Restless legs syndrome (RLS) is classified as a neurological disorder that can affect anyone of all ages. It becomes most painful when a person ages. Sometimes RLS is referred to as Willis-Ekbom’s disease or Wittmaack-Ekbom’s syndrome. Both names come from, among others, one of the first physicians to discover and identify RLS in 1943, Dr. Karl-Axel Ekbom.
To qualify as RLS, a patient must meet five specific criteria. First, he needs to feel a strong need to move his legs, usually accompanied by an unpleasant feeling of subcutaneous crawling on his legs. Secondly, the willingness to move the leg must increase during periods of prolonged rest or inactivity. Thirdly, leg movement must relieve at least some of the unpleasant sensations. Fourthly, RLS must happen most often at night. Fifthly and finally, the need to move the legs cannot be explained by any other medical or psychological condition.
As you can see, restless leg syndrome is more than just an irritation for the patient. It usually leads to sleep problems, making the body more susceptible to disease, irritable moods and reduced mental function. It’s a condition that can weaken the quality of life of the patient, causing not only drowsiness during the day, reduced immune functions, but also greater stress and a general decline in health.
Despite this long list of conditions to be met, RLS is unfortunately quite common. This disorder affects about ten percent of the world population. It can start early in life for unknown reasons or develop later, caused by factors such as poor diet (insufficient magnesium or iron), lack of physical activity and even as a side effect of certain drugs.
Most cases of RLS occur for no apparent reason. It may be genetic when doctors discover it in many members of the family who have symptoms before the age of 40 (such cases are called idiopathic or primary RLS). In other cases, doctors blame inadequate levels of dopamine and glutamate in the body. Finally, RLS appears as a symptom of an undiagnosed state of health, such as iron deficiency anemia or kidney failure. In such cases, doctors call RLS secondary disease, which is equally common in pregnant women and disappears shortly after birth.
What are the most common symptoms people with RLS experience? These are: painful spasms in the leg muscles, usually in the calves, annoying feeling of worms crawling on the legs, tingling, itching, burning or pulsing in the legs, the feeling as if the blood vessels in the legs were full of sparkling water, an overwhelming need to move the feet and legs. The effects of these symptoms may be mild or completely unbearable. Patients with RLS showing these symptoms in 80-90% of cases also suffer from PLMS, i.e. periodic movement of the limbs during sleep.
That was the case with Adam, who’s 61 years old and he’s suffering from RLS. The doctors prescribed him strong opioids, Oxycontin (which is often called “heroin for the poor) but they were working only for short periods of time and Adam was feeling high all the time. No, it wasn’t the pleasant type of high at all. He had trouble communicating with his family, he was sleepy all day long. He decided to go to his aunt in Quebec and mail order marijuana in Canada. When he smoked a joint all the pain disappeared for 3 consecutive days! That’s how Adam discovered CBD and its potential to treat restless legs syndrome, without any nasty side effects.
Since there is no cure for anxious leg syndrome, specialists focus on treating or alleviating symptoms. Many prescribed medications have their own unpleasant side effects. Opioids, benzodiazepines and antiepileptic drugs reduce the feeling of creep, but they can be dangerous or lose their effects if taken over a long period of time. Doctors also prescribe L-dopamine or drugs that increase iron levels in order to give you a feeling of relief. Medicines that simultaneously eliminate dopamine and glutamate imbalances are fortunately quite effective, but some people experience troublesome side effects. About 20% of patients develop impulse control disorders.
New findings recently published in Sleep Medicine Magazine indicate that cannabis use has helped people with severe anxious leg syndrome (RLS) to improve their condition.
To begin with, research shows that CBD acts as a powerful sleep inductor that allows people with chronic pain to sleep at full capacity. Patients with severely disturbed glutamate levels often complain about sleep deprivation. CBD oil can actually support glutamate signaling to reduce RLS symptoms. In addition, due to sleep difficulties, patients with RLS may experience other problems such as anxiety, depression, reduced mental function and wear and tear of the body’s immune system. Fortunately, CBD contains natural anti-anxiety and antidepressant properties. This cannabinoid can also provide the body with antioxidants that can help improve the immune system.
CBD oil also affects dopamine, increasing the number of neurotransmitters in patients’ brains. Stabilizing dopamine levels seems to minimize involuntary movement in people with any movement disorder.
Because CBD oil can directly affect the body’s nervous system, it can also relieve the symptoms of many different neurological disorders such as RLS, Parkinson’s disease and others. It does this through the endocannabinoid system of the body. Cannabinoids act as neural construction workers, re-opening the main paths of the brain, so that neurons and glial cells can better interact with each other. Instead of simply keeping dopamine in the brain as dopamine agonists do, cannabis seems to be improving neural networks involved in cognitive functions, emotions, food, motor control and more. Better infrastructure leads to better results. Some people say that cannabinoids are better than dopamine agonists.
A 2017 study found that inhaled medicinal cannabis reduces the symptoms of RLS. Five out of six subjects claimed to have experienced complete remission of symptoms after cannabis use. At the end of cannabis treatment, all participants experienced improved sleep. Another study found that Sativex (a sublingual cannabis spray that contains CBD and THC in most European countries, officially approved as a pharmaceutical drug) helped 40-50 % of patients with RLS with sleep problems.
Cannabis contains many different chemicals, so it is not clear which of them are beneficial for anxious leg syndrome, but it is suspected that CBD is the key ingredient in cannabis for RLS. Why? Well, CBD has a strong muscle relaxing and nerve calming effect that can really alleviate the discomfort of restless legs. Moreover, like iron and magnesium, CBD can be taken orally or topically on your legs.
So far, there are no clinical trials on the therapeutic properties of cannabis with RLS. There is currently one company trying to develop a type of rubber that may be able to treat RLS. AXIM Biotechnologies, Inc., a world leader in cannabinoid research and development, recently announced that it has entered into a service agreement with the Israeli CRO to launch a clinical trial to confirm the concept of combining cannabidiol and gabapentin in chewing gum as a way to treat restless leg syndrome in patients.
We are already familiar with CBD, but what is this second drug in chewing gum? Gabapentin is often used together with other drugs to reduce epileptic seizures. It can also be valuable in reducing nerve pain when it is a sign of shingles. In some cases, gabapentin causes drowsiness, dizziness, loss of coordination, fatigue, blurred / double vision, unusual eye movements, tremor and/or swelling of hands and feet. Chewing gum AXIM uses a combination of CBD and gabapentin and is now the second phase of this single-centre, double-blind, randomised, randomised study in which its efficacy will be tested in about 30 participants with RLS.
As Dr. Stuart Titus, President of Medical Marijuana, Inc., a major investor in AXIM Biotechnologies, Inc. says: “Research shows that RLS can be associated with abnormalities in the nervous system… We believe that advances in cannabinoid clinical research can be crucial in helping people feel relieved of symptoms due to difficult and debilitating neurological disorders.
Like many breakthroughs in cannabis and cannabinoid research, this one about cannabis use with RLS began after doctors noticed that patients were using cannabis and obtaining results. Maybe the revolution won’t be about better cannabis-based research in the end. Maybe there will be a new practice of listening to patients and taking them seriously?