Restless Legs During Opiate Withdrawal

Hi Folks and welcome to my blog about opiate addiction. When one quits opiates by going cold turkey or after a tapering process, they will most likely experience a variety of withdrawal symptoms. Some are worse than others while others are barely noticeable and simply a minor nuisance. Some of these withdrawals last for a few days while others can be felt for weeks. All and all, withdrawals from opiates can really make quitting opiates and staying clean an extremely difficult (yet possible) task.

If you were to ask me what withdrawal symptom I dread the most, I can say right off the bat and without a doubt that restless legs takes home the prize. Sure, the chills, sweats, aches/pains, stomach problems, and lack of sleep make for one hell of a week(s) but in my opinion, none of these symptoms come remotely close to how bad restless legs can feel. The awful feeling of having to constantly move one's legs while changing positions every 30 seconds is about as close to Hell as I can imagine. To make matters worse, I actually have the condition Restless Leg Syndrome, which makes the common opiate withdrawal symptom of restless legs feel like a million times worse when detoxing. Hell, even if I'm not withdrawing from opiates and am experiencing restless legs I feel so frustrated, defeated, and weak.

Therefore, I would like to use this post as an opportunity to provide you guys with some quick information about restless legs during opiate withdrawal along with some ways to help provide relief for such a nasty withdrawal symptom. While I will talk a little bit about the condition Restless Leg Syndrome (RLS), most of this post will concern restless legs as a symptom of opiate withdrawal rather than the actual medical condition of RLS.

 

What are Restless Legs and Why Do We Get Them

 

It is important to first identify and separate the medical condition known as Restless Leg Syndrome (RLS) and the symptom of restless legs that one would experience during opiate withdrawal. While both items carry with them near identical symptoms, RLS is usually a chronic condition meaning it is something one will have for quite some time and possibly for their entire life. On the other hand, restless legs as a symptom of opiate withdrawal is a result of the body undergoing a detoxification process and these symptoms will eventually disappear over time. To provide you guys with an example, pretend an individual takes part in an intensive exercise routine that results in their blood pressure increasing momentary. While this person did experience a bout of high blood pressure, it does not mean that the person suffers from the condition of having high blood pressure. Rather, the increase in blood pressure for this individual was a direct result of the exercise rather than an actual medical condition, illness, or disease. Thus, for this particular post, we will focus on restless legs occurring as a result and symptom of opiate withdrawal.

 

Restless legs can be described as having any of the following symptoms:

 

• Constant or frequent urges to move legs
• Itchy feeling in legs commonly described as "an itch you can't feel or itch"
• Crawling feeling within the legs
• Random jerks or reactions from legs
• Hot or cold flashes in the legs
• Pain or burning sensation in the legs

 

Common Symptoms of Restless Legs

Restless legs can truly be a nuisance and often limit or disturb one's sleep making detoxing off opiates that much harder. The condition also seems to worsen for many at night and/or when they are sitting or laying down. For many, this leads to numerous nights of tossing and turning in bed late at night in hopes of being able to find a comfortable position and achieve some level of sleep. Although less common, some people report having these feelings in their arms, neck, and shoulders as well.

The understanding of Restless Leg Syndrome and restless legs in general is pretty limited as of right now. Fortunately, the topic and area has been getting more attention over the last couple of years as the number of cases of patients experiencing restless legs or related symptoms continues to grow. In years past, many doctors and specialists thought restless legs were a symptom of a condition rather than an actual condition in itself. Today, the condition is actually labeled as an entirely separate beast and not simply as a symptom of something else. Some studies suggest that as many as 1 in every 10 people will develop Restless Leg Syndrome at some point in their lives, with those over 55 appearing most vulnerable.

Now, the restless legs episodes that most of us who are reading this blog experience are most likely a symptom resulting from opiate withdrawal rather than the actual condition of RLS. However, I mention the increase of attention in the condition RLS as it has led to numerous medications and treatments becoming available that can also be used to treat restless legs resulting from opiate withdrawal. Most of these medications are still in the early stages and as a result, there has been mixed reactions as far as how effective these medications are in treating restless legs.

