RLS: Chronic, Progressive, Often Misunderstood

According to the National Institute of Neurological Disorders and Stroke (NINDS), Restless Legs Syndrome (RLS) is a chronic, progressive neurological-based movement disorder that affects an estimated 10% of the U.S. population, or approximately 12 million Americans. RLS is particularly prevalent in older people and in those with other serious health conditions, including diabetics and people on dialysis. RLS also occurs more frequently in expectant mothers than in the average adult population. Sometimes known as Willis-Ekbom Disease, RLS causes people to experience paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), including throbbing, pulling, creeping, and pain in the limbs, as well as uncontrollable and sometimes overwhelming urges to move the legs. NINDS reports that some physicians may misdiagnose RLS symptoms, wrongly attributing them to nervousness, insomnia, stress, arthritis, muscle cramps, or simply “aging.”[1] Initially, RLS attacks may occur occasionally, but the progressive nature of the condition typically leads to attacks that increase in both frequency and severity over time. In serious cases, the severity of an RLS attack will jolt the patient awake from deep slumber. Chronic RLS patients often report multiple episodes of sleep disruption in a single night, occurring over many consecutive nights.

 

RLS Reduces Patients’ Quality of Life

RLS symptoms occur primarily when the person is lying down, resting and sleeping. Long periods of sitting or physical inactivity may also trigger or contribute to worsening RLS symptoms. As a result, many RLS patients begin to experience social isolation, eschewing car and airplane trips, and avoiding events where they might experience symptoms, such as dining in restaurants, attending movies or theatrical productions, or participating in social gatherings. The documented impacts on RLS patients’ reduced quality of life resulting from their condition include[2]:

  • Increased fatigue
  • Impaired memory and cognitive functioning
  • Impaired work performance
  • Drowsy driving
  • Reduced social life

 

Medication Therapy: Shortcomings

While medication therapy is often considered the first treatment option, most of the drugs prescribed to treat RLS have not been shown to effectively eradicate RLS. The medications most commonly prescribed for RLS include:

  • Dopaminergic agents, traditionally used to treat movement disorders such as Parkinson’s disease (e.g. levodopa, carbidopa)
  • Anti-convulsants (e.g. gabapentin, pregabalin)
  • Narcotic opioids (e.g. hydrocodone, oxycodone, codeine)
  • Muscle relaxants
  • Hypnotics such Benzodiazepines (e.g. diazepam [Valium], clonazepam [Clonipin], and alprazolam [Xanax])

Unfortunately, these drugs serve primarily to sedate the patient. They also are documented to produce many undesired side effects in patients, including debilitating dizziness and nausea, as well as potentially significant increased risk for such conditions as hypertension, obesity, heart disease, and diabetes over the longer term.

 

Augmentation: Medications’ Effectiveness Declines

Furthermore, the drugs typically prescribed to treat RLS have been found to actually worsen many patients’ RLS symptoms over time, despite initially providing relief.[3] This progressive worsening, known as augmentation, may cause the RLS patient to experience symptoms earlier and earlier in the day, until they are occurring around-the-clock. Their evening RLS symptoms also tend to increase in intensity. Options for addressing augmentation usually include increasing the RLS patient’s overall medication doses, creating “drug cocktails” by adding additional drugs to the treatment regimen, and prescribing multiple dosing regimens so patients begin taking medications more frequently throughout the day. All of these practices, however, may increase patients’ overall risk of side effects and potentially dangerous interactions with any other medications they may be taking.

 

Dependency and Addiction Risk

In addition, many of the drugs prescribed for RLS present the potential for dependency and addiction. Of particular concern are narcotic opioids, including hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs.

Skyrocketing rates of opioid-related dependency and deaths in the U.S. recently led the U.S. Centers for Disease Control to issue new prescribing guidelines on this category of medications. The guidelines recommend having patients try non-opioid medication options first, prescribing the lowest possible dosages, and limiting the length of time patients take these medications.[4] In addition, the guidelines stress that patients on opioid medications should not also be taking benzodiazepines, which increase the risk of life-threatening respiratory issues, as well as drug dependency and misuse.[5]

 

Relaxis: The Only Device to Undergo Double-Blinded, Randomized, Multi-Center, Controlled Clinical Trials & Attain FDA-Clearance as a Non-Medication Treatment Option

Because of the myriad issues associated with medication therapy, some clinicians now recommend their patients try Relaxis first to treat their RLS symptoms. As an FDA-cleared, drug-free treatment alternative for RLS, Relaxis provides a highly calibrated range of therapeutic vibratory counterstimulation, which has been documented to effectively address RLS patients’ symptoms. Relaxis, which is available by prescription only, has demonstrated proven efficacy in treating RLS symptoms and improving sleep quality in patients with primary RLS according to the results from two clinical studies, which have been published in a peer-reviewed medical journal.[6]

 

Advantages of Relaxis

  • Proven Safety and Efficacy. Relaxis has been clinically documented as improving the quality of sleep in people with chronic RLS. Over 90% of people who use Relaxis report experiencing relief from their RLS symptoms.*
  • Economical. Relaxis requires a single, one-time payment, as opposed to the regular and continuous co-pays required with drug refills.
  • Patient-Controlled. Patients use Relaxis only when needed, rather than taking daily (or multiple daily) doses of medication.
  • Side Effect-Free. Relaxis is a medical device that presents none of the negative side effects or risk of drug interactions associated with the medications typically prescribed to treat RLS.
  • Addiction Risk-Free. There have been no documented cases of patients’ addiction to or dependency upon Relaxis. This is not true with many RLS drugs, which can present high risk of dependency, addiction, and abuse.

 

Learn More

If you would like to know more about Relaxis as a treatment option for your patients suffering from primary RLS, please contact us at customerservice@myrelaxis.com or 888-475-7435.

[1] http://www.ninds.nih.gov/disorders/restless_legs/rls_brochure_508comp.pdf

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671944/

[3] http://www.ninds.nih.gov/disorders/restless_legs/rls_brochure_508comp.pdf

[4] https://jama.jamanetwork.com/article.aspx?articleid=2503508

[5] http://www.cdc.gov/drugoverdose/pdf/PDO_Checklist-a.pdf

[6] Burbank et al., “Improving sleep for patients with restless legs syndrome. Part II: meta-analysis of vibration therapy and drugs approved by the FDA for treatment of restless legs syndrome,” Jnl of Parkinsonism and Restless Leg Syndrome, Vol 2013:3. http://www.dovepress.com/articles.php?article_id=12636

 

*This data does not include patients who are averse to vibration (about 10%). Relaxis is not appropriate for patients who dislike the sensation of vibration.

Download a brochure to share with your patients:

Mark Buchfuhrer, M.D. Talks About Relaxis: