Restless Legs Syndrome

What is Restless Legs Syndrome and how does it typically affect patients?

Restless legs syndrome, sometimes known as Willis-Ekbom disease, is a disorder of the nervous system that causes an overwhelming irresistible urge to move the legs. In some cases, this can cause involuntary jerking of the limbs and arms, know as periodic limb movements.

It can also cause an unpleasant creeping, or crawling sensation in the legs and feet. This is often worse in the evening or at night.

How common is Restless Legs Syndrome and what are the common causes?

Around 1 in 10 people in the UK are affected by Restless Legs Syndrome at some point in their lives. It is not always known what causes Restless Legs Syndrome. In some cases, it can be caused by an underlying health disorder such as anaemia or kidney disease. It can also be quite common in the last trimester of pregnancy.

When there is no underlying disease, we don’t know what causes Restless Legs Syndrome, but it is thought to be to do with how the body handles the chemical dopamine. Dopamine is involved in controlling muscle movement and may be responsible for the involuntary movements associated with Restless Legs Syndrome.

What are the common treatments for Restless Legs Syndrome and what are the typical patient outcomes?

Treatments for Restless Legs Syndrome can be put into pharmacological and non-pharmacological categories.

Non-pharmacological treatments include:

• regular exercise
• leg massage / stretches
• sleep hygiene
• hot / cold therapy

Pharmacological (medication) treatments include:

• medications that increase dopamine levels in the brain, such as pramipexole / ropinirole
• anti-seizure medication, such as gabapentin / pregabalin
• opiates, such as codeine / morphine
• benzodiazepines, such as diazepam / lorazepam

Many of these medications can only be prescribed in the short term due to their addictive nature and potential side effects.

Can Medical Cannabis help with Restless Legs Syndrome?

Medical cannabis is not yet a first-line treatment for Restless Legs Syndrome, however some patients have reported benefits from its use, particularly in alleviating symptoms like discomfort, pain, and insomnia associated with restless legs.

Medical cannabis can help in different ways including:

Pain relief – medical cannabis contains compounds called cannabinoids, primarily tetrahydrocannabinol (THC) and cannabidiol (CBD). These cannabinoids interact with the body’s endocannabinoid system, which plays a role in pain regulation.

Improved sleep – one of the key issues for people with Restless Legs Syndrome is difficulty sleeping due to the uncomfortable leg sensations at night. Medical cannabis, particularly strains or products higher in CBD, has been reported to promote relaxation and improve sleep quality.

Reduced muscle spasms and discomfort – Restless Legs Syndrome is often associated with muscle twitching, restlessness, and discomfort. Some studies and anecdotal evidence suggest that medical cannabis, particularly THC-dominant strains, can help reduce muscle spasms and the general discomfort caused by restless legs.

Anti-anxiety effects – Restless Legs Syndrome can cause anxiety, especially at night when people are trying to relax or sleep. The CBD cannabinoid in medical cannabis has anti-anxiety effects, which could help reduce the mental stress and anxiety that often accompanies Restless Legs Syndrome.