According to the website Help Guide, scientists and doctors believe the cause of restless legs is as follows (in blue font):

"Experts believe that restless legs syndrome is caused by an imbalance of dopamine, a chemical that transmits signals between nerve cells in the brain. Restless legs syndrome is usually genetic, about 60% of people with restless legs have a family member with the condition. Although anyone can have restless legs syndrome, it is more common in older adults and women. In fact, about 40% of mothers experience temporary restless legs syndrome during pregnancy. Health conditions such as diabetes, iron deficiency, rheumatoid arthritis, and kidney failure can also trigger restless legs syndrome."

 

Web MD provides the following information (again, in blue font) in describing some of the potential causes or factors contributing to the presence of restless legs:

 

Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure, diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from restless legs symptoms.

 

Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing antihistamines may worsen symptoms.

 

Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

 

Now, it doesn't take a rocket scientist to figure out that the reason most of us who are reading this blog experience restless legs is due to withdrawing from opiates. However, some people (myself included) may actually have Restless Leg Syndrome so it is important that one is able to differentiate between the two. You don't want to be experiencing restless legs 3 months after detoxing off opiates thinking that you are getting the restless legs due to no longer using opiates. You may in fact actually have the condition Restless Leg Syndrome so make sure you evaluate your situation and talk openly and honestly with your doctor. A simple physical and possible lab blood test can sometimes determine whether or not you have RLS as well as possibly identifying the cause of it. Having any conditions, problems, or issues taken care of and in control will only make your road to recovery easier in the long run. You don't want to end up one night feeling frustrated and uncomfortable because you can't sleep or that your legs are bothering so much that you end up turning to your drug of choice for relief. I have been there before... more than once unfortunately.

As I previously mentioned, restless legs can be a direct result of something else other than opiate withdrawal. This situation is referred to as Secondary Restless Leg Syndrome and can occur in situations such as pregnancy, disease, nutrient deficiency, or as a side effect from certain medications. Diphenhydramine, the main ingredient in Benadryl, is a perfect example of Secondary RLS. A common side effect of this over the counter medication, especially when taken in higher dosages, is restless legs. I use this medication as an example because I know it is a popular choice as a medication among addicts (as well as non-addicts) to use to provide relief for insomnia. The sedative effect of Diphenhydramine is appealing to many addicts who are struggling to sleep during detoxification. However, the medication can have the exact opposite effect on some leaving them with a sense of restlessness and feeling worse. This was something that I dealt with numerous times until I finally figured out the medication was doing more harm than good. Please not that I am not knocking Benadryl as it can be really effective for some. At the end of the day, know your body and what works and doesn't work. The chart below provides some common factors that can lead to Secondary RLS.

 

Possible Causes for Restless Legs

 

Remedies and Treatments to Help Relieve Restless Legs

 

As I have previously stated, the methods and treatments used for treating restless legs right now are somewhat limited. There are several tips, treatments, and medications out there that claim to help in providing relief for restless legs. Some work well for some people while providing little to no relief for someone else. In other words, these medications and treatments have different degrees of success. At the end of the day, like so many other things in life, everyone is different and their bodies will react differently to different treatments and medications. However, I would like to include some of these medications and treatments in hope that maybe you will find one that works well for you. As always, be sure to talk these items over with your doctor and to know what you are putting into your body. A little research can go a long way.

 

This information was provided by the website Help Guide. You can access this information and learn more about restless legs by clicking HERE.

 

Help Guide's Lifestyle treatments for restless legs syndrome (RLS):

There is a lot you can do to take care of restless legs syndrome yourself. Mild RLS can often be treated with lifestyle changes alone. The following daytime habits can help reduce the frequency and severity of your restless legs symptoms.

