If you live with fibromyalgia, you already know how challenging it can be to manage widespread pain, fatigue, and disrupted sleep. But what happens when another condition—like Restless Legs Syndrome (RLS)—joins the picture? For many people with fibromyalgia, that uncomfortable urge to move their legs at night isn’t just annoying; it’s part of a complex pattern of symptoms that can deeply affect quality of life.

In this blog post, we’ll explore the connection between fibromyalgia and RLS, how to recognize the symptoms, and what you can do to find relief.

What Is Restless Legs Syndrome?

Restless Legs Syndrome is a neurological condition characterized by an overwhelming urge to move the legs, usually in the evening or at night. This sensation often comes with uncomfortable feelings like tingling, crawling, itching, or aching deep in the limbs.

These sensations are typically relieved by movement, which can make it hard to fall asleep or stay asleep—leading to fatigue and daytime sleepiness.

What Is Fibromyalgia?

Fibromyalgia is a chronic condition marked by widespread musculoskeletal pain, heightened pain sensitivity, fatigue, cognitive issues (often called “fibro fog”), and poor sleep. Though its exact cause is unknown, fibromyalgia is believed to involve changes in the way the brain and spinal cord process pain signals.

How Are RLS and Fibromyalgia Connected?

Research shows that people with fibromyalgia are more likely to experience RLS. Estimates suggest that as many as 30–50% of people with fibromyalgia also have symptoms of Restless Legs Syndrome, compared to 5–10% of the general population.

Several overlapping factors may explain this connection:

1. Disrupted Sleep

Both fibromyalgia and RLS interfere with sleep, creating a vicious cycle. Fibromyalgia is known to alter deep sleep stages, and the nighttime symptoms of RLS can make that even worse—leaving you exhausted, mentally foggy, and in more pain the next day.

2. Neurological Involvement

Both conditions are believed to involve dysfunction in the nervous system. Fibromyalgia is associated with central sensitization, where the brain becomes overly responsive to pain signals. RLS, on the other hand, involves abnormal dopamine activity in the brain. Some researchers believe these two systems may interact, making symptoms worse.

3. Iron and Dopamine Levels

RLS has been linked to low brain iron levels, which affect dopamine function—a neurotransmitter that helps regulate movement and mood. Some studies have found that people with fibromyalgia also have altered iron metabolism, suggesting a possible biological overlap.

4. Inflammation and Hormonal Imbalance

Chronic inflammation and imbalances in stress hormones like cortisol may play a role in both conditions, though more research is needed to confirm these links.

How to Tell If You Have RLS with Fibromyalgia

If you have fibromyalgia and experience an irresistible urge to move your legs at night, particularly if it gets worse with rest and improves with movement, you may be dealing with RLS. Other clues include:

• Sensations that feel deep in the legs (or sometimes arms)

• Trouble falling or staying asleep due to leg discomfort

• Daytime fatigue or trouble concentrating from poor sleep

If these symptoms sound familiar, talk to your healthcare provider. Proper diagnosis is key, as RLS can often be treated separately from fibromyalgia.

Treatment Options

While there’s no single cure for either condition, a combination of treatments can help:

For RLS:

• Iron supplementation (if levels are low)

• Dopaminergic medications

• Gabapentin or pregabalin (which may also help fibromyalgia symptoms)

• Lifestyle changes like cutting back on caffeine, alcohol, and tobacco

• Regular moderate exercise

For Fibromyalgia:

• Pain management strategies (e.g., medications, physical therapy)

• Cognitive behavioral therapy (CBT)

• Sleep hygiene practices

• Stress reduction techniques such as mindfulness or yoga

• Medications such as duloxetine or milnacipran

Many treatments, such as gabapentin, pregabalin, and improving sleep quality, can help manage both conditions at once.

Conclusion