Trucker MD
Restless leg syndrome?

By John McEllifott, MD
and Jeffrey Heinrich, Ed. D, PA-C

Do you have a madly annoying, unpleasant and even painful aching in your legs when they are at rest? A creeping, tingling, aching, bubbling, sometimes searing sensation or pulsing that compels you to move them? If so, then you may have Restless Leg Syndrome, or RLS.

What is it? RLS is a movement disorder that falls under neurological conditions. It usually occurs at night, but it can occur during the day, especially if you sit for long periods. It can affect the feet, upper legs and arms, too.

What causes RLS? It mostly occurs in middle age and older adults but the cause is not known. It can be associated with chronic kidney disease, Parkinson’s syndrome, hypothyroidism, hypoglycemia, iron deficiency, certain medications and pregnancy, to name a few. More than 50 percent of cases are familial, and a gene has been found that may be related to this condition. Stress in one’s life can increase the severity of RLS symptoms. Obesity is a risk factor, too.

How is it diagnosed? Physical examination usually reveals no signs related to the problem. If you have a peripheral neuropathy, sensation may be decreased to light touch and pinprick.

How do you treat it? There is no cure for RLS. Treatment is focused on relaxing muscles and reducing stress. Here are some tips on managing the condition:

  • Moving your leg will frequently stop the tingling sensation.
  • Good sleep habits are a must.
  • Take a warm shower before going to bed.
  • Avoid alcohol within two hours of bedtime.
  • Avoid caffeine products in the late afternoon and early evening.
  • A bowl of fruit or a banana with a glass of skim milk one hour before you sleep may help as the blood flow is concentrating on your stomach and not your brain.
  • Try to go to sleep with a clear mind. If you’re thinking about a person, task or issue, get it resolved before going to bed.
  • Make sure your bladder is empty so you don’t get up in an hour or two to go the bathroom.
  • A cool dark setting is recommended for a good night of sleep.
  • Being tired when you go to bed will help you reach REM sleep as fast as possible.
  • If you are not sleepy and your legs are twitching, then get up and move around.
  • Gentle stretching exercises may help and should be done three to five times each week.
  • Massage is another possibility.

Medications for RLS are problematic for truckers because of the expense and the side effects, which include drowsiness. Also, these drugs have no ceiling effect, which means that sometimes it takes more and more to achieve the same effect.

RLS and your driving job. RLS can affect you when you are sitting still and that, of course, includes driving. The symptoms for sitting (driving) and what you experience in bed are the same with the exception that you don’t lose any sleep. The bad news is that sitting symptoms can be more pronounced and the uncomfortable sensation more intense.

The prevention of RLS while awake is much easier. Treatment is the same. If your legs reach the floor, then just put your toes down and your heel up and let your legs move on auto pilot up and down. This motion is an automatic reflex in most folks causing the heel to go up and down very fast. This also reduces the lactic acid in the legs and improves circulation.

This exercise is helpful for you if you are not driving and simply riding shotgun. RLS can make for a miserable trip, especially if your feet do not reach the floor. So we short people must adjust the seat so that our feet reach the floor. The alternative for non-drivers is to elevate their feet or prop them up, maybe on the dash of the truck.

Again, meds should be used only as a last resort after consultation with a doctor who knows you are a trucker. LL