Restless Legs Syndrome: Medical cannabis as a therapy option
People with restless legs syndrome (RLS) complain of a strong urge to move their legs at night. Mostly also about tingling and aching legs. This is known as restless legs syndrome (RLS), a frequently occurring neurological disease.
The study situation regarding the therapy with medical cannabis for movement disorders is not yet clear. However, the results so far are promising.
Restless Legs Syndrome: typical symptoms
As its name suggests, the main symptom of this condition is to have restless legs. Those people affected by restless legs syndrome feel the urge to move their legs constantly. In addition, unpleasant feelings or sensations such as pulling or tingling in the legs can also occur. Frequently, cramp-like complaints and pain also occur.
Basically, patients experience RLS differently. While for some the urge to move is particularly agonizing, others suffer more from the sensations. In addition, both legs are not always affected at the same time. Thus, the complaints can occur in only one leg or they occur alternating in both legs.
However, it is typical for RLS that the symptoms worsen in sitting and lying down. Movements, on the other hand, provide relief. The following symptoms may also accompany the disease:
- Difficulty falling asleep and sleeping through the night
- Tiredness during the day
- Concentration disorders
Restless Legs Syndrome: What are the causes?
So far, the exact causes have not been clarified. Researchers suspect that the dopamine metabolism in the brain might be disturbed – similar to Parkinson’s disease, which also causes movement disorders. As a result of this disorder, the transmission of nerve signals can be defective. But a disturbance in the brain stem and cerebellum could also be the cause.
An inherited component may also be a possible cause. In the meantime, a gene has been identified that could be involved in the development of the neurological disease. However, the exact connections have not yet been clarified. It is also questionable whether this is the sole cause.
What forms of restless legs syndrome are there?
RLS distinguishes between the following two forms:
- Primary Restless Legs Syndrome (idiopathic form): The causes are not known here.
- Secondary restless legs syndrome: In the secondary form, the disease occurs as a result of other diseases. For example, the diseases diabetes mellitus, polyneuropathy, multiple sclerosis, Parkinson’s syndrome or thyroid dysfunction can trigger RLS. However, vitamin B12 deficiency, folic acid deficiency or iron deficiency can also be the cause.
What medications can cause restless legs syndrome?
It is now known that certain drugs can also trigger or even aggravate the syndrome. This is especially true for drugs that interfere with the brain metabolism. These include, for example, drugs with a mood-lifting effect (antidepressants).
Restless Legs Syndrome: diagnosis and therapy
The diagnosis is based on the typical RLS symptoms:
- The urge to move the legs only manifests itself at rest.
- The urge to move increases in resting phases.
- Sensations such as tingling, pulling or pain in the legs occur.
- The RLS symptoms are more pronounced in the evening or at night.
In addition, a blood test is carried out to rule out possible deficiencies. An extensive neurological examination is also necessary.
To confirm the diagnosis, doctors often carry out a so-called L-Dopa test. If the RLS symptoms improve while taking L-Dopa, this can confirm the diagnosis. If the symptoms do not improve, this does not mean yet that RLS is not present. This is because the connections between RLS and dopamine metabolism have not yet been definitively clarified.
The treatment of restless legs depends on how severe the symptoms are and how much the patient suffers. If it is possible triggering diseases have been excluded, the patient can be prescribed an L-dopa preparation (e.g. levodopa). It is also possible to combine the active substances levodopa and benserazide, as well as drug therapy with dopamine agonists (e.g. ropinirole, pramipexole or rotigotine). Dopamine agonists can imitate the messenger substance dopamine and thus develop a dopamine-like effect.
If it is a very pronounced and painful form of RLS, patients are sometimes prescribed anti-epileptic drugs or strong painkillers (opioids).
What helps against restless legs syndrome?
If the syndrome is mild to moderate, patients can help themselves with various measures. For example, many RLS patients report that foot baths, alternating showers and leg massages can alleviate the symptoms. Stretching exercises and regular sport can also help to alleviate symptoms. Patients should also avoid alcohol, caffeinated drinks and nicotine before going to bed, as these substances can increase the symptoms.
