Spinal Anesthesia Doesn’t Cause Restless Leg Syndrome

Spinal anesthesia won’t cause or worsen restless legs syndrome.
That’s the conclusion of a new study published as a letter to the editor in the Nov. 20 issue of the New England Journal of Medicine. The study compared people undergoing general anesthesia to those undergoing surgery with spinal anesthesia and found no difference in restless legs syndrome symptoms between the groups.

"Our study was designed to test the hypothesis that spinal anesthesia would worsen the symptoms of restless leg syndrome," said the study’s lead author, Dr. Thomas Crozier, an associate professor of anesthesiology at the University of Gottingen Medical School in Germany. "This is important, because restless legs syndrome is a very unpleasant condition that affects up to 10 percent of the population," he added.

Restless legs syndrome (RLS) is a disorder that causes people to feel a compelling need to move their legs, especially when they’re lying down. An observational study in 2002 had suggested that spinal anesthesia was responsible for transient restless legs syndrome after surgery, the researchers said.

"The study that prompted this one found new onset RLS that lasted six weeks and then abated," said Dr. Sam Awada, chief of family medicine at St. John Macomb-Oakland Hospital in Warren, Mich.

The current study included 359 people undergoing surgery. One hundred and forty-seven had spinal anesthesia, and the remaining 212 had general anesthesia. Thirty-two people said they had RLS symptoms before the study began.

The study volunteers filled out questionnaires before surgery, and then again at one and four weeks after surgery.

No one in either group reported new onset restless legs syndrome, and no one that had RLS at the start of the study reported a worsening of symptoms.

"Restless legs syndrome arising after surgery probably has more to do with the surgery itself or with the forced immobilization in the hospital," Crozier said. "We think that it is important for people suffering from restless legs syndrome to know that there is, at worst, only a very small likelihood that spinal anesthesia, which is the best choice for a number of surgical procedures, will worsen their condition," he added.

Awada called the new study’s findings "interesting," but said more research should be done to definitively rule out a relationship between spinal anesthesia and restless legs syndrome.

Another recent finding -- this one presented at the Neuroscience 2008 meeting in Washington, D.C., on Nov. 16 -- linked restless legs syndrome with the use of allergy medications.