Compression Devices Bring Non-Invasive, Non-Drug Relief from Restless Legs Syndrome

There’s new hope that people who suffer with restless legs syndrome (or RLS) may be able to get a good night’s sleep. This strange-but-true malady makes it all but impossible to sleep soundly and has been frustratingly difficult to treat. Some medications help some people, but they have numerous side effects. However, when one woman’s RLS problem was coincidentally calmed by post-surgical treatment for a different problem, researchers investigated and found that, indeed, using a compression device that applies pressure to the legs at regular intervals can alleviate RLS. Here are the details…

A NEW USE FOR A COMMON MEDICAL DEVICE

The pneumatic compression device (PCD) is a common piece of medical equipment in hospitals, typically used to prevent blood clots in the legs of patients who are sedentary and at risk for clot formation, such as those who have recently had surgery. Patients wear leg wraps attached to the PCD, which periodically squeezes their legs to stimulate blood flow.

When a woman with restless legs syndrome had a hip replacement, her RLS symptoms vanished when she was treated post-surgically with the pneumatic compression device, recounts Arn H. Eliasson, MD, Colonel in the United States Army (Retired) at Walter Reed Army Medical Center in Washington, DC. Since her symptoms returned when she went home, she attributed the surprising “holiday” from RLS to the PCD. The hospital lent her a PCD to use at home and again, the problem went away.

“We were convinced she was on to something so we began our first study in 10 patients,” reports Dr. Eliasson. In the initial trial, nine out of 10 people had a positive response to PCDs. Next he and his colleagues at Walter Reed randomly assigned 35 RLS patients to wear sham pneumatic compression devices for at least one hour daily, delivering squeezes to the legs for five seconds every minute. The participants kept daily logs of PCD use, RLS symptoms and estimates of their RLS-related sleep loss. Assessing them before treatment and after one month of therapy, researchers found that…

  • About a third of those using pneumatic compression devices for at least an hour each day got complete relief of RLS symptoms, compared with none in the sham group. According to Dr. Eliasson, “many patients report a prolonged RLS symptom holiday even after ceasing use of PCDs — we don’t know how long this holiday tends to last, nor can we predict who will get it. This is fertile territory for future investigations.”
  • Patients treated with PCDs also reported significantly greater relief from RLS symptoms and improvements in daytime function, daytime sleepiness, sleep quality, emotional well-being and quality of life.

Results of this study were published in the January 2009 issue of Chest.

SAFE AND EFFECTIVE — BUT INSURANCE DOES NOT COVER IT

Though it’s not known exactly how compression devices relieve RLS symptoms, one theory is that they work by relieving poor blood flow and peripheral edema (severe swelling and fluid build-up) in the legs. The devices are unwieldy but not uncomfortable, says Dr. Eliasson. The leg wraps must be worn while sedentary, which most people find convenient in the evening — you can wear them while eating, reading, working on the computer or watching TV. Dr. Eliasson advises patients to wear the leg wraps for an hour before symptoms make their usual appearance, which is typically at night while you sleep.

Unfortunately, at present PCDs are not readily available outside the hospital… and even if you are able to get one from your local hospital or physician, it’s unlikely to be covered by your insurance company since it is not approved for RLS. Dr. Eliasson notes that these studies are promising but further research is required, adding that there have been no adverse reactions and studies have shown compression therapy to be safe and effective. So, if you suffer from RLS and can figure out how to get a PCD, it may be worthwhile to give it a try.

Alternatively, until regulations and availability change, several of Dr. Eliasson’s patients have achieved good results with similar-acting devices called “massage boots” sold at many drugstores and online (e.g., http://www.tesco-shopping.com/Massage_Boots.htm), which cost about $150.