Restless Leg Syndrome

[MediumTex]

MT, do you ever have minor circulation issues? Cold hands/fingers or cold feet?

No.

[WiseOne]

MT, take a look at my previous post and feel free to message me if you want.  It so happens that I'm a neurologist, and what you're reporting is actually quite common.  I've enjoyed all the wisdom you have added to many PP discussions, and you certainly deserve a little friendly advice.

I'll just add that the comments about dopamine are just a bit scary to me.  Low dopamine has nothing whatsoever to do with leg pain - it is the primary cause of parkinsonism (when idiopathic we call it "Parkinson's disease"), which is usually related to degenerative or otherwise acquired damage to the basal ganglia.  Increased dopaminergic receptor activity (the converse) has been hypothesized as a cause of schizophrenia.  Fortunately, none of the (nonprescription) things that have been suggested would seriously interfere with dopaminergic function in a normal, healthy individual.  I would NOT recommend taking any dopamine agonists or supplements if you don't have a good indication for it, including bromocriptine, levadopa, etc.  The most you'd likely get from the experience are vivid nightmares, but it's still nothing to be fooling with.

Magnesium wouldn't hurt you, so feel free to try that if you want.  If you seriously think this is a problem you can always get a magnesium level checked.  While you're at it, get a full blood electrolyte panel since that checks several possible causes of muscle cramping (if that's what the problem is).  Along with magnesium, add calcium and vitamin D supplements since low calcium is also a common trigger for muscle cramps.  Also, you might try drinking tonic water for the quinine in it - a little known but surprisingly effective remedy.

This won't help if the problem is sciatica though....neuropathic pain is also compatible with what you describe, so if you could characterize it a bit more that would help.

[MediumTex]

Given that the pain only happens in one setting, I'm sure it's a mental thing manifesting in leg pain.

In the same way that people get stress-triggered back pain, I feel like this leg pain is that kind of thing.

When I get into a "flow" state, the pain goes away.  I just have trouble getting into and maintaining a flow state in that setting, and that creates frustration and anxiety...and then the pain starts.

[MachineGhost]

Magnesium wouldn't hurt you, so feel free to try that if you want.  If you seriously think this is a problem you can always get a magnesium level checked.  While you're at it, get a full blood electrolyte panel since that checks several possible causes of muscle cramping (if that's what the problem is).  Along with magnesium, add calcium and vitamin D supplements since low calcium is also a common trigger for muscle cramps.  Also, you might try drinking tonic water for the quinine in it - a little known but surprisingly effective remedy.

What are the ways of identifying muscle cramping from an electrolyte panel?

Where does one buy this tonic water with quinine?

[WiseOne]

When I get into a "flow" state, the pain goes away.  I just have trouble getting into and maintaining a flow state in that setting, and that creates frustration and anxiety...and then the pain starts.

Interesting.

In my experience, people get psychosomatic symptoms when they're trying to avoid dealing with unpleasant emotions or memories.  The fact that you're so open and introspective about your stress level makes me think that the problem has a physical component. 

I wonder if you are unconsciously doing something to aggravate the underlying condition when you're at work and stressed, such as squeezing your legs against the chair.  Can you try to pay attention to what you're doing when the pain starts, or is about to start?

Also, the quality of the pain is important.  Is it cramping/soreness or is it burning/shooting?  Can you describe it precisely?

What are the ways of identifying muscle cramping from an electrolyte panel?

Where does one buy this tonic water with quinine?

Low calcium or magnesium, low potassium, low bicarbonate, and abnormal renal function (BUN and creatinine) can all trigger muscle cramps.  Typically if these are off there is an underlying medical condition that needs to be looked into.  The most common causes of muscle cramps, though, are probably mild dietary insufficiencies (mainly calcium) and nerve injury (most often, sciatica or lumbosacral spinal stenosis).

Quinine's use in tonic water dates back to the British occupation of east Africa, where they drank it to prevent malaria.  The recipe hasn't changed since then.  Pretty much any of the usual brands of tonic water will work, but check the labels as some may rely on artificial flavors.  Schweppe's is the one I'm most familiar with.  Most grocery stores carry it.

[MediumTex]

When I get into a "flow" state, the pain goes away.  I just have trouble getting into and maintaining a flow state in that setting, and that creates frustration and anxiety...and then the pain starts.

Interesting.

In my experience, people get psychosomatic symptoms when they're trying to avoid dealing with unpleasant emotions or memories.  The fact that you're so open and introspective about your stress level makes me think that the problem has a physical component. 

I wonder if you are unconsciously doing something to aggravate the underlying condition when you're at work and stressed, such as squeezing your legs against the chair.  Can you try to pay attention to what you're doing when the pain starts, or is about to start?

Also, the quality of the pain is important.  Is it cramping/soreness or is it burning/shooting?  Can you describe it precisely?

It's not a shooting or stabbing pain.  It's sort of like a sprained ankle-type of throbbing pain right behind my knees.  Elevating my legs seems to help, though elevating the legs seems to be more a response to symptoms than causes.

It feels like my body has just gotten into a routine of experiencing this, sort of like a dog salivates when he hears the pots and pans coming out in the kitchen.

[WiseOne]

Also, the quality of the pain is important.  Is it cramping/soreness or is it burning/shooting?  Can you describe it precisely?

It's not a shooting or stabbing pain.  It's sort of like a sprained ankle-type of throbbing pain right behind my knees.  Elevating my legs seems to help, though elevating the legs seems to be more a response to symptoms than causes.

It feels like my body has just gotten into a routine of experiencing this, sort of like a dog salivates when he hears the pots and pans coming out in the kitchen.

This must be really irritating.  I wonder if some of your aversion to your job is related to this and causing a vicious cycle.

That was a useful piece of information - now I'm thinking it could be varicose veins.  It's a very common problem and easily treated.  Can you feel or see any large surface veins in that area?  Sciatica from S1 stenosis, nerve root compression, or piriformis entrapment is still on the list.  Any history of knee or leg injuries?  Also any other exacerbating/relieving factors?

Let me qualify by saying that email-telemedicine is pretty random and probably not the most reliable way to diagnose something.  There is nothing like a face to face visit with a neurologist who is willing to do some detective work (which our entire medical system opposes, unfortunately), but I'm happy to email back and forth or continue this thread, as you wish.

[MachineGhost]

Here's a segment of a video interview on rhodiola from the director of Boston School of Herbal Studies:

http://vimeo.com/47815516