Restless Legs Syndrome and Rheumatoid Arthritis—Is There a Connection?


Katrina Woznicki

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Restless legs syndrome

What might a burning sensation in your legs have to do with pain and stiffness in your hands and wrist? Restless legs syndrome (RLS) and rheumatoid arthritis (RA) are two very different disorders, but they might share a common connection: iron deficiency.

RLS occurs in about 10% of the U.S. population. Nearly one-third of these people also have RA, a type of autoimmune disorder. Both conditions are more common among women than men. Sleep disturbances and chronic fatigue are problems for people with both RLS and RA.

Why is RLS so common among people with RA? The brain chemical dopamine is critical to both your central nervous system and immune system function. To do its job properly, dopamine needs iron. Many people with RLS have low iron levels. This can reduce the effectiveness of dopamine in your brain.

Many health conditions can affect how much iron is in your brain, or how it’s used. This increases your risk for RLS. One of these conditions is RA.

Watch: Managing RA With Lifestyle

Dopamine: The Common Factor

Dopamine is a chemical that helps brain cells talk to one another. It controls multiple bodily functions, including movement. In addition to affecting nerve cells, dopamine may affect how immune system cells behave. One study shows that flawed dopamine signaling increases the level of inflammation in your body. This contributes to the cartilage damage that occurs in RA. In fact, researchers have found that dopamine may be more important to immune system cell regulation than previously thought. This might help explain the connection between RLS and RA.

Dopamine relies on proper levels of iron to function properly. Iron is a mineral found in foods such as meat, vegetables, and legumes. Simple blood tests can determine if you have an iron deficiency. Daily oral iron replacement is the most commonly prescribed therapy for iron deficiency. If your doctor prescribes iron replacement therapy, keep in mind that vitamin C or orange juice boosts the absorption of iron supplements, and calcium-rich foods block absorption.

Exercise: Ease Pain and Sleep Better

There are a number of things you can do to relieve symptoms of both RLS and RA. First of all, engage in regular, gentle exercise. It can help in a variety of ways, including:  

  • Easing leg discomfort

  • Improving sleep

  • Increasing flexibility

  • Preserving joint mobility

  • Reducing pain

Walking and yoga are recommended if you have RLS and RA. Some research has shown that if you have RLS, gentle yoga can help you sleep better.
Be sure to rest when you need to, and don’t overdo any activities or strain yourself trying something new. If you’re beginning an exercise regimen, do so under the guidance of your health care provider and a certified trainer, such as a credentialed fitness teacher.

Practice Unwinding

If you have RLS and RA, you face physical and emotional challenges that can create stress and anxiety. Taking steps to lift your stress can help ease symptoms and reduce pain.  Regular rest periods can help, as can relaxation or visualization techniques. Other ways to cope with stress include exercise, such as yoga, and participation in a support group.

Key Takeaways

  • Restless legs syndrome and rheumatoid arthritis might share a common connection: iron deficiency.

  • The brain chemical dopamine is critical to both your central nervous system and immune system function. To do its job properly, dopamine needs iron. Many people with RLS have low iron levels.

  • RA can affect how much iron is in your brain, or how it’s used. This increases your risk for RLS.

  • Gentle exercise and stress reduction can help relieve symptoms of both conditions.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Feb 19, 2016

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Medical References

  1. Innes K, et al. Effects of a gentle yoga program on restless legs syndrome (RLS) symptoms and related outcomes in women with RLS: a pilot study. BMC Complement Altern Med. 2012; 12(Suppl 1): P212.
  2. Gjevre JA and Taylor-Gjevre RM. Restless Legs Syndrome as a Comorbidity in Rheumatoid Arthritis. Autoimmune Diseases. 2013; 2013(3):352782.
  3. Sarkar C, et al. The immunoregulatory role of dopamine: an update. Brain Behav Immun. 2010;24(4):525-8.
  4. Nakano K, et al. Dopamine Induces IL-6–Dependent IL-17 Production via D1-Like Receptor on CD4 Naive T Cells. J Immunol. 2011 Mar 15;186(6):3745-52.
  5. What Causes Restless Leg Syndrome. National Institutes of Health. National Heart, Lung, and Blood Institute.
  6. Handout on Health: Rheumatoid Arthritis. National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
  7. Restless Leg Syndrome Fact Sheet. National Institutes of Health. National Institute of Neurological Disorders and Stroke.

Watch: Managing RA

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