• Sleep better by sticking to a regular sleep schedule. Fatigue can worsen the symptoms of restless legs syndrome, so doing what it takes to get enough sleep is crucial. Try hitting the sack at the same time every night, (or try warm baths or reading in bed) allowing plenty of time for winding down.
• Exercise in moderation. Daily activity, including moderate aerobic exercise and lower-body resistance training, can significantly reduce the symptoms of restless legs syndrome. Swim, go for a walk, take the stairs, or spend a few minutes doing jumping jacks. Keep in mind that excessive exercise—like training for a marathon—can actually make restless legs syndrome worse.
• Cut back on caffeine. Caffeine often makes the symptoms of restless legs syndrome worse. Try reducing or eliminating your consumption of coffee, tea, soft drinks, and caffeinated foods such as chocolate.
• Avoid alcohol and cigarettes. Many people with restless legs syndrome find that their symptoms improve when they stop drinking and smoking.
• Consider dietary supplements. Check with a doctor or nutritionist to find out if you’re low on iron, vitamin B, folic acid, or magnesium. Deficiencies can bring on RLS.
• Lose weight. If you’re overweight, dropping the extra pounds can often relieve or lessen the symptoms of restless legs syndrome.
• Try practicing relaxation techniques such as yoga and meditation. Stress can make RLS symptoms worse. Daily stretching and meditation can promote relaxation and alleviate (RLS).

Help Guide's Self-help treatment for restless legs syndrome (RLS):

Living well with restless legs syndrome means knowing how to manage situations where you must be still. The following tips and tricks will help you control RLS so it doesn’t control you.

• Pressure can help relieve the discomfort of restless legs syndrome. Try wearing compression socks or stockings or wrap your legs in bandages (but not so tight you’ll cut off circulation).
• Try sleeping with a pillow between your legs. It may prevent nerves in your legs from compressing.
• Try to find or create a work setting where you can be active. If you work at an office, look into a desk that lets you stand and type.
• Tell friends, family, and coworkers why you have to move more than others. They’ll likely be accommodating and want to help you create a healthy environment.
• Choose an aisle seat at movies and on planes so that you can get up and move.
• Give yourself stretch breaks at work and during long car rides.

Help Guide's Stretches for restless legs syndrome (RLS):

Simple stretching can help stop the symptoms of restless legs syndrome in their tracks. Here’s a handful to help you get started.

• Calf stretch – Stretch out your arms so that your palms are flat against a wall and your elbows are nearly straight. Slightly bend your right knee and step your left leg back a foot or two, positioning its heel and foot flat on the floor. Hold for 20 to 30 seconds. Now bend your left knee while still keeping its heel and foot flat on the floor. For a deeper stretch, move your foot back a bit farther. Switch legs and repeat.
• Front thigh stretch – Standing parallel to a wall for balance, grab and pull one of your ankles toward your buttock while keeping the other leg straight. Hold for 20 to 30 seconds. Switch legs and repeat.
• Hip stretch – Place the back of a chair against the wall for support and stand facing the chair. Raise your left foot up and rest it flat on the chair, with your knee bent. (Or try placing your foot on a stair while holding the railing for balance.) Keeping your spine as neutral as possible, press your pelvis forward gently until you feel a stretch at the top of your right thigh. Your pelvis will move forward only a little. Hold for 20 to 30 seconds. Switch legs and repeat.

Help Guide's Treatment for restless legs syndrome (RLS):

If self-help doesn’t relieve your restless legs syndrome symptoms, you may benefit from visiting a doctor or a sleep specialist.

Diagnosing restless legs syndrome (RLS)

While there are no laboratory tests that can determine if you have restless legs syndrome, your doctor can diagnose it by reviewing your medical history and conducting a physical exam. To diagnose RLS, your doctor will request:

• A complete medical history
• A survey to see if anyone else in your family has similar symptoms
• A diagnostic interview, to rule out other medical conditions
• A blood test for low iron levels

Your doctor may also review the medications you’re taking as some prescription and over–the–counter drugs can make the symptoms of restless legs syndrome worse.

Help Guide's Medications that can make restless legs syndrome (RLS) worse:

• Over-the-counter sleeping pills
• Antihistamines (found in many cold and allergy pills such as Benadryl, NyQuil, and Dimetapp)
• Anti-nausea medications (such as Antivert, Compazine, and Dramamine)
• Calcium channel blockers (used for high blood pressure and heart problems)
• Antidepressants (such as Prozac, Effexor, and Lexapro)
• Antipsychotics (used for bipolar disorder and schizophrenia)

If a medical condition, such as iron deficiency, diabetes, or nerve damage is triggering your restless legs syndrome, treating the underlying problem may relieve your RLS symptoms. But if there is no underlying condition and lifestyle changes don’t bring enough relief, you may need medication to reduce the restlessness in your legs.

