Restless Leg Syndrome

[MediumTex]

First of all, I think that Restless Leg Syndrome is a stupid name for what are essentially many different kinds of leg discomfort, many of which involve little "restlessness" and a lot of good old fashioned pain.

So I have this problem of getting intense pain in the backs of my legs (from the top of the calf to the bottom of the hamstring region) when I sit at my office desk.  I have a Steelcase Amia chair, which is wonderful, so I don't think that a chair upgrade would help (the pain predates this chair so I don't think it is chair-related).  I use a footrest, so that base is covered.  I sit in a comfortable position, good posture, etc.  There is no back, shoulder, upper thigh or foot pain. 

The backs of my legs just hurt for much of the day.

It doesn't happen at home, so I'm sure there is some kind of weird biofeedback, psychosomatic, stress-related process going on here, but I can't seem to stop it.

Walking around and stretching don't help, though stretching does reveal a lot of tightness in the backs of the legs.

I've tried taking magnesium and potassium supplements and eating foods rich in these minerals, and have not seen any difference.

Oddly, even pain relievers really don't really dent this pain much (if any).  Similarly, drugs like Xanax at doses that allow me to remain conscious also don't seem to help relieve the tightness much.

One thing that does help a little is holding a muscle massage wand (like Brookstone sells) right on the back of the legs, but this isn't practical to do for more than a few minutes at a time.

I am considering trying out a stand up desk just to see if working around the whole seated position will help (I suspect it would, but standing all day creates a new set of challenges).

I am also thinking about the large foot and calf massager that Brookstone sells.

Any thoughts from my brilliant and insightful friends here?

[Reub]

Could this be some kind of claudication? Do you feel it more during or after walking?

[MediumTex]

Could this be some kind of claudication? Do you feel it more during or after walking?

I only feel it when sitting at my desk, regardless of what I did before I sat down.

I have thought about getting a TENS unit and putting pads on the back of both legs and shocking the muscles to the point of exhaustion, but that's a lot of work to do every day.

[Benko]

MT,

This is a weird entity which I haven't encountered (in terms of helping people) often.

How long have you had it?  What was going on in your life in the 3-6 months prior to your getting it i.e. were there any major life stressors?  (these two questions produce significant clues more often than you might expect. feel free to PM me).

LEF.org: I have mixed feelings about the place, but there is a section on restless legs which might be worth reading NOT FOR THEIR SUPPLEMENT RECOMMENDATIONs, but for info about the condition

http://www.lef.org/protocols/neurologic ... ess%20legs

e.g. link to lack of exercise.  If you have not had a physical exam including routine bloodwork and bloodwork mentioned in the LEF reference that would be a good place to start.

COnditions which clearly don't fit the western medical model such as this may do well with acupuncture and if the physical exam, blood work and answer to my question above don't turn up clues/answers, this is what I would personally try.


EDIT: cosider the LEF info a place to start, but probably worth double checking their info.

[MediumTex]

MT,

This is a weird entity which I haven't encountered (in terms of helping people) often.

How long have you had it?  What was going on in your life in the 3-6 months prior to your getting it i.e. were there any major life stressors?  (these two questions produce significant clues more often than you might expect. feel free to PM me).

Probably 3-5 years.  It's been a long time.  I can't put my finger on any particular outside event or experience that might have coincided with beginning to feel the leg pain.  My stress level wasn't any different in recent years than at other times in my life.

Unfortunately, I think that my body has gotten into a routine of triggering this response when I am in my office setting.  It's weird, but it seems to be part of what is happening.

RLS is apparently believed to be correlated with low dopamine levels.  I wonder if boosting dopamine levels could provide some relief.

[WiseOne]

Doesn't sound like restless leg syndrome.  RLS properly refers to involuntary leg movements during sleep that wake people up.  Sometimes there's a "crawling" sensation, but it's not painful.

First question is whether it is neuropathic pain rather than muscular.  Neuropathic pain has a shooting, lancinating, burning quality, and it doesn't respond to over the counter pain meds.  If it's neuropathic, the most common explanation is sciatica.  This could be due to compression of the S1 nerve root as it exits the spine, or possibly compression by the piriformis muscle as the nerve passes behind it.  It's kind of hard to think what could be causing muscle pain that is only present for part of the day.

3-5 years is a long time for a single cause of pain to persist.  Sounds like whatever it is, it's being constantly irritated.  I'd still guess it has to do with sitting for long periods of time.  If you've already tried getting up 1-2x/hr to walk around and stretch, you probably should go see a neurologist.

p.s. it's not claudication.  That would make for pain that gets worse with exercise.

