The Reality of Fake Illness: Restless Leg Syndrome

Have you ever visited your physician for sickness just to be prescribed a medication before you were actually examined?  The article “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick” by Steven Woloshin and Lisa Schwartz gives readers an insight into that same phenomenon of the doctor who prescribes before she or he diagnoses, but on a much larger scale.  The article’s authors claim that pharmaceutical companies largely aim to make money and have financial success, not to treat the health ailments of their customers, and that the media backs such behavior, termed “disease mongering.”

The rhetoric used in the article to characterize this phenomenon involves a comparison between the presentation of “information” versus the media’s presenting of “infomercials,” here specifically, about ‘restless legs.’  According to webMD,  “people with restless leg syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The condition causes an uncomfortable, "itchy," "pins and needles," or "creepy crawly" feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting.”

Additionally, the article lists the following as criteria for having restless leg syndrome:

1.  An urge to move the legs due to an unpleasant feeling in the legs.

2.  Onset or worsening of symptoms when at rest or not moving around frequently.

3.  Partial or complete relief by movement (e.g. walking) for as long as the movement continues.

4.  Symptoms that occur primarily at night and that can interfere with sleep or rest.

RLS (Restless Leg Syndrome) affects about 10% of Americans (more females than males).  It is considered a sleep disorder because its symptoms tend to impact sleep:

Now then…I have undoubtedly experienced days and nights of immense restlessness during which I would probably have reported feelings of ‘tingliness’ or itchiness in my legs, and even would have probably conceded an inability to totally rest as I my legs continued to move.  However, I agree with the authors’ shared lack of confidence in the science used to cite many of these such [very] common yet somehow unknown clinical ailments.

For example, the 10% estimate I mentioned above (from the trusted website WebMD!), according to the article, came from a study that used only a single question to diagnose restless legs syndrome rather than the clinical diagnostic criteria.  A diagnosis based on only a single question begs for refute.

How is it that a syndrome (not a disease, mind you, but simply a set of unexplained correlated symptoms) can be clinically diagnosed so easily?  It cannot – which is why the promotion of RLS in the media is in fact “disease mongering.”

Still, instead of highlighting the misfortune we experience in this persistent and unfair reality, presented in other health areas of health concern [Eh-hem, excuse me, I am looking at you, ADHD over-diagnosis], I offer a few solutions to curb the problem:

The following suggestions to information outlets aim to counteract the three common malpractices of media that contribute to disease mongering, as named by the article, i.e. exaggerating disease prevalence, encouraging more {too much} diagnosis, and suggesting that all disease should be treated.  My thoughts…

1.   Fact-check the information you spout before you present it as truth.  Perhaps do so by monitoring the sources used, comparing the information found in one to the same information search in another source.

2.   Encourage less diagnosis.  The American people lead busy, stressful lives – they have enough ailments that result from their demanding schedules as it is.  Do encourage strict diagnostic procedures on the part of physicians.

3.   Not all diseases need treatment.  Patients can sometimes return from a period of sickness just by practicing rest, self-care, proper nutrition, and healthy sleep.  Encourage holistic health instead of promoting primarily medication, as medicines often can have side effects that outweigh potential therapeutic benefits.

Lastly, I offer that since I have been consistently sleeping 7-9 hours/ night the last several nights, I have not experienced phenomena like RLS as a result of stress or fatigue.  When I am very sleep deprived, having also engaged in a lot of physical and mental activity, I do sometimes get RLS-like symptoms.  This anecdotal evidence should give weight then to the idea that RLS, perhaps like ADHD is prevalent because it is over diagnosed and undervalued in real cases.