Nail Clinic: Restless Legs Syndrome
Restless legs syndrome can disrupt your sleep and make sitting still at a manicure table nearly impossible. What’s a tech to do?
“It’s a creepy-crawly feeling.” “There’s a burning and urge to thrash around.” “It feels like an electric current going through my legs.” Sufferers of restless legs syndrome (RLS), also called Willis-Ekbom Disease, may describe their symptoms in different ways, but they share the same condition. Classified as a sleep disorder and movement disorder, RLS is a painful condition of the nervous system characterized by persistent sensations in the legs that can only be eased by movement. It tends to flare up toward the end of the day and peak after bedtime, resulting in poor sleep.
Although RLS may sound like a benign problem, sufferers and medical experts are quick to dispel that notion. “Restless legs syndrome has a name that makes people think it’s a silly condition,” explains J. Steven Poceta, MD, a neurologist and RLS specialist at Scripps Clinic Viterbi Family Sleep Medicine Center in La Jolla, California. “But when it’s severe, it really lowers a person’s quality of life. Imagine not being able to tolerate sitting still for more than a couple of minutes. People with restless legs syndrome really need help.”
According to the National Institutes of Health/ National Institute of Neurological Disorders and Stroke, untreated RLS can cause “exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance and personal relationships.” Daily tasks become major hurdles as the ability to focus and remember is compromised by RLS-related lack of sleep. Work productivity decreases, and depression and anxiety can take over. For people whose jobs require sitting in one place for long stretches of time—such as nail techs—RLS can be a career destroyer. “Most of the time it’s triggered at night, but several times I’ve had it happen in the daytime,” says Teresa Lopez, a nail tech at Salon 132 in Grover Beach, California, whose first symptoms of RLS showed up in 2015. Fellow sufferer Kris Kiss, a nail tech at Couture Nail Studio in Port Jefferson Station, New York, notes that, “Holiday time is especially rough because there are such long days of sitting.”
The good news is that although there’s no cure for RLS, lifestyle changes, practical techniques and medical treatments can alleviate the symptoms of this mysterious ailment. Here’s what all RLS sufferers need to know.
Understanding Restless Legs Syndrome
To the unknowing eye, the behavior of someone with RLS can look like ordinary restlessness, and it can be hard to understand why the sufferer can’t just “stay still.” But scientists have uncovered genetic, metabolic and neurological connections to the condition that show why RLS isn’t a question of a “mind over matter.” Recent research published in the Journal of Physiology in 2018 has zeroed in on specific motor nerve cells that appear to “target” muscles, sending signals that result in the twitching, burning and cramping sensations that sufferers experience.
What prompts nerve cells to behave this way? Researchers have identified a list of potential culprits, including gene variants; low iron levels; low levels of the neurotransmitter dopamine; existing conditions, such as nerve damage, renal disease and Parkinson’s Disease; prescription medications; pregnancy; sleep disorders; and the use of alcohol, nicotine and caffeine. By addressing each of these factors in turn, doctors make individualized treatment recommendations to their patients.
Statistics show that women are more likely to suffer from RLS than men, and that many of those most severely affected are middle-aged or older. Symptoms may come and go at first, but often worsen and become more frequent with age, and may even start to affect the arms.
Treatment and Self-Care
If you think you may have RLS, your first course of action should be to consult a physician with expertise in the condition. Medications to address RLS generally fall into five categories: iron supplements, anti-seizure drugs, dopaminergic agents, opioids and benzodiazepines, each of which comes with its own set of potential side effects, but can be appropriate depending on the severity of the RLS and length of use.
Fortunately, medications aren’t always needed, and lifestyle changes might be enough to preserve an RLS patient’s quality of life. “In the beginning when
I didn’t really have the resources or knowledge of what to do, I would resort to pounding my leg with my fists, against a bed, a wall or even the other leg, in order to divert the pain,” confides Lopez. “My doctor’s go-to was pain medication, but I refuse to mask the pain, so I found my own ways of dealing with it.” Lopez helps keep her symptom in check with heating pads, weekly massages, chamomile tea before bedtime and “my No. 1 recommendation: a warm to hot bath with Epsom salts to relax the muscles,” she says. Other conservative approaches include increased consumption of iron-rich foods, such as dark green leafy vegetables, beans and fortified cereals; reduced alcohol, nicotine and caffeine consumption; regular and moderate exercise that includes aerobics and leg-stretching; and a consistent sleep pattern. Also, the Federal Drug Administration recently approved medical devices that apply vibration and/ or pressure to help ease RLS symptoms.
Kiss has been doing better since her diagnosis. “My doctor recommended reducing my caffeine intake, and the exercise has helped—I walk and ride my Pelaton bike,” she says. “At work, I find that getting up and moving around helps the unpleasant feeling go away temporarily.” That self-awareness, agrees Lopez, is critical to managing the condition. “As a manicurist, it’s easy to get stuck in the goings-on of the business and forget about yourself—but self-care is vital,” points out Lopez, who takes 15-minute breaks throughout her work day to walk around. “Now that I know what RLS is, I’m able to prepare myself before it actually happens.”
- Approximately 5% to 10% of U.S. adults, and 2% to 4% of U.S. children, suffer from restless legs syndrome (RLS).
- Untreated moderate to severe RLS can lead to a 20% decrease in work productivity.
- Anywhere from 40% to 90% of individuals affected by RLS report having at least one affected parent or sibling.
- More than 80% of people with RLS also experience a condition called periodic limb movement of sleep (PLMS), marked by involuntary twitching or jerking of the legs during sleep.
Sources: National Institutes of Health/National Institute of Neurological Disorders; Restless Legs Syndrome Foundation; National Sleep Foundation; The Yale Center for Restless Legs Syndrome, medicine.
–by Linda Kossoff
This story first appeared in the May issue of Nailpro magazine. To receive the magazine, click here to subscribe.