Back pain and RLS

[Tennis52]

I have lower back pain which varies in severity during the year. These days it’s high and bothers me more at night. I get pain in both legs in the buttocks thighs and calfs. It disturbs my sleep and is also accompanied usually by itching sensation in the scrotum.

im confused whether the legs pain is due to my back issue or due to RLS.

As such I don’t know if I should take pregabalin which might resolve the issue.

for the back I do certain exercises and walk and I can manage the pain during the day. But I need to do something about the sleep at night.

I would be grateful for some expert advice.

[SueJohnson]

What does your doctor for your back say? Have you had an MRI? Nerves can be compressed which can cause the pain you are experiencing. Leg pain can also be caused by RLS. Pregabalin treats both RLS and nerve pain.

Is your RLS controlled otherwise? What are you doing or taking to control it or attempt to control it?

[Tennis52 in reply to SueJohnson]

Thank you Sue.

Yes I’ve had MRI and there is deterioration in l4,L5,S1 and I’m doing rehab exercises.

My RLS symptoms are old also and I cope with it by getting up at night and stretching. I’m not comfortable with taking medicines. I did try pregabalin a few years ago and things did improve but for fear of side effects I discontinued it after some months.

Now I’m thinking of starting again. Since you say it treats both conditions.

[SueJohnson in reply to Tennis52]

I have the pain in my calves from spinal stenosis caused by compression of the nerves diagnosed by an MRI which is why I asked. I sleep on my stomach and was advised to put a pillow under my hips to take the pressure off and ir works.

My RLS is controlled by gabapentin which is basically the same as pregabalin. If you didn't have any side effects you couldn't live with on the pregabalin then you don't need to be afraid of them. Beginning dose is usually 75 mg pregabalin. It will take 3 weeks before it is fully effective. After that increase it by 25 mg every couple of days until you find the dose that works for you. Take it 1 to 2 hours before bedtime as the peak plasma level is 2 hours. Most of the side effects will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require200 to 300 mg pregabalin." Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it at Https://mayoclinicproceedings.org/a...

Have you had your ferritin checked? If so, what was it? Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including multivitamins that have iron in them 48 hours before the test, don't eat a heavy meat meal the night before, fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.

It's interesting that you mention stretching. When I used to get RLS I did the exercises for the leg involved as described under calf stretch and front thigh stretch at healthline.com/health/restl.... In addition, I walked for about 3 to 4 minutes rolling the foot of the leg affected back and forth as I walked. It worked every time although I might wake up later at night and have to do them again. Actually on the calf stretch I didn't hold it for 20 seconds, but instead did the exercise for 20 - 30 times. I also pushed my heel back before I leaned forward. I, also moved my leg to each side when it is stretched. On the thigh stretch, I only held it for a few seconds, but then repeated it 6 - 10 times.

Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, eating late at night, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices, using a standing desk, listening to music, meditation and yoga. Keep a food diary to see if any food make your RLS worse

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.