Member

    Reputation Points:
    Jan 7, 2009
    56 y/o Male
    Swim has to agree with Dickon that the RLS during opiate detox and the a RLS that a normal person would get are not the same.For swim it was his whole body that was restless the worst being his head.When he would either sit or lay down he just couldn't stop his head from thrashing back and forth[drove him crazy].He did get some relief from a combination of zolpidem and hydroxyzine only to end up abusing them just like any meds he has ever been prescribed.
  7. OhCasey

    OhCasey Palladium Member

    Reputation Points:
    Apr 26, 2007
    Male from U.S.A.
    Of course theyre not the same in severity. Ive actually read that if RLS is induced from drug withdrawals then its considered Secondary RLS and not primary.
    Last edited: Jul 3, 2009
  8. Benniboi

    Benniboi Newbie

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    Dec 16, 2008
    34 y/o Male from U.K.
    yeah to further agree with dickon, opiate PAW RLS and normal RLS may be phisologically related due to acute dopamine imbalances in the brain. but obviously they would need to be treated differently on a subjective basis. When swim had it, he had it in the left arm in the joint of the elbow, almost like a deep ache that was possibly (with the crawling skin and terrible flushes) one of the worst parts of withdrawal, it zapped swim of energy and made him feel boarderline suicidal because of the attritional aspect of it- swim was just completely worn down and could not get a minutes rest. I sympathize with anyone who has to go through this and I can olny imaigne how horiffic it would be for anyone who had to deal with this on a regular basis
  9. sleepwalker

    sleepwalker Silver Member

    Reputation Points:
    May 26, 2009
    45 y/o Male
    Here we speak of "Ants running up and down your bones", when its from withdrawal.
    When from withdrawal several hot baths a day help ,for as long as your in the tub.
    Problem allways is getting out of the tub again.
  10. opiatestillIdie

    opiatestillIdie Newbie

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    Jun 15, 2010
    Female from U.S.A.
    I do not remember having RLS as a child, I believe I have developed RLS from 16 years of Opiate abuse. I have not tried anything stated above while WD from Heroin or Methadone. I had very large habits of $200 a day while on Heroin and 160mg while on Methadone (a ridiculous attempt at sobriety). Anyhow, I don't think anything except being fully sedated (like the looney bins do) would have helped. I now have a very small habit, 20mg of Oxycontin. Sometimes more sometimes none. I now have RLS every day, but no where near as severe as with stronger opiates. I also have access to Neurontin, and occasionally Requip (Ropinirole). I find that large enough doses of Neurontin sometimes will help, but the Requip is awesome. I feel that my RLS is because I have 'broken' my brain and no longer create enough Dopamine. The requip is a dopamine agonist and when enuff is taken it is pretty effective. This is just my two cents......and first post.
  11. Flush06

    Flush06 Silver Member

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    Oct 28, 2013
    Male from U.S.A.
    Just over the counter quinine pills do wonders for me when I was detoxing off methadone. I took 2 grams 3x a day and it worked wonders. And I had to detox off 125 mg a day methadone in 7 days and I had the same issue. I tried Advil and that helped some cramps at night. But then I read up on quinine at work (I work at a vitamin store) and I was so greatful. I actually slept the same day I started taking it.
  12. Nefret

    Nefret Silver Member

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    Mar 13, 2013
    Female from Canada
    That's great thanks!

    Tonic Water has quinine in it to :)