From the office of Robert S. Grimshaw Jr MD FACP Internal Medicine 3535 Hill Blvd Yorktown Hts NY 914 962-3180 Guides

Restless Leg Syndrome:    


Restless leg syndrome is a feeling of deep discomfort at rest. Patients will describe the feelings as creeping, crawling, itching, tingling, burning, pulling and jitters.  80% report the involuntary movements.   While the cause is not known, abstaining from smoking, alcohol and caffeine usually helps.  We should make sure there’s no drop in iron, folate or vitamin B-12, and check for medication effects, thyroid and kidney disease.  Therapies include stretching, Sinemet, Klonopin, and Neurontin.  Occasionally, quinine can be helpful – but really only for leg cramps, not for true Restless Legs.

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To stretch, lean against a wall, placing your feet about a yard from the base of the wall while on the balls of your feet, then  slowly come down onto your heels, with your knees locked.  Do this for about 30 seconds.  This will stretch the muscles in the back of your legs.

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Sinemet, Klonopin and Neurontin are prescription items.

From the Mayo Clinic Proceedings, Dr. Siong-Chi Lin and colleagues report that the anti-Parkinson drug pramipexole (Mirapex) may be very useful.  They started with 1/2 of a 0.25 mg pill nightly 2 hours before bedtime.  Only 1 of their 16 patients couldn’t take the drug.  Most noted less leg restlessness including involuntary “jumping” and better sleep.  The main side effect was fatigue or stiffness.  The pills cost about $1 each.

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For quinine, the easiest source is Schweppe’s Tonic Water - one glass at bedtime.  Other sources can include the prescription Quinam tablets at bedtime.