[Benko]

So you're saying it happens when sitting at work, but not at home in a very similar kind of chair?  You could do a trial and bring your home chair to work, or vice versa, but if you are really sure of that (and you may want to try to be sure), than you are absolutely correct:

"I'm sure there is some kind of weird biofeedback, psychosomatic, stress-related process going on here"

What do you do for a living?  Is your pain better or worse Monday morning vs Friday afternoon?

[smurff]

Another condition to consider if fibromyalgia, particularly if it is in the same region on both sides of the body, regular pain relievers don't help, if you have any trouble with sleep, and it's been going on a long time without resolving.

But I'm not a doctor, so I don't know anything.

[MediumTex]

What do you do for a living?  Is your pain better or worse Monday morning vs Friday afternoon?

I do fiendishly complex and mostly pointless legal work.

It's not good for the soul (or perhaps the back of the legs), though it is occasionally interesting and it keeps my mind sharp for the other things I like to do.

There is clearly a distaste for some of the things that happen to me mentally when I'm at work, but it's interesting that it would manifest this way, and I wonder what I would need to do to stop it (short of finding a different line of work, which I don't want to do).

One way or another, I am pretty sure it's something in my head, simply because it doesn't happen away from work.

The chair I sit in is awesome (no back or shoulder pain and very comfortable, except for the leg thing).  I am certain it's not related to that.  I actually bought this chair hoping it would improve the leg thing, but it had no effect.

[smurff]

There is clearly a distaste for some of the things that happen to me mentally when I'm at work, but it's interesting that it would manifest this way, and I wonder what I would need to do to stop it (short of finding a different line of work, which I don't want to do).

Well, if you decide to change your mind, I vote for working as a writer.

[Benko]

It's not good for the soul ...

There is clearly a distaste for some of the things that happen to me mentally when I'm at work,

Given your words, you are clearly in a job which is toxic for you and your body.  You even have your own experimental control i.e. sitting at work yields pain, sitting similarly at home does not yield pain.  It does not get more obvious than that, and you knew it yourself re-reading your original post.

I would strongly suggest that at a minimum, long term you not stay in this job, as this kind of thing can yield more unpleasant physical consequences down the road.

[Gumby]

Often oral magnesium isn't well absorbed. It's worth trying transdermal Magnesium Oil to target the pain (you can buy it at Whole Foods or Amazon). However, it makes some people a little drowsy. The trick with Magnesium oil is to administer it at the right time of day for your own body. If it makes you sleepy, spray it on you in the evenings. Rarely, some people experience a paradoxical effect, and it keeps them up at night. If it keeps you up at night, spray it on in the morning. Start with only two sprays in the beginning and work your way up to 18 or so sprays over your entire body for a full RDA dosage of Magnesium (as needed). The dosage effect from transdermal magnesium oil is similar to bathing in a hot spring. It tends to have a muscle-relaxing effect.

[MediumTex]

It's not good for the soul ...

There is clearly a distaste for some of the things that happen to me mentally when I'm at work,

Given your words, you are clearly in a job which is toxic for you and your body.  You even have your own experimental control i.e. sitting at work yields pain, sitting similarly at home does not yield pain.  It does not get more obvious than that, and you knew it yourself re-reading your original post.

I would strongly suggest that at a minimum, long term you not stay in this job, as this kind of thing can yield more unpleasant physical consequences down the road.

There is also the option of coming up with some more robust coping skills, right?

Isn't that what the samurai did?  They didn't stop fighting, they just figured out a way to cope with the stress without it destroying them.

To a degree, I think that the problem is with me.  I don't think that the soul-sucking I am experiencing is necessarily specific to this job.  I may have opened the spigot on my own soul and as it leaked out it may have just looked like the job was causing it.  I think that this dynamic is often what makes people run from one thing to another in life without realizing that the thing they are trying to get away from is actually some aspect of themselves, and that's why it can be such a frustrating exercise.

So the trick then is to find out how to close the spigot with as little disruption as possible. 

All men put on the face of right-mindedness, but they do not truly think about it. Because of this folly, when some unpleasantness is visited upon a man, he is unable to bear it and spits out words of abuse. The object of these words is then mortified and proceeds to throwaway his life in retaliation. This man is not only lacking in right-mindedness, he reeks of desire.

***

What is called desire is not simply attaching oneself to wealth, or thinking only about one's fancies for silver and gold.

When the eye sees colors, this is desire.

When the ear hears sounds, this is desire.

