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Restless Leg Syndrome

Restless leg syndrome (RLS) can be described as the compulsive urge to move the legs and is often accompanied by an unpleasant and strange creeping or crawling sensation in the feet, calves and thighs. It tends to be worse at night or at rest and it can severely impact the quality of sleep.

Night is a relatively yin/quiet time, when the ability of the body to move blood and fluids through the muscles and tissues is at its lowest. Firstly, when someone is lying down there is less contractile muscular pumping activity or gravity to assist the movement of the fluids in their body; in addition, lying puts pressure on the tissues of the legs, which also inhibits flow. Secondly, with the decrease in heart rate resulting from inactivity, less blood is physically pumped through the vessels.

All of this translates to a dryer ‘climate’ in the tissues - a lack of blood and fluids. As a result, the entry and exit of blood to and from the legs is restricted and they become achy and uncomfortable, leading to the irrepressible desire to move them. This movement helps push blood into the deprived muscles, temporarily decreasing the discomfort as well as serving as a distraction from the uncomfortable sensations. But what makes some people susceptible to this condition and not others?

In some cases there may be a material deficiency in the quantity of someone’s blood, meaning there is not enough to reach the periphery and extremities. Or there may be a qualitative deficiency, where the functional aspect of the blood and its role in the body are compromised. Or it may be that neither of these are the case and the restless legs are purely an issue of localised deficiency, whereby blood cannot reach an area owing to blockage from cold, damp or stasis in the body.

In our society where food is so readily available it might be hard to understand how someone could be deficient in blood. Too much physical labour or lack of nutritious food were common factors in ancient times, but not so common today. While modern food production methods or patient dietary choices may be a contributing factor, they are not a problem that needles can resolve. As acupuncturists we tend to be more interested in how vigorously the blood is moving through the abdomen and perfusing the intestinal tissues, which will impact the efficient uptake and transport of nutrients, and therefore the quality of the blood.

Given the highly sedentary nature of our modern lifestyle, where sitting on chairs takes up much of the day - thereby restricting movement and circulation through the pelvic region - it is probable that someone suffering from RLS would also have some level of localised blood stasis and/or deficiency in the legs. This is even more likely if they intersperse prolonged sitting with intense gym workouts involving repetitive movements with a limited range of motion (such as HIIT classes, spinning, running etc) and insufficient stretching; as these habits can cause the overused muscle tissue to become tight, inflamed and subject to micro-tears and fascial adhesions (similar to repetitive strain injuries).

How do we know if there is local stagnation and/or depletion in the legs causing RLS? Signs that we look out for include spider veins and varicose veins, tight and dense muscles that present temperature irregularities, sensations of burning or cold, dry cracked heels and/or nail problems which indicate that blood is not reaching the extremities. In addition, heat or stagnation signs in the groin area can include constipation, haemorrhoids, endometriosis, bloating and frequent urinary tract infections; these symptoms can all indicate that the blood is pooling in the lower abdominal area because of restricted flow into the legs.

In cases where such signs and symptoms are not so obvious, we can use our needle to check the quality and consistency of the flesh. Using a needle allows us to feel into the layers of tissue between the skin and the bone. If the tissue is dense and sticky close to the bone, this indicates blood stasis or cold. If there are layers that feel dry and crunchy as we insert or withdraw the needle, causing the needle to ‘snag’ or catch on the layers, we know this tissue is not well perfused with blood and fluids and there are adhesions in the fascial layers. If the tissue feels harder than it should, which can feel like needling into a very resistant or dense dead substance akin to tyre rubber, we know this has been caused by long term depletion of fluids and blood – basically the tissue has stopped breathing and needs to be ‘resuscitated’.

Our treatment strategy for RLS often involves freeing up local tight, congested and stagnated tissues in the groin region, hips and legs in order to ensure that blood and fluids can flow appropriately so that it is no longer necessary to shake out the legs. For long-lasting results we will also demonstrate how to wring out the muscles through twisting and spiralling movements that counteract the linear nature of most modern exercises. This combination usually achieves relief relatively quickly, so don't hesitate to get in touch if RLS is something that is affecting you!

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