Restless Leg Syndrome & Massage Chairs

I’ve never given a lot of thought to Restless Leg Syndrome (RLS) since being in the massage chair business or, for that matter, in private practice before that, but it has come up from time to time. I recall certain patients saying that the conservative therapy administered in my clinic did help their RLS. I have also heard anecdotally, from massage chair customers, that their massage chair helped relieve some of their RLS symptoms.

I’m embarrassed to say that, because of it’s infrequency, I didn’t really know much about RLS. I figured it was just twitching legs when trying to sleep. I honestly didn’t think it was that significant of a syndrome (of course, unless we’ve struggled with something ourselves, we never think it’s as significant as it really is in someone’s life who is actually dealing with it!). I hadn’t even read up on the topic, to be completely honest.

Then, one day I received an email from a prospective customer looking for a massage chair as a possible addition to their RLS therapy regimen. It was not until I read this email that I suddenly realized that RLS really can be quite significant. Here are a few lines from that email…

I have severe, and I mean severe in the worst possible sense, Restless Leg Syndrome, it’s in my legs, butt, arms and shoulders, it manifests itself in a urge to move my muscles until they are burning with fatigue. I have taken opioids and Parkinson’s drugs and darn near every conceivable concoction my doctors can think of that “might” help. I use Chiropractic care, holistic medicines, natural oils, acupuncture, and nothing has worked without some pretty severe side effects. I currently take 7.5 – 10mg of methadone around 8pm and it works but…….. I’m not certain I can survive without it, but I’m getting ready to find out, more on that towards the end of this letter. I believe the long term use of this drug is causing issues with memory, clarity of mind, depression and many of the issues related to long term opiate use. Even with this drug, many nights the RLS breaks through and well, it can be a nightmare of an evening.

I mentioned, above, that I am on methadone. I currently take a small dose, 7.5-10MG. I have noticed a pretty significant decrease in memory, mental focus and the ability to learn new things over the past 4 years. My doctors believe it may have something to do with lack of sleep and long term opiate use. However, they do not believe I’ll be able to stop taking the drug without causing the RLS and PLMD to become too severe for me to function. However, I’ve decided I must try. I’m going to taper off this dosage of methadone, while being monitored and try to use message, exercise, and meditation to control the problem. My doctor thinks having a chair with message and heat could help during the period of time I’ll have some withdrawal issues.

I had no idea that RLS could affect someone so profoundly. In fact, you can tell from this man’s email that his quality of life has been profoundly affected…and that may even be an understatement. He was sincerely looking for some assistance, possibly from a massage chair, to give him any sort of a reprieve from his pain and sleeplessness so that he could cut back on some pretty heavy-duty medications and their side effects.

This motivated me to read up no this condition to find out if a massage chair really could help out with alleviating any symptoms. As I stated earlier, I had heard anecdotally from customers that a massage chair could help, but I wanted to know why, if in fact, it did help.

I found a great summary write up of verified treatments for RLS on healthline.com. All 11 of these treatments referenced in this piece were supported by cited studies. I’m going to list them below and we’ll talk about the two that can be supported by massage chairs.

  1. Ruling out potential causes of RLS, like bad health habits (including alcohol, caffeine, and tobacco), certain medications and health conditions, and other health triggers, like eating lots of sugar or wearing tight fitting clothing.
  2. Healthy sleep habits – regular sleep schedule, cool, dark, and quiet sleep area, minimal TV & phone distractions, avoid electronic screens prior to turning in for the night.
  3. Iron and vitamin supplementation – iron deficiency is thought to be a major cause of RLS, followed by vitamin D deficiency.
  4. Exercise – especially aerobic exercise and lower body resistance training.
  5. Yoga and stretching
  6. Massaging leg muscles
  7. Prescription medications – dopaminergic drugs, gabapentin, benzodiazepines, and opioids (see my customer’s statement above for benefits and concerns).
  8. Foot wrap – called restiffic, this foot wrap puts pressure on certain points on the bottom of your feet, which tells muscles affected by RLS to relax.
  9. Pneumatic compression – an inflating/deflating sleeve to gently squeeze and release your legs.
  10. Vibration pad – place the pad on your affected leg and the vibration offers a stimulation that overrides the RLS symptoms (almost like a distraction).
  11. Near-infrared spectroscopy – the infrared lighting penetrates the skin and causes vaso-dilation, which increases circulation in your legs, increasing the oxygen level helping to relieve the RLS symptoms.

#6 & #9 should interest us the most, in terms of massage chairs. I think massaging the leg muscles is an obvious benefit, especially with newer chairs having calf rollers AND foot rollers. The rollers, combined with the foot and calf airbags, offer significant massage therapy to the calf muscles (gastrocnemius) and the soles of the feet (plantar fascia).

The compression feature of the airbags can simulate, to some degree, pneumatic compression. They do not fully encircle the whole leg, but they are fantastic for the soft tissue of the calves and feet most used and fatigued by day-to-day living.

Another customer suffering from RLS sent me a link to an interesting clinical trial for a product called the restiffic foot wrap. Published in the Journal of the American Osteopathic Association in July 2016, in the article “Targeted Pressure on Abductor Hallucis and Flexor Hallucis Brevis Muscles to Manage Moderate to Severe Primary Restless Legs Syndrome” by Phyllis J. Kuhn, MS, PhD; Daniel J. Olson, DPM; John P. Sullivan, MD (to view the article on the JAOA’s website, click here), this foot wrap adds pressure to particular foot muscles to treat RLS symptoms. The results were statistically significant as 97% of the study participants experienced a decrease in their symptoms with an average 69% decrease in the severity of their symptoms over the 6 week trial. I bring this study up because massage chairs utilize foot rollers and airbags to compress the structural components of the feet. The foot rollers in many massage chairs will hit the abductis hallucis and flexor hallucis brevis muscles accompanied by lateral compression of the big toes by the interior foot airbags. The word “hallucis” refers to the big toes and those two muscles are responsible for the spreading and bending of the big toes.

So, having read this, I can see why some customers have claimed some RLS relief by using their massage chair. It’s not that crazy of a recommendation for sufferers.

Dr. Alan Weidner

https://www.healthline.com/health/restless-leg-syndrome/treatments#vibration-pad

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