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Unable to walk or move without searing pain the first week. Second week better, but still unable to walk more than a few steps without pain or holding on to something.
My primary dr thinks it’s the methotrexate and wants me to stop. Using 20mg/day prednisone and found some relief, but still a big issue.
Anyone else have this happen? Any thoughts? I don’t see a rheumatologist for another month…

November 2, 2025
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A myRAteam Member

I just took my first dose of mexotrexate Wednesday. 10mg. Thursday I felt very fatigued and felt like I was getting sick. Today, Fri, I feel normal. Not sure what to expect. This is all new to me.

November 28, 2025
myRAteam

Are severe muscle cramps and pain side effects of methotrexate?

Muscle cramps aren't a common side effect of methotrexate, but muscle spasms are, and these spasms can sometimes lead to cramping. Many myRAteam members have shared experiences with leg cramps, describing them as painful charley horses that can make walking Show Full Answer

Are severe muscle cramps and pain side effects of methotrexate?

Muscle cramps aren't a common side effect of methotrexate, but muscle spasms are, and these spasms can sometimes lead to cramping. Many myRAteam members have shared experiences with leg cramps, describing them as painful charley horses that can make walking difficult.

If you're experiencing severe muscle cramps while taking methotrexate, it's important to talk with your rheumatologist. They can determine whether methotrexate is the cause and help you manage the symptoms while continuing to treat your RA.

Here are some ways to manage muscle cramps:

* Stretch regularly - Gently stretch muscles before and after exercise, or before bed if cramps happen at night
* Stay hydrated - Drinking plenty of fluids helps prevent muscle irritation and promotes proper muscle function
* Try heat therapy - Hot packs, water bottles, or compresses can alleviate spasms and improve blood flow
* Take pain relievers - Over-the-counter options like naproxen or ibuprofen may help with mild to moderate cramping pain
* Consider folic acid - Many people taking methotrexate use folic acid supplements to minimize various side effects

Your doctor might also adjust your methotrexate dose or timing to reduce side effects. Don't stop taking your medication without consulting your healthcare provider first.

November 2, 2025

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