Re: RLS/Spinal Cord

[Guest guest]

Hi June and all

You may well be onto something. After listening to you all for several

years and observing myself, I have reached the conclusion that the

incidence of RLS secondary to abnormalities of the spine is

underestimated. You have to keep in mind how common disc disease and

arthritis of the spine are and that many cases could be just coincident

diseases. But time and time again I have read somebody say, " I am fine

except for RLS and disc disease. " I have had two herniated cervical

discs, supposedly not causing spinal cord compression, for years. Years

ago, prior to any RLS drugs and prior to RLS in my arms, I found that a

short course of Indocin or other NSAID relieved the radiation of pain

down my arm and also the shoulder pain. I would be fine until I worked

above my head or did something with my arms that was too strenuous.

Within 24 hours, the pain would be back. Then I found Sinemet and my RLS

in my legs was relieved. After several years of Sinemet, I developed RLS

in my arms. I blamed it on augmentation from the Sinemet. Then came

Permax with temporary relief and then Mirapex with good relief of the

RLS in the legs but not the arms. One day I got the old pain from disc

disease back again and took some Indocin. In 48 hours, the pain was gone

and for the most part so was the RLS in my arms. It's been several

months and I am symptom free as long as I take the Mirapex. The RLS in

my arms has been minimal. Could this be a coincidental temporary

regression of the RLS in my arms? Sure, but the time relationship is

intriguing. RLS has been reported in cases of lumbar (low back) spinal

problems with nerve irritation but I don't know of any documented

reports of RLS with cervical spinal problems. Most RLS docs say that

they have seen it but have not written it up and published it. Of

interest is Dr. Bara's work at NIH, sponsored partially by the RLS

Foundation, that suggests that RLS patients have " increased

excitability " of their spinal cord. Could there be a relationship

between disc disease and this excitability of the spinal cord? Some

neurosurgeons feel that disc disease causes symptoms because of

inflammation of the spinal bone and thus responds to NSAID therapy. This

could explain why you don't have to have spinal cord compression from

the bulging disc to have symptoms.

This reasoning does not explain genetic RLS or the other secondary types

of RLS like renal failure, iron deficiency, folate and B 12 deficiency,

etc. It also does not explain the changes in the brain on scans

following dopamine-labelled material. It could explain why

dopamine-active drugs work in RLS. The increased dopamine levels just

happen to reduce the excitability. It also could explain why Neurontin

works. Its main action is to reduce excitability of the brain and spinal

cord. It could also explain why there are isolated cases of RLS that

report that OTC NSAIDs give them relief.

My main point is that boney changes of the spine and disc disease in the

neck and lower back may be associated with RLS much more frequently than

is recognized. I am NOT recommending that everybody with RLS and spinal

changes run out and have surgery. The results of surgery are not that

great. There are medical ways of treating disc disease and spinal

arthritis that deserve a chance. If a bone spur of the spine causing

nerve compression or a " cervical rib " is found, then surgery probably is

indicated.

Dr. Levin

[Guest guest]

There is no doubt in my mind that some RLS is spinal cord related. After my

cervical accident I got RLS. For me it was pressure on the spinal cord that

needed surgery.

Ed-Cyberphilly

[Guest guest]

I thought it was a very interesting article in Night about

RLS/PLMD maybe a spinal problem. My lower back has bothered me for

years, when I was in high school they had me in a " gentle " traction

several times a week, and the Orthopedic surgeon noticed I had an extra

vertabrae in my lower back above my tail bone. My Mom has artheritis in

her back, but what we have noticed is that after her hip surgery her RLS

got worse, then a Dr. injected protien in her neck as she had arthritits

there also, she could not move her head before the treatments, and is now

symptom free, but he injected it into the bones of her spinal column.

After that her RLS became worse than ever. I am certainly no expert on

it, but it does seem awfully coincidental....

TTFN

Happy day to all..

Debbie

, Ca.

41 and holding

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