Muscle twitching in the thigh - Restless Legs Syn...

Restless Legs Syndrome
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Muscle twitching in the thigh


Hi all: Occasionally I will have fairly active muscle twitching in my thigh. Can last for a few hours while lying down in the evening. Is this just another kind of RLS or is it a magnesium deficiency? I don't necessarily want to move like RLS, but it is annoying.

48 Replies

I have twitching 24/7 and pins and needles

I tried the RLS medications pramipexole and it did nothing for the twitching.

It is not RLS but the sensations in the legs are so so annoying.

There is no medication for it.

How do you know the spasms/twitching aren't RLS?

Others with RLS will be better to answer this, but in short fasculations of the muscles are not RLS and the RLS medications do not treat twitching

The muscle spasms and twiyching is by coincidence called BFS

in reply to sarah19902

Hi, did you stop taking Mirapex OK? Have you had the BFS diagnosed now? How are getting on?

in reply to Manerva

I did stop taking it. I tried to call the neurologist and they haven't called me back in a week; great standard of care.

I was just told by the receptionist to do what I thought was best.

My muscles physically twitch.

My partner gets RLS so I directly compared his symptoms. He said he cannot stop himself from moving when it occurs. This is not what I experienced at all.

I'm just going to go with BFS for now.

Thanks for checking in Manerva xxx

in reply to sarah19902

Actually, it might be lucky that you weren't prescribed Gabapentin for RLS. It might have worked since it can also work for BFS, I read.

in reply to Manerva

Manerva, you do seem to have a great experience with reading everyone's symptoms etc so I'm hoping I could as a question.

My legs sometimes feel like they are going to contract and kick. It lasts a second and then releases. It can happen for hours at a time while resting.

I'm not sure if it is because the muscle is twitching deep inside.

Do you know what this could be?

in reply to sarah19902

That seems to be an oversensitivity of the nerves going to the leg muscles.

I can't say exactly what might be the cause of it.

It actually does sound a bit like RLS, that's how I' d describe my symptoms, except in my case my legs actually do kick.

in reply to Manerva

Oh no.

It feels like the muscle is contracting and going to kick but it doesn't. Do you think I need to reconsider RLS now?

This is honestly a nightmare.

in reply to sarah19902

I think you need to see a good neurologist and stop trying to guess what the problem is.

There are conditions that cause RLS like symptoms, I'm still thinking the Mirapex would have worked if you have RLS. To fulfil all 5 diagnostic criteria for RLS, all other possible explanations have to be eliminated, so as it is dubious you have RLS you particularly need to address that criteria.

in reply to Manerva

Thankyou, yes I've already been to three. None have been very helpful. One diagnosed RLS.

My mental health is the worst I've ever had in my life after this has started.

in reply to sarah19902

I did write "good" neurologist, but that may be a bit of a tall order!

It was suggested to me by my GP earlier, to see a neurologist privately. However, that may mean just seeing one more quickly rather than seeing one that's any better.

I did search for one locally, but the only one I could find was the same one who I saw as an NHS patient ten years ago who apart from his appalling interpersonal skills prescribed Pramipexole without any explanation or warnings.

I did try to find one more nationally, but there seem to be very few and the information you can get doesn't say much about them.

It may be that other members of this community can give you some pointers, I'm sure that there must be some "good" ones somewhere.

Another suggestion is you see your GP and persuade them to give you a "health MOT". That is a basic neuroexamination plus some blood tests, such as Ferritin, Full blood count, Diabetes, kidney function and thyroid function + vitamin D.

The neuroexam could include a discussion of any other symptoms you have, anything, that you may not realise are connected. The blood tests could identify any deficiencies you have that might be causing neuromuscular symptoms.

I understand your anxiety about this but this may also be a factor worsening your symptoms. Perhap s you have some "usual" strategies for calming your anxiety, or perhaps you need some suggestions.

I feel like I'm having a nervous breakdown worrying about muscle twitching and RLS in general.

I've read a lot about muscle twitching now, and nowhere does it mention RLS. It's dehydration, exhaustion (me), stress (me), exercise and some mineral issues. I don't see twitching on the RLS foundation site either, but I could be wrong. I see a neurologist on Monday and will let you know what I find out.

I hope the neurologist gives you some clarity.

Your descriptions to date are ambiguous.

The "twitching" people get with fasciculation, i.e. small movements of local muscle groups is probably best described as "tremors" whereas the twitching I get with RLS is probably better described as "gross" involuntary movement

It sound as if the problem on the plane is possibly due to the Dramamine.