When the nose smells fragrances, this is desire.

When a single thought simply germinates, this is called desire.

This body has been solidified and produced by desire. and it is in the nature of things that all men have a strong sense of it. Although there is a desireless nature confined within this desire-firmed and produced body, it is always hidden by hot-bloodedness, and its virtue is difficult to sow.

-Takuan Soho, "The Unfettered Mind"

[MediumTex]

Often oral magnesium isn't well absorbed. It's worth trying transdermal Magnesium Oil to target the pain (you can buy it at Whole Foods or Amazon). However, it makes some people a little drowsy. The trick with Magnesium oil is to administer it at the right time of day for your own body. If it makes you sleepy, spray it on you in the evenings. Rarely, some people experience a paradoxical effect, and it keeps them up at night. If it keeps you up at night, spray it on in the morning. Start with only two sprays in the beginning and work your way up to 18 or so sprays over your entire body for a full RDA dosage of Magnesium (as needed). The dosage effect from transdermal magnesium oil is similar to bathing in a hot spring. It tends to have a muscle-relaxing effect.

I was thinking about that as I was reading your posts on this topic in the supplements thread (or wherever that came up).

I took a mineral bath one time in a natural spring (Thermopolis, WY) and afterward I felt like a feather sitting on top of a perfectly calm pond in a world made up exclusively of good things.

[Gumby]

I was thinking about that as I was reading your posts on this topic in the supplements thread (or wherever that came up).

It's worth a shot. It's a very safe way to take Magnesium (provided you don't have kidney issues). And while it may bring temporary relief each time you apply it, you may need to keep applying it every day for about three months to get your Magnesium stores back up. After that, you can just apply it two or three times a week as a supplement.

The funny thing about oral Magnesium is that, if you are deficient, you actually have a much harder time absorbing it orally than someone who is not deficient. So, oral Magnesium often passes right through those who need it the most. Magnesium oil bypasses the digestive system and rapidly brings the Magnesium directly into the bloodstream. Magnesium can also be delivered intravenously or nebulized into the lungs for those with severe problems.

I took a mineral bath one time in a natural spring (Thermopolis, WY) and afterward I felt like a feather sitting on top of a perfectly calm pond in a world made up exclusively of good things.

Pretty cool. Supposedly "Ancient Minerals" brand produces the most pure Magnesium Oil — though, I haven't tried that brand yet. They also make Magnesium bath flakes, but you would need to add six to eight pounds of Magnesium flakes to a bath just to equal the concentration of the Magnesium in the ocean. So, if you can bathed in the ocean for an hour each day, that's also therapeutic. Alternatively, the flakes can be poured into a foot bath. Your feet just suck the Magnesium up like straws. Some people just use the Magnesium flakes to make their own Magnesium oil brine (boiling down flakes and distilled water). But, the commercial Magnesium oils are a bit more pure than the home-brewed oil.

[Benko]

MT,

"There is also the option of coming up with some more robust coping skills, right?"

Sure, it is possible.  The advantage you have is that your body is giving you feedback so you'll know if you are sucessful.

"To a degree, I think that the problem is with me.  I don't think that the soul-sucking I am experiencing is necessarily specific to this job.  I may have opened the spigot on my own soul and as it leaked out it may have just looked like the job was causing it."

It souinds like you are just trying to convince yourself, but obviously I have no way of knowing.  This might be worth bouncing off (in person) someone who knows you well and who you trust and perhaps they can provide you useful feedback on this.

[MediumTex]

It sounds like you are just trying to convince yourself, but obviously I have no way of knowing.  This might be worth bouncing off (in person) someone who knows you well and who you trust and perhaps they can provide you useful feedback on this.

You may be right.  I just want to consider all possibilities.

Anyone have any thoughts on the low dopamine idea?  That has intuitive appeal to me.

[lazyboy]

MT, I trust that your intrinsic openness, self awareness and curiosity will lead you to a healing solution. In order to gain some insight into my own (and other's)  physical problems, sometimes I've turned to a little booklet a spiritual teacher recommended to me some years back: Heal Your Body- Metaphysical Causations For Physical Illness by Louise L. Hay. Sometime's I've found her insights to be helpful, sometime not so much. She lists physical problems, a "probable" metaphysical cause and a suggested new thought pattern to try out as a remedy. I offer these to you in the spirit of friendship so, like it or not, here's what she says about legs and leg problems: The legs carry us forward in life, upper leg problems are about holding on to old childhood traumas and lower leg problems are about the fear of the future, not wanting to move.  She gives a combined affirmation for both leg problems as follows (you may have to unpack what part of this affirmation is useful to you): "They were doing the best they could with the understanding, awareness and knowledge they had. I release the past with love. I move forward with confidence and joy, knowing that all is well in my future." 

