Optimizing Restless Legs Syndrome Care: Integrating Rehabilitation into Multimodal Management

Abstract

Restless leg syndrome (RLS) is a common yet frequently
under-diagnosed condition. The exact pathophysiology is
unknown, however multiple factors including genetic
factors, brain iron deficiency and dysfunction of
dopaminergic system are associated with RLS. It is a clinical
diagnosis confirmed by International Restless Legs
Syndrome Study Group (IRLSSG) consensus diagnostic
criteria (2012). Several pharmacological and non -
pharmacological management options are available for
treatment of RLS. Non-pharmacological management
options include lifestyle modifications, therapeutic
exercises (aerobic training, resistance training and flexibility
exercises), physical modalities (pneumatic compression,
vibration therapy, and near-infrared light) and mind body
approaches (yoga, cognitive behavioural therapy,
acupuncture, massage, and mindfulness). Pharmacological
management of RLS include drugs from various classes
including gabapentinoids, dopamine agonists, opioids and
iron therapy. Novel treatment options like peroneal nerve
stimulation, botulinum toxin injection, transcranial
magnetic stimulation, vagus nerve stimulation, spinal cord
stimulation and deep brain stimulation are still in
experimental phase.
Keywords: Deep Brain Stimulation; Vagus Nerve
Stimulation; Gabapentin; Anemia, Iron-Deficiency;
Acupuncture