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Muscle Twitches and Rheumatoid Arthritis: Can RA Cause Muscle Spasms?

Posted on July 21, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Marnie Willman

If you’re living with rheumatoid arthritis (RA), you may occasionally experience muscle twitches (also called muscle spasms). These random muscle movements can make it hard to sleep, exercise, and carry on with your day-to-day activities.

Members of myRAteam often discuss this issue. “I’m so frustrated,” one member wrote. “I’ve been suffering muscle spasms and no one can tell me why. My leg muscle keeps going into a spasm. With RA, you expect joint pain, but what bothers me, even more, are the muscle spasms.”

Fortunately, there are ways to get muscle spasms under control. In this article, we’ll show you why muscle twitches and spasms happen, the conditions related to RA that can cause them, and how you can manage your symptoms to improve your quality of life.

Conditions That Can Cause Muscle Twitches

One common cause of muscle twitches is muscle weakness, which is often a symptom of RA. Muscle weakness can be caused by higher-than-normal levels of calcium in your body. Why this happens, however, is still being examined by doctors and scientists. People living with RA have 25 percent to 70 percent less muscle strength than people without RA. Lack of use (resulting in atrophy) and inflammation are the primary causes.

In addition, several conditions have muscle twitching as a symptom, several of which are common in people who are also living with RA. If you have concerns that you might have other conditions in addition to RA, you should discuss this with your doctor or rheumatologist.

Restless Legs Syndrome

About 30 percent of people living with RA also have restless legs syndrome. By comparison, it affects 3.9 percent to 14.3 percent of people without RA, according to the journal PlOS One. Scientists think there may be a link to pathways in your brain or metabolic system that may induce this condition, but the definitive answer isn’t clear yet.

Polymyalgia Rheumatica

Both RA and polymyalgia rheumatica (an inflammatory condition) fall into the category of autoimmune rheumatic diseases. Per an article in the journal Australian Prescriber, after RA, polymyalgia rheumatica is the second most common autoimmune rheumatic disease, with a risk rate of approximately 2.4 percent for women and 1.7 percent for men.

RA and polymyalgia rheumatica are very similar symptomatically and are often confused for one another, even by doctors. Polymyalgia rheumatica can lead to muscle weakness, so if you have this condition, you may have a higher chance of experiencing muscle spasms or twitches.

Polymyositis

Polymyositis is an inflammatory disease that causes muscle weakness. Having RA increases your chances of developing polymyositis, so people who have both conditions may be more likely to experience muscle spasms due to their weakened muscles.

Managing Muscle Spasms

There are several strategies that can help you manage the discomfort and pain that may result from muscle spasms. Keep in mind, however, that you should always consult a physician if you are experiencing regular muscle spasms or discomfort. If you’re living with RA, discuss any changes you want to make or medications you’d like to try with your doctor before you get started.

Muscle Relaxants

You and your health care provider may decide that you should try using muscle relaxants to reduce muscle spasms and the pain they cause. Always seek medical advice before trying any new treatments (including over-the-counter medications like supplements). Medications that can reduce muscle spasms include:

  • Benzodiazepines including diazepam (Valium) or lorazepam (Ativan)
  • Non-benzodiazepines like metaxalone (Skelaxin) or orphenadrine (Muscol)

Physiotherapy

You can also take advantage of physiotherapy or physical therapy to reduce muscle-related problems like twitches. A physiotherapy team may use a variety of interventions to reduce the severity and/or frequency of muscle twitches, including:

  • Hot/cold treatments to reduce muscle cramping
  • Electrical stimulation delivered to specific muscles to reduce spasms or abnormalities (including electromyography, EMG)
  • Range-of-motion and exercise regimens
  • Compression gloves or assistive devices
  • Massage therapy

Always keep your doctor informed about your plans for any of these interventions, as well as your outcomes. Your physiotherapist should send progress documents directly to your doctor to ensure your full health care team is aware of how the treatment plan is going.

Hydration

If you wind up dehydrated, you may experience muscle twitches that are unrelated to RA, so staying hydrated can help prevent muscle spasms. Make sure you’re drinking lots of water each day. If you’re low on electrolytes from dehydration, try consuming a sports drink or other products that can replenish these.

Always speak with your rheumatology team right away if you experience muscle spasms or twitches that interfere with your quality of life. Your health care providers can help you find ways to reduce this symptom and manage your RA at the same time.

Talk With Others Who Understand

On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 193,000 members come together to ask questions, give advice, and share their stories with others who understand life with rheumatoid arthritis.

Are you living with rheumatoid arthritis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Marnie Willman is a Ph.D. candidate in medical microbiology and infectious diseases at the University of Manitoba. Learn more about her here.

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