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Fibromyalgia and Restless Legs Syndrome (RLS)

Living with FMS and RLS

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Updated October 01, 2013

A lot of people with fibromyalgia (FMS) have sleep disorders, and restless legs syndrome (RLS) is a common one. In a 2008 study, 64% of participants with FMS also had RLS.

Most doctors, researchers and FMS patients will tell you that the better you sleep, the milder your FMS symptoms will become. Getting a good night's sleep, however, is easier said than done. The first step toward sleeping better is to diagnose and treat any sleep disorders you may have, which usually involves a sleep study.

What is Restless Legs Syndrome?

People with RLS have strange sensations in their legs, such as creeping, burning, crawling or tugging feelings. Sometimes these sensations are fairly minor, while other times, they're painful. The sensations start when you relax, which means they can keep you from falling asleep or wake you up several times throughout the night, causing you to be exhausted and have a hard time functioning.

RLS is a neurological condition, but we don't yet know what causes it. Some cases may have a genetic cause, while others are believed to be related to:

Why Do Fibromyalgia and Restless Legs Syndrome Go Together?

So far, we don't know the underlying causes of either fibromyalgia or RLS. Until we learn more about these conditions, we likely won't understand why they occur together frequently. Both FMS and RLS are considered neurological conditions, so they may have common mechanisms in the brain and/or nervous system.

A theory with growing scientific support is that both of these conditions are central sensitivity syndromes.

Diagnosing Restless Legs Syndrome

There's no single diagnostic test for RLS, so doctors generally diagnose it based on your symptoms and medical history.

Diagnostic criteria for RLS include:

  • A desire to move limbs, often linked to odd sensations
  • Symptoms that are present (or worse) when you rest; movement provides some temporary relief
  • Motor restlessness
  • Worsening symptoms at night

Your doctor may do lab tests to rule out other possible causes of your symptoms, and he/she may also order a sleep study.

Symptoms of Restless Legs Syndrome and Fibromyalgia

Fibromyalgia and RLS share these symptoms:

  • Excessive daytime sleepiness
  • Problems with concentration

The primary symptom of RLS is odd sensations (parethesias) or unpleasant sensations (dysesthesias) in the legs and an uncontrollable urge to move to relieve these sensations. This phenomenon is not associated with FMS and requires different treatment.

Restless Legs Syndrome Treatment

RLS treatments can include medications and lifestyle changes.

For mild-to-moderate symptoms, your doctor may suggest you cut down or eliminate use of caffeine, alcohol and tobacco. If you have nutritional deficiencies, especially iron, folate or magnesium, your doctor may suggest supplements.

Other lifestyle management techniques include:

  • Maintaining a regular sleep schedule
  • Regular, moderate exercise
  • Avoiding excessive exercise
  • Hot baths
  • Leg massages
  • Applying heat or ice

These measures, however, don't generally provide complete symptom relief.

Your doctor may suggest medication to treat RLS. The more common types include:

  • Dopaminergics: (Examples are Requip, Mirapex) These drugs act like dopamine, which is a neurotransmitter that regulates muscle movement.
  • Benzodiazepines: (Examples are Valium, Xanax) These are central nervous system depressants, generally used as anti-anxiety medicines, that also suppress muscle contractions.
  • Opiates: (Examples are Darvon, Percodan) These pain killers also relax you and can suppress RLS in some people.
  • Anticonvulsants: (Examples are Neurontin, Tegretol) These are normally for preventing seizures but sometimes help relieve muscle contractions.

Some medications may make RLS symptoms worse, including antinausea, anticonvulsant and antipsychotic drugs and some cold or allergy medicines. If you're taking any of these, you may want to talk with your doctor about changing to drugs that are less likely to worsen your symptoms.

Restless Legs Syndrome Treatment vs. Fibromyalgia Treatment

RLS treatments don't generally conflict with FMS treatments, and in many cases, treatment may help both conditions. Many people with FMS find relief from benzodiazepines, opiates or anticonvulsants. (While they're widely used, benzodiazapines and opiates aren't part of official recommendations for FMS.) Also, many RLS lifestyle management techniques (regular sleep schedule, moderate exercise, hot baths) can be useful in managing FMS symptoms.

If you're taking or considering medications for both fibromyalgia and restless legs syndrome, be sure to talk with your doctor and pharmacist about any possible drug interactions.

Living with Restless Legs Syndrome and Fibromyalgia

It's hard to manage one medical condition, and harder still to manage two or more. The good news is that RLS treatment -- and the resulting better-quality sleep -- is likely to ease your fibromyalgia symptoms.

The following resources can help you learn more about RLS and getting a better night's sleep:

Sources:

European Neurology. 2008 Dec 9;61(2):107-111. "Restless Legs Syndrome Is Common among Female Patients with Fibromyalgia."

National Institute of Neurological Disorders and Stroke. "Restless Legs Syndrome Fact Sheet"

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