Is the severe leg pain and sciatica after starting methotrexate related to RA or the medication?
This is a serious situation that needs immediate medical attention. While muscle spasms are a reported side effect of methotrexate, muscle cramps themselves are not common. The severe sciatica and inability to walk you're Show Full Answer
Is the severe leg pain and sciatica after starting methotrexate related to RA or the medication?
This is a serious situation that needs immediate medical attention. While muscle spasms are a reported side effect of methotrexate, muscle cramps themselves are not common. The severe sciatica and inability to walk you're experiencing could be related to several factors.
RA can cause nerve-related symptoms. Up to 20 percent of people with RA experience nonjoint symptoms affecting their nerves, which can include tingling and numbness. However, severe sciatica causing walking difficulties needs urgent evaluation.
Methotrexate typically takes 3-6 weeks to start working, and it may take up to 12 weeks to feel full effects. Since you've only had 3 doses, the medication hasn't had time to control your RA symptoms yet, so a flare-up is possible.
Other potential causes of severe leg pain include:
* Compressed nerves
* Insufficient blood supply to the legs
* Mineral deficiencies
* Overworked or strained muscles
Contact your rheumatologist immediately about this severe pain and mobility issue. Don't stop your methotrexate without medical guidance, but your doctor needs to evaluate whether this is a medication side effect, an RA flare, or another serious condition requiring different treatment.
November 2, 2025
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