Hi Manerva,

I just read more carefully where your muscle twitching is "gross". I'm sorry to hear that about you. What are causing your larger movements? Is it directly related to RLS? How long have you struggled with this and how do you treat it?

Mine is just the thigh, on the side, where you can see the muscle twitch or spasm for a couple of seconds and then stops. I suppose you could call it a tremor. No urge to move it. I'm sorry I keep beating this horse, so to speak. My issues with the plane are separate and apart from this more recent symptom, that appeared about a month ago. Happened about 9 x's in a month. Always in the evening when I'm at rest -- I think it's due to stress/exhaustion -- at least that's what the websites say regarding muscle spasms.

I think my last reply was a little misleading.

"Fasciculations" are very small contractions and fairly localised, affecting a small area.

"Tremors" are larger scale, affecting a larger area and may be felt as if you're about to move or as shakiness.

The movements I experience with RLS are larger movements, kicking legs or thrashing arms and can be quite violent.

The word "twitching" could be applied to any or all of those.

OH, this helps more -- OK, I think I'm using the wrong terminology based on what you just wrote (this is getting confusing, my apologies). My contractions are a small muscle group -- a couple of inches of muscle on the side of my thigh (either right or left). The muscle contracts for a couple of seconds and then releases. Sometimes my thigh might rise by half an inch and then fall back down. Would you consider that gross? I don't have those larger movements. Now, I'm worried about you ; )

in reply to sarah19902

There are degrees of movement, "fasciculations" are small muscle movements in local muscle groups e.g. in the thighs, or eyelids.

"Tremors" affect a larger area and are rhythmical. The movement they cause is not large movements and may be experienced as feeling as if you're about to move, but don't or as shakiness.

The limb movements in RLS are larger movements, e.g. kicking, lashing out, thrashing etc.

Any or all of these could be implied by "twitching".

Hi, after re-reading your previous post, I'm not sue if you have RLS or not.

In your previous post you said you had mild RLS. I presumed at the time that you may have had this diagnosis confirmed by a doctor. If it was, the doctor may be wrong. If this was a self diagnosis, it's more likely to be wrong.

There are five criteria for a diagnosis of RLS, your symptoms must match ALL 5, even if 4 match, then you don't have RLS.

Here is a link to the criteria

In this post you say you don't have the urge to move. Since this is THE principal defining symptom of RLS, it seems that you don't have RLS. You also describe muscle twitching in your thigh. If this is your ONLY symptom, I'm pretty sure you don't have RLS.

The twitching I experience with RLS it involves the whole leg and I would further describe it as rhythmic kicking. It's not just confined to small twitches of a single muscle group.

The muscle twitching you describe sounds more like fasciculation. If this is the case then you may actually be able to see the twitching. I also get fasciculations now and again. Most often round my eyes, but sometimes elsewhere. They usually last about 2 weeks.

More persistent fasciculations may be a part of the condition Benign Fasciculation Syndrome, (BFS).

Here is a link to some information on this.

In your previous post your main issues were anxiety and insomnia and the fasciculation could be tied up with this. You seemed to think that the insomnia and twitching were causing the anxiety, it may actually be the other way round.

I suggest you see a doctor to clarify if you have RLS at all, if the twitching is just fasciculation and if persisting your anxiety and insomnia.

If the doctor considers you're suffering moderate anxuety, in the short term only, I stress this, short term only the doctor may prescribe something. This is usually an SSRI e.g. Citalopram. This will deal with both anxiety and help sleep.

You may find this link helpful

Furthermore, if you were to take an SSRI and your symptoms improve, this would further confirm you don't have RLS, since SSRIs make it worse.

I note in your previous post someone recommended Alimemazine for anxiety. This drug is usually prescribed for itching due to urticaria, not anxiety. It is an antihistamine.

In conclusion : If you don't ever get the urge to move, then you don't have RLS, not even mild. If your twitching is small movements confined to a single muscle group in your thigh then it sounds like fasciculation. This may he caused by anxiety. It may be BFS.

I'm not a doctor, I suggest you see one and discuss all these issues.

Excellent advice Manerva. I do think I have RLS however, and tend to get it when I'm on a plane, having taken a Dramamine for late afternoon flights (never morning flights), and it can usually be handled when I get up from my seat and move around. It's gone by the time I'm off the plane. However, the muscle twitching now, is a muscle group on the right side of my thigh, that can lift the whole leg. I have an appointment with a leading specialist from Stanford in December and will talk to him then. btw, the twitching goes away as soon as I drop off to sleep.

