MyRestlessLegSyndrome

Traditional Chinese medicine approaches disorders that are not among the ancient disease categories, such as Restless Legs Syndrome, primarily through analysis of symptom patterns. The excessive movements of the legs are interpreted as being a manifestation of “internal wind,” a condition that is related to liver blood deficiency. The fact that the disorder occurs more notably at night and disturbs sleep suggests that the weiqi that circulates at the surface during the day fails to fully return to the interior at night, a problem that is usually attributed to a fluid deficiency of the internal organs, such as yin and blood deficiency of the liver. Disturbance of sleep, a common aspect of the disorder, may also implicate deficiency of the heart. The limitation of the movements to the legs, which are said to be influenced by the liver-kidney system, suggests a deficiency of those two organs. The liver-kidney system is said to deteriorate with aging and to be responsible for many of the disorders that arise with aging, so this relationship may also explain the prevalence of the disease among the elderly. The strange leg sensations described by those who experience Restless Legs Syndrome may correspond to the “numbness” pattern that is attributed to blood deficiency and blood stasis in the traditional Chinese system.

Modern findings can also contribute to the Chinese medical understanding. The possibility of a brain metabolism defect may suggest deficiency of the kidney (since the brain is considered an outgrowth of the kidney system in the Chinese understanding) and a deficiency of the heart, which influences brain activities. The correlation of Restless Legs Syndrome with poor circulation suggests that blood stasis is affecting the legs. The deficiency of iron and folate in the blood may correspond to a blood deficiency syndrome (usually depicted as liver blood deficiency).

Therefore, the Chinese medical therapy would primarily involve tonifying the deficiencies and promoting blood circulation. The deficiency syndrome appears to mainly involve the liver and kidney (possibly also the heart), and the stasis mainly involves the legs. Certain herbs immediately come to mind, such as: rehmannia and cornus for nourishing liver and kidney; tang-kuei and peony for nourishing blood of liver and heart; millettia and achyranthes for nourishing and vitalizing blood (achyranthes is also relied upon to direct the blood flow to the lower body). Chaenomeles is often included Chinese formulas for contracture of the leg muscles, and is especially used in deficiency syndromes; the traditional pair of peony and licorice is typically given to reduce spastic activity, also in deficiency syndromes. In China, these deficiency syndromes would also be treated by consuming organ meats (such as liver), thus providing iron and folate.

Restless Legs Syndrome does not appear frequently in the modern Chinese literature. However, a small number of clinical trials have been reported. For example, in one study involving 21 patients (6), the formula given was a modified Peony and Licorice Combination (Shaoyao Gancao Tang). The basic pair of herbs (usually in equal quantities) was modified by adding three herbs for vitalizing blood circulation: achyranthes, salvia, and pueraria (use of pueraria as a blood vitalizer is an application developed during the past 30 years), and adding chaenomeles for the spastic movement. Another report of similar nature (7) involved the same treatment-except for the herb pueraria-for 18 patients. In both cases, all the patients were said to have improved (restless legs no longer a consistent problem), with only one case recurring after a year. Chinese therapeutic massage, acupuncture, and other therapies might also be utilized in the clinics.

In response to a question about treating Restless Legs Syndrome, Lin Zongguang (a clinician at the Shidong Hospital in Shanghai) reported on his experience treating more than 20 such cases (8). He said that he found the disorder related to “the deficiency and injury of the heart, liver, and kidney.” For cases dominated by deficiency of liver and kidney, he suggested a modified version of Rehmannia Six Formula (Liuwei Dihuang Wan), adding ligustrum and tang-kuei. In cases of heat syndrome, he would use the standard modification of Rehmannia Six Formula that adds phellodendron and anemarrhena. For cases in which heart and liver deficiency dominated, he suggested a modified Ginseng and Longan Formula (Guipi Tang), adding rehmannia.

MyRestlessLegSyndrome

References

1. Lin Zongguang, How to treat Restless Legs Syndrome with Traditional Chinese medicine, Journal of Traditional Chinese Medicine 23(4): 305-307.
2. Shan Yipu, Treatment of 21 cases of Restless Legs Syndrome with modified Shaoyao Gancao Tang, Shandong Journal of Traditional Chinese Medicine 1986; (2): 17-18.
3. Fruehauf H and Dharmananda S, Treatment of Difficult and Recalcitrant Diseases with Chinese Herbs, 1997 ITM, Portland, OR.
4. Subhuti Dharmananda, Restless Legs Syndrome and Chinese Medicine