Replacement limbs & rls?: My rls... - Restless Legs Syn...

Restless Legs Syndrome

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Replacement limbs & rls?

PeterMasih profile image
9 Replies

My rls started after I had a hip replacement. My surgeon assures me there's no connection. Is there any evidence or research on this?

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PeterMasih profile image
PeterMasih
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9 Replies
Pippins2 profile image
Pippins2

Hi Pete,I dont know of any research on this but have heard there is possibility of one RLS expert looking into it as it happens time and time again! At least once a week I hear of someone saying their symptoms started after surgery,not particularly hip replacement but surgery in general.Very often after hip,back and knee surgery.i dont know how soon after your op it started for you ,some say after they were given anti sickness meds and many say after they stopped taking the strong painkillers ,So yes plenty of anecdotal evidence but to my knowledge no legit research.If anyone knows of any they will hopefully come foreward

PeterMasih profile image
PeterMasih

Thanks, Pippins.

Suspected as much

If you had spinal anesthesia rather than general anesthesia for your hip replacement the following article may apply. Scroll down to the section that talks about "medications." Then look at the last red dot thereunder. It indicates that spinal anesthesia can provoke symptoms but will only last at most several months.

ummidtown.org/health/medica...

m1946 profile image
m1946

Like you I had an operation and although I had previously experienced bouts of rls after the operation it became so severe that I felt I had to visit the doctors. Rls prevented me from sleeping until 7am !!!

I was prescribed Ropinirole 1mg which I take around 9.30pm and generally I am able to sleep for 8 hours.

However getting back to your question YES THETE IS MORE RESEARCH NEEDED to find out why surgery seems to make the effects of rls worse!

williesophie profile image
williesophie

exactly the same thing with my husband after partial shoulder replacement...and same response from doctor. I, too, have heard it is the anti-nausea drug added to the anesthetic. The only thing that has helped him after a year of this and that is oxycodone 5 mg 3x daily. yes, there are some side effects but the RLS was unbearable. The doctors MUST hear this a lot, but I am sure they don't want to open that can of worms. The authority is Dr, Mark BuchFuhrer in Downey California and he has a great website and will answer your emails. A wonderful resource. Also this site. good luck.

PeterMasih profile image
PeterMasih

Thanks everyone. Yes I did have a spinal anaesthetic in at least one of my 2 operations. So we may be on to something

PeterMasih profile image
PeterMasih

It's all a bit fuzzy now, but I don't think the problem developed immediately after surgery. So I don't appear to fit the expected pattern. I'm pretty sure the research mentioned in nejm.org/doi/citedby/10.105... would have concluded that I didn't get rls because of the surgery, because they interviewed patients only up to 4 weeks after surgery. I think I was still on pain killers at that stage.

in reply to PeterMasih

You probably have to think this thru and decide if you want to take the dopamine agonists or try to gut it out. I'm not sure why with someone people it disappears after a few months after the spinal and for some it doesn't. My theory on how this works is that the anesthesized spine (aka the central nervous system) isn't very good at transporting dopamine (the substance that relaxes our legs) to our peripheral nervous system. You may have a genetic predisposition and you're fine but add one little bump in the road (a numb CNS) and you have RLS. I am genetically pre-disposed to RLS as well. All I have to do is take one antacid, one Benedryl, or one antidepressant, or melatonin, and I have restless body for the night. I believe these substances compete with the transport of dopamine or more likely iron in the brain. Supposedly our brains have plenty of dopamine (unlike Parkinson's patients) but our d2 receptors (the portholes through which dopamine passes on its way to the CNS) are VERY shoddy and only get more shoddy with age. So whereas must people have a nice flow of dopamine going down their spine we have a drip, at least that's how I picture it. That drip may be just fine and certainly enough to relax our legs and arms but throw it one curve ball (spinal anesthesia) and we're down and out for the count.

PeterMasih profile image
PeterMasih

This all started 5 years ago. I'm on Ropinirole which works reasonably well for me - except for the problem of feeling pretty weird for the hour after taking it... and augmentation - I'm up to 2.5mg nightly now. My mum also suffers from rls, so there's probably a genetic element. Though I started with rls a lot earlier in life than she did.

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