Help Guide's Medication as treatment for restless legs syndrome (RLS):

No single medication works for everyone with restless legs syndrome. In fact, a drug that relieves one person’s restless legs may actually make your symptoms worse. In addition, many people with restless legs syndrome find that medications that work initially become less effective over time.
It’s also important to be aware of potential side effects, such as nausea, headache, and daytime sleepiness. If you struggle with compulsive shopping, gambling, or binge eating there is also a risk that medication for RLS could make these problems worse.

Before using medication for the treatment of restless legs syndrome (RLS)

Have you…

• given self-help a fair shot with non-medication treatments?
• considered how medication side effects may impact your life?
• weighed the pros and cons of medication vs. lifestyle changes?
• talked to your doctor about existing health conditions and drugs you’re taking?

Parkinson’s medication for restless legs syndrome (RLS):

The US Food and Drug Administration (FDA) has approved three Parkinson's medications for the treatment of restless legs syndrome, with the latest addition, the dermal patch Neupro, approved in April, 2012. The three are:

•  Pramipexole (Mirapex)
•  Ropinirole (Requip)
•  Rotigotine Transdermal System (Neupro)

Medications Used to Treat Restless Legs

Other Parkinson’s drugs that are sometimes used to treat RLS include Sinemet (carbidopa/levodopa), cabergoline and pergolide. Side effects of Parkinson's medications for restless legs syndrome include nausea, lightheadedness, fatigue, and an increased risk of heart disease.

Help Guide's Other common medications for restless legs syndrome (RLS):

• Prescription painkillers (such as codeine, oxycodone, Vicodin, and Percocet) can provide relief in severe, unrelenting cases of restless legs syndrome. However, prescription painkillers can be addictive. Side effects include nausea, dizziness, and constipation.
• Sleep medications and muscle relaxants (such as Ambien, Sonata, and Klonopin) can help you sleep better if the symptoms of restless legs syndrome keep you up at night. However, these medications do not eliminate the uncomfortable leg sensations and can cause daytime drowsiness.
• Anti-seizure medications (such as Neurontin, Tegretol, and Epitol) can be effective for painful daytime symptoms of restless legs syndrome. Side effects include dizziness and drowsiness.

Conclusion

 

As you can see, there are several ways one can go about in treating restless legs. In my opinion, the most important step one should first take is to determine why they are getting restless legs. Ask yourself if you were experiencing restless legs before, during, and after your use of opiates or rather did they appear right after you began detoxing and withdrawing off opiates. One must determine whether it is the detoxing off of opiates that is causing the restless legs or is it perhaps an underlying condition or symptom of one?

 

It may also be a good idea to get a lab blood test done as deficiencies in certain vitamins or minerals such as Iron can also cause restless legs. The lab blood tests are pretty easy to get done and can tell you and your doctor a lot about what is going on inside your body.

 

In my experience, I have used hot baths, stretching, moderate exercise, and the medication Requip (Ropinirole) to treat bouts of restless legs. Overall, these have provided me with moderate relief but are defiantly not miracle drugs or techniques. I have yet to withdraw and experience withdrawal since being on Suboxone so I can't speak much about how effective the Requip medication is in treating restless legs from opiate withdrawal. As I stated earlier, I actually have Restless Leg Syndrome and can honestly say the Requip has been effective in treating the restless legs but as most of you, opiate withdrawal is an entirely different beast so its effectiveness for this kind of situation remains to be seen.

 

My best advice is to talk with your doctor about what your options are for treating this dreadful withdrawal symptom. Your doctor might be able to prescribe you with something or possibly recommend some things, such as a change in diet, that can help your particular situation and needs.

 

As always Guys, thanks for taking the time to read and participate in my blog. Feel free to leave any comments in the comment section about your experiences with restless legs and what helps/doesn't help in treating this symptom of opiate withdrawal. I look forward to hearing from you guys in the comment section and remember to keep seeing the light!

 

Take Care,

 

Seeingthelight