Furthermore, the intake of vitamin B12, folic acid and iron could also have a beneficial effect. However, this should be discussed in advance with the doctor treating you.
Medical cannabis as a therapy option
Clinical studies on the use of medical cannabis in restless legs syndrome are very few and far between. Nevertheless, these few studies are promising. At the Université de Bordeaux in France there was a case study with six RLS patients who used cannabis to relieve the symptoms (1). Five of the patients reported that the symptoms disappeared almost completely after cannabis use. One patient even spoke of complete remission. The patients further explained that the quality of sleep improved significantly under cannabis use.
Interesting is also a study from the Universidad Complutense de Madrid. It is known that cannabinoids from the cannabis plant such as delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) interact with the cannabinoid receptors (CB1 and CB2 receptors) of the endocannabinoid system. The researchers found indications that this could also regulate dopamine release. This dopamine regulation has already been shown to be effective in the treatment of movement disorders, for example in Parkinson’s disease.
Cannabidiol (CBD) against restless legs
Various studies suggest that the non-psychoactive cannabinoid cannabidiol (CBD) may relieve symptoms such as tremor, anxiety and sleep disturbances. The use of CBD in restless legs syndrome could be considered as a solution to the anxiety and sleep problems (2).
With regard to CBD and movement disorders, the study results are inconclusive. For example, in one study, Parkinson’s patients did not experience symptom relief from CBD therapy (3). The researchers believe that CBD might play less of a therapeutic role, but could be used preventively in Parkinson’s Disease. Further research is needed, however.
The current study data are not yet sufficient to draw conclusions regarding the movement disorders associated with restless legs syndrome. Despite the widespread publicity about the medical benefits of cannabinoids, further pre-clinical and clinical studies are necessary to better characterize the pharmacological and therapeutic effects.
(1) Département de Neurophysiologie Clinique, France, Megelin T1, Ghorayeb I2, 2017, “Cannabis for restless legs syndrome: a report of six patients”
Alexandra Latour verfügt über langjähre Erfahrungen als Autorin im medizinischen Bereich. Ab dem Jahr 2017 hat sie sich als Medical Writer auf das Thema Cannabis als Medizin spezialisiert und war für Leafly Deutschland tätig.
Clinical studies on the use of medical cannabis in restless legs syndrome are very few and far between. Nevertheless, these few studies are promising.
Does Cannabis Relieve Symptoms Of Restless Leg Syndrome (RLS)?
Restless leg syndrome (RLS) is a neurological condition that can severely impact one’s quality of life. Here’s the latest on using cannabis to treat the symptoms of restless leg syndrome.
For many people who suffer from restless leg syndrome (RLS), the worst part about the condition is not just the uncomfortable sensations they have to endure. Often times, RLS can have serious implications on one’s overall quality of life. In this domain, research is now suggesting that cannabis may provide relief from some RLS symptoms.
WHAT IS RESTLESS LEG SYNDROME?
Restless leg syndrome (RLS), sometimes referred to as Willis-Ekbom Disease or Wittmaack-Ekbom Syndrome, is a condition where people experience tingling and itching sensations in their legs, with an irresistible urge to move them. The syndrome was discovered and classified by Swedish neurologist Dr. Karl-Axel Ekbom in 1943.
RLS can affect people of all ages in various ways, although the symptoms often get more pronounced with age. Moreover, symptoms are usually at their worst when people are sitting or lying down; moving around can provide a certain degree of relief. Then again, RLS doesn’t affect everyone the same. There are also those symptoms that are not eased by moving about, such as any combination of:
- Unpleasant sensations of tingling, itching, or sensations like “ants crawling” on the legs
- Restlessness, tossing and turning in bed paired with sleeping problems
- Involuntary twitching and jolting of the legs during sleep or waking hours
- A constant urge to move the legs to relieve uncomfortable sensations
- Fatigue and sleepiness
What causes RLS is not exactly known, although it is believed that it can develop as a side effect from certain medications. Since it is unclear what the root cause of restless leg syndrome is, this also means that there are currently no effective ways to prevent it—but there are ways to alleviate the symptoms.