[MachineGhost]

Often oral magnesium isn't well absorbed. It's worth trying transdermal Magnesium Oil to target the pain (you can buy it at Whole Foods or Amazon). However, it makes some people a little drowsy. The trick with Magnesium oil is to administer it at the right time of day for your own body. If it makes you sleepy, spray it on you in the evenings. Rarely, some people experience a paradoxical effect, and it keeps them up at night. If it keeps you up at night, spray it on in the morning. Start with only two sprays in the beginning and work your way up to 18 or so sprays over your entire body for a full RDA dosage of Magnesium (as needed). The dosage effect from transdermal magnesium oil is similar to bathing in a hot spring. It tends to have a muscle-relaxing effect.

What's a good source to buy from?

[MachineGhost]

Anyone have any thoughts on the low dopamine idea?  That has intuitive appeal to me.

Psychological issues are never an easy fix and hardly intuitive.

Low dopamine could be a consequence of your job too.

It seems to me that your political beliefs and your job have to be a source of conflict, eventually.

Have you been to a chiropractor?  It may not be in your legs per se.

Does your chair have a waterfall edge?

Are your hips and legs at a 90 degree angle when sitting?

[MediumTex]

Anyone have any thoughts on the low dopamine idea?  That has intuitive appeal to me.

Psychological issues are never an easy fix and hardly intuitive.

Low dopamine could be a consequence of your job too.

It seems to me that your political beliefs and your job have to be a source of conflict, eventually.

The work I do (trying to keep the government from confiscating too much of my clients' property) isn't inconsistent with my political beliefs.  It's just tedious and boring at times (like many things in life can be).

Have you been to a chiropractor?  It may not be in your legs per se.

Finding a good chiropractor is harder than finding a good doctor.  I haven't had the time or energy to start that process.

Does your chair have a waterfall edge?

The Steelcase Amia chair has a front edge that pivots.  It's a very nice feature and is a vast improvement over the Aeron chair I used to have.  Here is a brochure with some of the features of this great chair: http://store.steelcase.com/brochures/amia/

Are your hips and legs at a 90 degree angle when sitting?

More or less.  I have a pivoting footrest as well, so I can get into whatever position I want for the most part.

Remember, too, that this pain is experienced in only one setting.  One way or another, it's in my head.  My mind is fettered.

[MediumTex]

So here is my dopamine deficiency remediation plan:

1. Increase exercise levels.  30-60 minutes a day on the treadmill should do it.

2. Begin the following supplement regimen: L-Tyrosine, Rhodiola Rosea, and Yohimbe.  Adjust dosage as needed.  All three of these items are believed to help increase dopamine levels.

3. Use mental visualization techniques to facilitate reconfiguration of brain chemistry.

[AdamA]

So here is my dopamine deficiency remediation plan:

1. Increase exercise levels.  30-60 minutes a day on the treadmill should do it.

2. Begin the following supplement regimen: L-Tyrosine, Rhodiola Rosea, and Yohimbe.  Adjust dosage as needed.  All three of these items are believed to help increase dopamine levels.

3. Use mental visualization techniques to facilitate reconfiguration of brain chemistry.

I'm on board with 1. and 3.  You might use the elliptical trainer instead of the treadmill to spare your knees a bit, though.  Can you tell where you got idea number #2?  I don't know much about these kinds of supplements, and I'm always skeptical about this sort of thing.

How is your work inconsistent with your political beliefs, by the way?
I was surprised to read that.

[Gosso]

MT,

My first thought is a lack of physical exercise, so the jogging may help.  Also yoga may help get the energy flowing properly.

My second thought is a complication from medication you may be taking.

However, it sounds more likely that your subconscious is trying to get your attention.  It may have something to do with the so called "mid-life crisis".  Based on my limited understanding of Jungian analysis, this usually involves the need to withdraw from the outside world and then enter the inner world.  Jungian analysis also involves recording your dreams and attempting to read the symbolism present in them, which may lead to answers.  Personally, it all sounds a little "horoscopey" to me, but there may be something to it.

[MediumTex]

You might use the elliptical trainer instead of the treadmill to spare your knees a bit, though.

I do fast walking on an incline, so the knee and back stress is not too bad.

Also, I have a treadmill, I don't have an elliptical trainer.