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Restless Arm Syndrome

What is Restless Arm Syndrome?

‘Restless arm syndrome’ is an initial symptom of ‘restless leg syndrome’. In both ‘restless arm syndrome’ and ‘restless leg syndrome’ are an uncomfortable tingling sensation or feeling of something crawling beneath the skin of the extremities, especially at the resting mode of the body. This uncomfortable feeling insists to continuous arm movement and in progressive condition legs also move continuously, which cause sleep disturbance at night¹.

Symptoms

At the initial stage, sensation of ‘wiggling’ and ‘tingling’ feeling at resting position overwhelm to create an urge to arm movement
Some patient complains feeling of itching, pin or needle pricking sensation,
The movement of arm provides a feeling of relief of sensation
Desire of moving arm gives feeling of restless
The symptom become worse at sitting and lying posture
Symptoms are aggravated at night
Continuous sleep disturbance leads to insomnia
Dizziness at day time
If symptoms arise at daytime, then progression of day hours aggravate the symptoms

Approximately 48.7% individuals suffering from ‘restless arm syndrome’ progressed to ‘restless leg syndrome’. But in some patients, initially ‘restless leg syndrome’ initiates ‘restless arm syndrome’. The severity of the symptoms varies from mild to severe^1,2,3.

Causes

The pathophysiology of the ‘Restless arm syndrome’ is unknown. Therefore, ‘Restless arm syndrome’ is idiopathic. The different case study analysis expected that irregular hyperexcitability in the specific region mainly at cervical segments or lumbosacral part or in the entire spinal cord probably the elementary reason of sporadic arm and associated or not associated leg movements.

The hypothetical elicit system linked with the restless arm movement is due a nonspecific supraspinal connection is associated. Other evidential findings support that central involvement is also worked and that is backed up with dopaminergic activity. Iron deficiency or other abnormality associated with iron absorption impairment also influential reason of onset of the ‘Restless arm syndrome’.

Iron deficiency probably one of the factor in dopamine synthesis reduction, dopamine (D₂) receptor binding affinity or dopamine transportation impairment. However, no neurological impairment found in the development of ‘Restless arm syndrome’^1,2.

Triggering Factors

There are certain factors identified as a triggering factor of ‘ restless arm syndrome’. These are:

Certain chronic disease conditions like Parkinson’s disease, iron deficiency anemia, peripheral nerve disorder, renal failure, diabetes etc. often has a symptom of restless arm syndrome. The proper treatment of the condition can cause restless arm syndrome relief.
Certain medications like anti-emetic drugs, anti-allergic drugs, antidepressants and other antipsychotic medications may lead to worsening the symptoms.
Some pregnant women experience restless arm syndrome along with restless leg syndrome at the third trimester and the condition is eradicated within one month of the childbirth.
Chronic alcohol users also experience restless arm syndrome and restless leg syndrome. Stopping of alcohol consumption leads to relief from the symptoms.
Sleep deprivation aggravates the restless arm syndrome. Proper sleeping can cause improvement of restless arm syndrome^2,4.

Diagnosis

There is no specific medical test available for direct diagnosis of restless arm syndrome. But blood test and other diagnosis tests are performed to detect the underlying cause. The symptomatic analysis is the primary diagnosis approach for restless arm syndrome. During consultation doctor goes through the patient’s medical history, ask about family history, detail knowledge about patient’s medication etc. assist in understanding the cause of the condition.

In some cases a nocturnal polysomnogram is conducted, in the case of patients suffering from restless arm syndrome in association with restless leg syndrome, the test report showed periodic movements of extremities, inefficient sleep pattern describes deprived sleep, and pattern of graphical representation also shows sleep disruption with extreme arousals^1,2,3.

Treatment

Diagnosis and the treatment of the underlying cause of restless arm syndrome can control the condition. However, the treatment plan usually established to lessen the symptoms of the restless arm syndrome.

In the case of mild to moderate symptoms, restless arm syndrome can be controlled by some positive lifestyle alterations like following proper and routine exercise program, maintaining proper timing for sleep, reduce or eliminating tobacco, caffeine and alcohol consumption. Some home based remedial therapy can improve the symptomatic relief, which includes:

Massage of the affected limb
Hot pad application or hot bath can lessen the symptoms; however, in some patient application of ice pack also relief the symptom.
Early bed and proper sleep habit can lessen the condition
Vibrating pad or relaxis application also provide comfort in some patent.

There is no specific medication for all affected individual. Some drug effective for some people, whereas that can cause worsening the condition to others. Certain drugs, which are identified in the treatment of restless arm syndrome are as follows:

Some dopaminergic drugs, like Neupro, Mirapex, and Requip are FDA approved drugs use to treat ‘restless arm syndrome’ treatment. These drugs act on dopamine, a neurotransmitter present in the brain.
Benzodiazepine group of drugs assist in treating sleep deprivation and improving sleep pattern. however, these drugs can cause drowsiness at daytime.
Opioid analgesic may prescribe for patient with severe syndrome
Anti-epileptic drugs like Horizant, Neurontin, Tegretol, and Lyrica may prescribe in some patient.

However, the above mention treatments are only for relief the symptom, but not for complete curing medication for restless arm syndrome^1,2.

References

Thomas Freedom, Michael P. Merchut, (2003); Arm Restlessness as the Initial Symptom in Restless Legs Syndrome; Retrieve from http://jamanetwork.com/journals/jamaneurology/fullarticle/784374
William Blahd, (2015); Restless Legs Syndrome; Retrieve from http://www.webmd.com/brain/restless-legs-syndrome/restless-legs-syndrome-rls#1
Herniated disc at C6-C7 – having ‘restless arm syndrome’ at night; Spine Health; Retrieve from http://www.spine-health.com/forum/discussion/15730/pain/neck-pain-cervical/herniated-disc-c6-c7-having-restless-arm-syndrome-night
What are some causes of restless arms at night?; Retrieve from https://www.reference.com/health/causes-restless-arms-night-5ec0636380994ba6