Thanks again for such a thorough response. I will follow the links you provide.

I said I'm not sure if you have RLS as you said you don't have the urge to move. If you don't have the urge to move, then it is most unlikely that you have RLS. The urge to move i.e, "restlessness" is the defining feature of RLS.

You say you get "RLS" on a plane. This doesn't say what symptoms you're actually getting. All you're saying is that you think you have RLS and you get it on a plane. If what you get is NOT the urge to move then, again, it's not RLS you're getting.

It will only definitely be RLS you're getting if you get the urge to move. However, you did say you don't get the urge to move.

Having to get up on a plane doesn't in itself mean you have RLS, there are possibly many reasons for that.

The symptoms you describe, i.e. "muscle twitching" still sound like fasciculation. Fasciculation is relieved when you move, so could be your reason for getting up on a plane.

If you said you get unpleasant sensations in your legs so that you can't resist moving I would agree that this describes RLS. Your descriptiion does not fit RLS.

Furthermore Dramamine contains an antihistamine and antihistamines are known to make RLS worse. Not better. Other anti-sickness medicines which may have prochlorperazine in them, may also make RLS worse.

It would be best to consult a doctor who is a in a position to discuss the possibility if RLS with you rather than self-diagnosing. Self diagnosing can lead to inappropriate self treating.

Nobody on this site can diagnose you with having RLS or NOT having RLS, including me.

Manerva, Not sure if I ever answered you, and you're so generous with all of your information -- I have been getting some muscle twitching in my thigh at night, but it's mild, and I don't feel the urge to move to relieve it. It goes away when I drift off to sleep.

I have had RLS symptoms in the past when I've taken anti-histamine when flying and sitting in a cramped situation. I get up, move around, and it's usually relieved, and disappears when the flight is over.

My neurologist today thought my twitching probably wasn't RLS, but wasn't absolutely certain, so he just suggested I take a little more gabapentin, which he though might help.

Otherwise, he didn't seem concerned.

My real issue is my own mental health regarding all of these symptoms, and my anxiety level goes off the charts -- which in turn affects any symptoms I might have, plus deprives me of sleep.

Quite a bad circle of negative thoughts. But that's my problem and I shouldn't submit all of you to my mental health. ; (

I think it's pretty clear that your "twitching" is not RLS. It may be fasciculatiom. Whatever it is it sounds as if you have become overconcerned about it.

It may be that you suffer from anxiety as a reaction to the twitching, but possibly you suffer from GAD, (,Generalised Anxiety Disorder) and the twitching has become a focus for it. It may be that anxiety is a causative factor.

A possibility, perhaps remote, is that your twitching is "Functional Neurological Disorder".

Perhaps you need some professional help with your mental health generally. I appreciate that GPs aren't particularly good at dealing with mental health issues and that services aren't good but it might be worthwhile you seeing a counsellor, privately if necessary.

I don't know, but there may be features of your circumstances which are causing your anxiety. I believe its commonly thought that anxiety has a cause, but actually in many cases anxiety and depression are a result of the way we see the world, the habitual way we perceive things and react to them and the way we see ourselves. It's not so easy to deal with that, it requires a radical change in the way you think. That's why Cognitive Behaviour Therapy (CBT) and Mindfulness CBT have been found to be very effective.

Ubfortunately, doctors are probably overwhelmed with the numbers suffering mental health issues, (often manifesting as apparent physical issues) that they just dish out prescriptions that only deal with symptoms, not the underlying issue.

Thanks for your concerns about me. That's something you don't need to worry about. My RLS is well controlled at the moment and when I had twitching episodes in the past, I have always been conscious and never come to any harm apart from, sometimes, total lack.of sleep.

Yes, I am sometimes coming apart at the seams because of anxiety, and am seeing a therapist.

How insightful you are . . .

So, are you married? Because if not, I might ask you to marry me. ; )

Sorry, I've been married 3 times. I don't think I can manage another.

Manerva, I do feel the urge to move on a plane, so it's RLS. Now the question is how bad and frequent will it get?

I was also distressed to see that PPI's can't be used for heart burn. So what does a person do?

Zoneedssleep, are you saying you only get the urge to move when on a plane..? Do you have that urge to move at home resting, in bed a night when going to sleep.? You said in your post you dont have to move like RLS. Going by how you are describing your symptoms it doesnt sound like RLS to me.

