Inflammation and RLS redux

[nocturne]

I've both queried and written about the possible roles that inflammation plays in RLS, but wanted to share what I recently learned, which again indicates that the relationship between the two is complicated.

I was recently on methyl prednisone for a few days to calm down post-surgery inflammation and pain, and my RLS got a LOT worse. I normally take 1 or at most 2 codeine-Tylenol #3 pills per night for RLS, but they had no effect. It turns out that prednisone counteracts opioids, which explains why codeine stopped working. But the bigger issue is: prednisone is a powerful anti-inflammatory. If inflammation exacerbates RLS, prednisone should have made it better, not worse. I've seen a tiny number of articles discussing the comorbidity of RLS with autoimmune and other inflammatory conditions, including this one that states that steroids do improve RLS in some: sciencedirect.com/science/a...

But in my case, steroids made things unbearable. So, I think this whole issue is more complicated than sometimes thought. I think there's also a mind-bogglingly high degree of individual variances with this condition. For example, there's the conventional wisdom that alcohol exacerbates RLS. But I have no RLS if I drink a glass of wine with dinner. But alas, I can't have much because it causes joint pain (yup, inflammation). Go figure.

[Joolsg]

Likewise. Whenever I've been put on steroids for my MS attacks in the past, my RLS became much worse. (I was on DAs the last time I took them).And, like you, alcohol isn't a trigger for me. Nor is caffeine and coffee. They actually improve my RLS.

I totally agree with you. One size does not fit all with RLS. We all respond differently to meds/diets/triggers/iron therapy and there do seem to be several causes. Until billions are spent on research, like in other neurological diseases ( MS, PD) we won't discover the many, many causes or find new therapies.

[nocturne in reply to Joolsg]

Omg, thank you so much for sharing! I was feeling like a totally anomaly, so I appreciate your validation.

[Graham3196 in reply to nocturne]

Its almost enough to make you wish for a broken leg, easy to diagnose and easy to fix!

We are all anomalies.

[nocturne in reply to Graham3196]

I know what you mean, but you might get anti-inflammatories for the swelling from the broken leg, which may or may not make the RLS worse, etc. Ugh, it never ends.

[Graham3196 in reply to Graham3196]

Your a real pessimist. I was optimistically thinking of a swap service. I guess it would be just another shambles You'd ask to swap RLS for a broken leg and they'd give you some horrible worse disease or break your right arm by mistake

[nocturne in reply to Graham3196]

Haha, if the swap service is anything like some doctors, you very well might end up with much worse. But seriously, I'm so sorry that your RLS is bad enough to fantasize about a broken leg. : ( I hope you find relief soon.

[Graham3196 in reply to nocturne]

Thanks but seriously I'm doing alright with a strict diet and, just recently, 100mg of Gabapentin.

[nocturne in reply to Graham3196]

Congrats on keeping it under control with minimum meds!

[jebsat]

agree...One doc prescribed a course of steroids for me as she thought my RLS pain was shinsplints...another story...and my legs were perfect for about 2-3 nights and then back to the usual. And alcohol gives me bit of relief from RLS. But of course I'm not going to drink every night.

[nocturne]

Hahaha, don't we wish we could drink ever night! : ) Thank you for letting me know that you experienced worsening with steroids, too.

[RLSLearner]

Thanks for sharing. Yep so complicated and variable. I think one day we will have RLS type 1, type 2, type 3 ...