RESTLESS LEG SYNDROME

RESTLESS LEG SYNDROME:

Cannabis and Restless Leg Syndrome 

Whittney Wacker, BSN, RN, Leaf411 Agent

Eloise Theisen, MSN, RN, AGPCNP-BC, Leaf411 CNO

Restless Leg Syndrome (RLS), also known as Willis-Ekbom disease, is a condition that is characterized by unpleasant sensory and motor abnormalities of one or both legs1. It is often accompanied by an uncontrollable urge to move the legs, especially at night and can impact a person’s quality of sleep. Other symptoms include abnormal sensations such as achiness, itching, throbbing, creeping and crawling and possible jerking of the limbs. Often a person with RLS needs to move the legs by walking around to relieve the symptoms. It is estimated that 7-10% of the population suffers from RLS. While it can affect someone at any age, it is most common in older adults and tends to affect women more than men2. 

There are two main types of this disease, primary (unknown origin) and secondary. Exact origins of primary types may be unknown, but a positive family history may indicate the propensity for diagnosis in certain individuals. It is also believed that primary RLS could be related to dopamine dysfunction, putting those with Parkinson’s disease at greater risk of developing RLS. Secondary RLS is thought to be associated with other underlying conditions such as iron-deficiency, end stage renal disease, pregnancy, neuropathy, excessive use of alcohol, nicotine or caffeine and some medications like anti-nausea, antidepressants and antihistamines2. 

Diagnosing RLS is done through a clinician by performing a thorough health history and reviewing criteria that is most likely to lead to a diagnosis of RLS.

The 5 areas assessed are as follows2:

1) desire to move the extremities, often associated with numbness and tingling or other unpleasant sensations. 

2) motor restlessness that is only partially relieved by movement.

3) worsening of symptoms at rest or with inactivity.

4) worsening symptoms especially in the evening or at night.

5) the above are not related to any other underlying medical condition.

Once a diagnosis of RLS is confirmed, treatment consists of lifestyle and diet changes as well as prescription medications. Iron supplements may be helpful if someone is anemic and other medications like antiseizure medications, opioids, benzodiazepines and dopaminergic agents may be prescribed. 

Currently, cannabinoids are not a recommended treatment for RLS, but that doesn’t mean they cannot be helpful. The research for cannabis and RLS is sparse with only 3 primary meta analysis studies evaluating cannabis efficacy. Cannabinoids have been shown to be effective with muscle spasms and chronic neuropathic pain which can be helpful in RLS3. There is also evidence to suggest that cannabinoids can be effective in sleep disturbances3. 

Determining the right amount of cannabis, the proper cannabinoid to start with and the best route of administration can take some time if you are new to cannabis. Working with a knowledgeable cannabis healthcare professional can help you get on the right track quicker which improves results and saves time and money. Our nurses at Leaf411 answer questions like this on the hotline and help consumers discover the proper product, dose and route for their symptoms. With proper guidance, cannabinoids may be a safe and effective treatment for RLS.

1)  Medical-Surgical Nursing: Assessment and Management of Clinical Problems.” Medical-Surgical Nursing: Assessment and Management of Clinical Problems, by Sharon Lewis et al., 9th ed., vol. 2, Mosby, 2014, pp. 1427–1428. 

2) National Institute of Neurological Disorders and Strokes, 2020. Restless Leg Syndrome Fact Sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet#3.

3) https://www.nap.edu/resource/24625/Cannabis_committee_conclusions.pdf