HOW RLS CAN AFFECT LIFESTYLE
One of the most frustrating aspects of this condition is that symptoms tend to worsen in the evening. Because of that, sufferers often have serious problems falling asleep and/or frequently waking up at night. As a result, RLS can sustain a huge impact on one’s quality of life.
But lack of sleep is not the only way RLS affects peoples’ lives; the pain and discomfort experienced can be enough for sufferers to avoid social gatherings where they would need to sit or stand for an extended time. As people are forced to withdraw from their social life, this can lead to isolation, anxiety, and depression.
It is estimated that up to 10% of people in the United States are affected by RLS. Although there is no cure for this condition, evidence is now mounting that cannabis can possibly help relieve some symptoms.
HOW CANNABIS CAN HELP RELIEVE THE SYMPTOMS OF RLS
Although restless leg syndrome has now been known for quite some time, it is only recently that treating the disorder with alternative methods, including cannabis, has come to the forefront. Previously, the only way to alleviate the symptoms of RLS was to use pharmaceuticals, massages, warm baths, hot and cold compresses, foot wraps, and specific exercises. Recent studies indicate that cannabis may help with RLS as well.
A study  performed at the Clinical Neurosciences Center at Bordeaux University Hospital found medicinal cannabis to alleviate RLS symptoms in a small group of subjects. For the study, six RLS patients were given medical cannabis containing CBD. Five of the six reported that their symptoms entirely disappeared after consuming cannabis. All of the participants in the study reported an improvement in their sleep after their treatment with cannabis ended.
In a study on “Sleep, Pain and Cannabis”  published in 2015 in the Journal of Sleep Disorders and Therapy, researchers mention the proven abilities of cannabis to relieve pain and promote sleep. In their report, the researchers suggest that cannabis could possibly help with such conditions as sleep apnoea or RLS—conditions that involve sleeping troubles and/or pain. However, the researchers do conclude that more research in this area is needed.
Although medical studies on using cannabis to treat RLS symptoms are sparse, there is plenty of anecdotal evidence among RLS patients that it can certainly make coping with the disorder easier. The word is still out on whether cannabis can directly address the underlying causes of the condition, but its relaxing, pain-relieving, and soothing effects may help patients get to sleep, and perhaps reduce some of their anxiety or depression symptoms too.
WHICH CANNABIS STRAINS ARE BEST FOR RLS?
If you want help with RLS, cannabis strains that have a sedating and/or pain-relieving effect can be best. Look for strains that are high in THC (to promote drowsiness) and/or high in CBD (to reduce anxiety) because such strains can help you achieve a good night’s sleep.
For fast relief, you can just smoke or vape these strains to enjoy their sedative and pain-relieving properties. You can also make them into edibles, oils, or even topical ointments so you have a variety of methods at hand. You can then keep track of which methods work best for you!
We recommend these cannabis strains if you’re seeking relief from RLS:
Purple Queen is a gorgeous indica-dominant Kush variety that can provide you with a deeply relaxing physical stone. Dreamland will not be far away after a few tokes of this one.
SPECIAL KUSH #1
Special Kush is another good candidate if you need help with RLS symptoms. This modern variant of an old-school Kush has a hash-like flavour and serious indica dominance (80%). Expect a robust body stone that relaxes the limbs and gently eases you off to sleep.
TREATING RLS WITH CANNABIS—THE TAKEAWAY
Even as we wait for more studies to unveil cannabis’ full potential for treating restless leg syndrome, many patients say it’s worth it to experiment with the herb to find relief. Anecdotal accounts may not be entirely verifiable, but the success stories are certainly growing in number. Hopefully, we can look forward to more research on treating RLS with cannabis in the near future.
Restless leg syndrome can be more than an inconvenience—it can completely disrupt your lifestyle. Is cannabis able to provide relief from RLS symptoms?