Has any one of our members worked with Restless Leg Syndrome. I have much information on the subject, but little evidence of efficacy of Massage Therapy for this condition.

Matthew Dilosa

-- Matthew Dilosa (newlife@netspace.net.au), October 15, 2001

Answers

Yes Matt I have a client with the condition. She has reported that she has less instance of attacks after massage. Also reports sleeping better which may be the reason for less attacks. I would appreciate some additional information on the condition if you can direct it to me. John Cavanagh

-- John Cavanagh (lochcav@bigpond.com), October 15, 2001.

Hi Matt Hi John - cannot immediately help on Restless Legs without time for a real search but it conjures two thoughts - geriatric - nocturnal - so I would suggest including in the regimen the James Waslaski's 'Gearbox Exercise' - he taught us to do it prone and knees flexed but I find this is beyond most oldies so I have modified it to be sitting on the bedside at retirement - I haven't written it into my collection of patient protocols so give me a week or two and I will send it to both of you as soon as I find time to write it out - kind regards - Joel Morrell

-- Joel Morrell (arn@tsn.cc), October 17, 2001.

Has the client in question had a blood test to determine whether the condition is being caused by or exacerbated by iron deficiency? (Anemia and low levels of iron in the blood are associated with symptoms of RLS.)

One of my clients suffered from restless leg syndrome (she was amazed to discover the condition actually had a name!) and I found heaps of useful information on the website of the RLS Foundation. You may well have checked this site out already but just in case: www.rls.org

There is no research mentioned as to the efficacy of massage but they site anecdotal evidence that massage does relieve the symptoms in some cases (spectacularly conclusive, eh?).

As I type this it occurs to me that there are so many things that we should be mounting clinical trials to investigate. Who else is going to do it for us? Maybe AMT needs a research institute as well. We could apply for goverment grants to fund our endeavours. (PLease cue insane laughter).

-- Rebecca Barnett (rebeccabarnett@bigpond.com), October 18, 2001.

I have now committed to my computer (and thus to email) the Gearbox Exercise for lower legs referred to in my posting in October. It is too long for the Bulletin Board but I would be happy to email it as a Word Attachment on request.

With kind regards - Joel Morrell arn@tsn.cc

-- Joel Morrell (arn@tsn.cc), November 14, 2001.

On my way to researching something else I came upon a site which mentions Restless Legs Syndrome and has a good description of it. The site - www.intelihealth.com features Harvard Medical School's Consumer Heatlh Informaton about all sorts of interesting things - check it out!

On RLS it notes that "simply exercising, massaging your legs, or taking a hot bath may bring relief. As Rebecca noted earlier they also link some cases to anaemia or a low ferritin level.

-- Diana Glazer (dglazer@zip.com.au), November 29, 2001.

Hi Matthew,

I'm going to talk about Akathisia, a differential diagnosis of Restless Leg Sydrome.

Most of my experience with clients of this this kind of problem have experienced akathisia (neuroleptic induced restless legs + other problems) as a side effect from medications such as SSRI's (Antidepressants and anxiety medications - drugs such as Prozac, Luvox and Zoloft) as well as some of the older antipsychotic mediations such as Halperidol and Clopixol. Some newer antipsychotic medications such as Olanzapine (Zyprexa) and Risperidone also cause Akathisia, but in fewer clients and with less severity.

Mainstream psychiatrists prescribe such medications such as Cogentin, and Benzodiazepine such as Diazepam (Valium)and Temazepam to treat these side effects. These are extremely effective in the short term on Akathisa and Dystonia.

My point is that it is important to take into account the fact that doctors tend to use a cocktail of medications in treating mental health disorders - an example might be as follows:

1) Treat the psychiatric condition (ie psychotic depression) with an antipsychotic, a mood stabiliser as well as an antidepressant)

2) Use another medication - to treat the side effects (ie treat a movement disorder with Valium ).

Then, just to make the situation more confusing, the client self medicates: 3) The client then drinks 12 cups of coffee/day to get the caffiene to counteract the sedative effects of the Valium. What they don't realise is that caffeine in actual fact exacerbates the akathisia!

Therefore, in relation to clients that present with movement disorders it is important to take into account neuroleptic medications that they may be taking.

While the massage therapist is not a mental health professional it is essential to be aware of what medications the client is taking and why. It is important to be aware of the clients medication adherence because you may notice a huge improvement in the clients presentation only to find out that this week Joe is actually taking his cogentin whereas last week he could barely lie on the table due to his movements (he didn't take it last week!)

-- Sonny McNamara (massagetherapy@primus.com.au), April 26, 2002.