Sophia

[cheesecake68]

Having a hip replacement operation started a nightmare for me, I have restless legs for 15years but it was pretty mild, now after hip operation, I feel like a zombie. I cannot get any sleep its there during day sometimes.

[Joolsg]

Sadly, hip and knee replacement ops trigger worsening RLS.Often the anti emetic given with the anaesthetic is to blame, or blood loss or stopping the opioid pain medication.

But RLS after stopping opioids should settle within 6 weeks.

When did you have the op?

What medications are you currently taking including over the counter meds?

What is your serum ferritin level?

[cheesecake68 in reply to Joolsg]

Hi, thanks for the reply, I had operation 9 weeks ago, docs been trying me with pramipexole, never done a thing, I've had restless legs for 15 years, I've had ropinorole for a few years, gabapenton for a while, but I never really had it bad, but since the hip Replacement, it's really bad, I get no sleep at night, sometimes I get a few hours during the day, but really getting me down, docs putting me on pregabalin today, never tried it, it's driving me mad, serum levels are 80, hope your OK

[Joolsg in reply to cheesecake68]

Were you put on opioids like Oxycontin for pain relief after the op? Stopping opioids causes withdrawal RLS for at least 6 weeks.Are you still taking Ropinirole?

Serum ferritin between 75 and 100 requires an iv iron infusion.

[SueJohnson]

Welcome to the forum. You will find lots of help, support and understanding here.

As Joolsg said, it is normal to have increased RLS after an operation. In addition to the reasons she gave surgery causes inflammation which makes RLS worse. On the opioid, you should be slowly weaned off it to lessen any withdrawal effects. Ask your doctor if you can get enough to slowly wean off it. But in any case it will get better.

I see you are taking pramipexole. How much are you taking? You might want to increase it temporarily by .125 (.088) mg.

Once everything settles down you would be well advised to get off the pramipexole. Up to 70% of people will eventually suffer augmentation according to the Mayo Clinic Updated Algorithm on RLS which believe me you don't want because it can be hell to come off it and the longer you are on it, the harder it will be to come off it and the more likely your dopamine receptors will be damaged so that the now first line treatment for RLS gabapentin or pregabalin won't work nor might iron and it has been found that suffering from augmentation can lead to painful RLS which you don't want. And one expert believes everyone will eventually suffer augmentation. Check out the Mayo Clinic Updated Algorithm on RLS which discusses augmentation and the latest guidelines on RLS treatment. Https://mayoclinicproceedings.org/a...

Have you had your ferritin checked? If so, what was it? This is the first thing your doctor should have done. 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 in a multivitamin 48 hours before the test, avoid a heavy meat meal the night before and 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.

Some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, artificial sweeteners, carbs, foods high in sodium, foods that cause inflammation, foods high in glutamate, ice cream, eating late at night, oestrogen (estrogen) including HRT, dehydration, electrolyte imbalance, melatonin, Monosodium Glutamate (MSG), collagen supplements, eating late at night, stress and vigorous exercise.

Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennell, low oxalate diet, a low-inflammatory 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, applying a topical magnesium lotion or spray, doing a magnesium salts soak (epsom salts), vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, playing and listening to music, creative hobbies, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any I may be able to provide a safe alternative.

By the way it would really help us to give you advice if you would indicate on your profile what country you live in.

[MemaK]

hi. I take Horizant once daily at 5pm, been on it for 3-4 years and it’s a wonder drug for me. Main ingredient is Gabapentin but coupled with some other drugs too.

I truly feel like it saved my life.

[SueJohnson in reply to MemaK]

That's great but to set the record straight there are no other drugs in Horizant. It is an extended release form of gabapentin.

[Merny5]

Welcome to the forum! After each joint replacement (4) I experienced an uptick in my RLS symptoms. I believe the reason for me was inflammation. After anywhere from 4-8 months it settles down. I’m sure yours will too.