Elissa, I rarely get RLS at home at night, it's happened a couple of times. The plane experience is when I've taken a dramamine. But my question is about muscle twitching, which occurs in my thighs at night, and it actually moves my leg but I don't have the urge to move.

Can you also help me understand how to treat heartburn if we can't take any PPI's? Sorry for all the mixed questions, so much I don't understand.

The muscle twitching is as Manerva said, so we know thats not RLS or part of RLS.. I take a OTC heartburn product for my heartburn and it has no effect on my RLS. I am in the UK, and i take Gaviscon.

That is very reassuring Elisse. It's so discouraging to see the list of RLS triggers increase leaving many of us so few options for help.

Hi Zoreneedssleep. Good question. Personally, I thought it was RLS because to me, it was. That was just part of 'my' RLS. I am very interested to hear what folks have to say because their answers could help a lot of us to feel better if only we knew what it was. Fingers crossed!

I think also the way we describe fasculations as twitching is different to the way people describe RLS twitching

I think you're right -- I don't think it's RLS. It's painless, happens when I'm really tired/stressed, and doesn't cause me to move my legs. Doesn't keep me awake.


Muscle twitching CAN be nothing more than calcium/magnesium deficiency. Throw RLS into the mix, and it gets complicated. And magnesium has helped some with RLS, worth a try.

in reply to Hidden

Yes, I'm taking it. I think it's regular muscle spasms, like many people get. Thanks for your response.

I get frequent spasms and contractions in my thighs if i move the wrong way. It feels like oompa loompas (charlie and the chocolate factory) are in my thighs, cranking my muscles. It is so painful I actually use my lamaze breathinng while they are at their worst. They get extremely painful, then relief for a second, kind of like labor contractions. They last anywhere from 5 min to half an hour, sometimes longer. Does this sound like what ur experiencing? I don't really know what it is bc if you mention it to a dr they act like you r crazy. I haven't asked a neurologist yet bc i am sort of on a doctor strike right now. I have had some bad experiences lately and im taking a break from them. If you do find out anything pls post in this forum. Good luck, i hope you find some answers.

Hi there -- mine don't hurt, just mild spasming. They can go on, until I fall asleep, always at night and when I'm at rest. I think it's just due to stress/exhaustion. I'm more concerned about yours and how painful they are. The doc thinks it's probably stress, but can't rule out RLS. He gave me more Gabapenten. Doesn't seem to be too worried about them.

Sorry haven't been on lately. I am working on them so if I get any answers will post. Thanks for your comments.

in reply to atwitsendd

Have you had tests for thyroid and diabetes vitamin b12 folates vitamin d iron minerals ?

A metabolic problem with auto immune disease can complicate your symptoms. Hope you have found some answers. No how it feels to be at wits end.

in reply to hawii60

Yes I have, they are negative so still trying to find an answer. Thanks for the info.

in reply to atwitsendd

Did you say you had taken zinc supplements? Zinc deficiency can cause muscle cramps and twitching. If the electrolyte balance is altered from taking medicines, or from sodium potassium chloride and bicarbonate imbalance you can ask for blood test for this.

Calcium imbalance might affect your muscles. Parathyroid gland malfunction leads to calcium imbalance a possible indicator of muscle cramps and restless legs. Did you have a full thyroid panel done? If you get a print out, of your test results, you might find the thyroid test only included TSH without tests for thyroglobulin levels. You should have tests for ferritin levels as well as iron as well as free T3 and free T4 thyroid hormone levels.

Intense exercise can bring it on. Your shoes might also affect your calf and thighs muscles if you wear high heels. If you have too much uric acid from a high protein with red meat, this can also affect muscle function. Ketosis and kidney problems might also need screening. Think you should go to the doctor about this.

I' don't know never heard that feeling in my thighs only in my feet Have you had any discussion with your doctor about it as of yet

An interesting article can be found at :- have found homeopathy can help medical conditions

and can be taken alongside conventional medicine. Zinc . magnesium and potassium supplements might also help or found in high levels in foods such as bananas, may help muscle stretching and twitching and pain. Hope you find the cause for the twitching more in one leg than the other as may be it is to do with lying on the nerve, or is worse when sleeping on one side of the body.

I get severe twitching in my bi

I have severe twitching in my bicep. But mine really hurts and can last for days.

I've been on pramipexole for years and for some reason have woken up at 3am with awful left thigh RLS. I don't understand the thing with magnesium, I tried it once, years ago and it did nowt for me. I'd guess your thigh problem is RLS related. Hope you can get it sorted.

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