I go through phases of getting them at night- the ones in the calf that wake you up out of the deepest sleep. I've never noticed a connection between them and whether I'm on or off any med- but I've never thought to look for a connection, either!

I may have an idea of why.

Ra attacks all tissues that are "synovial" and bursas are covered by synovial tissue. Bursas are all over our bodies...not just the big ones at joints that we've all had problems with(RA bursitis is a B@#$%). But we have small ones between all our muscles that put out fluid to keep the muscles sliding easily against each other. If while on a biologic the bursas lose their inflammation, then your muscles would work properly but when off the biologics, they would become inflamed again and your muscles would grind to a halt and spasm.

I suggest this as my form of Ra started with severe tendosynovitis and bursitis so badly the big bursas would rupture. So I figured that some of my severe muscle pain and spasms were from the same process with bursas that are deep between the muscles. Once I started on Orencia, they got better and the muscle pain/spasms stopped. When I had to stop for surgery, my joints didn't become inflamed...the tendons and bursas did. Back on Orencia....better. Back off for more surgery, bursas and tendons got worse. Been back on for 2 years but it's never been the same. Back to having cortisone shots for tendosynovitis and bursitis.

Maybe??????

hugs........Jen

I have terrible Charlie horses and also twitching (fasciculation). It is absolutely tied to my RA. My RA is not typical - it's all bursa and tendon and synovial related. I can flex my toes once and the rest of the day they want to cramp. I can do the same with my neck and I almost get a cramp all day long. It's awful when a cramp actually makes its way in - because then I'm sore for a long time.
I don't know why you are having a hard time with the biologics not "taking" for longer. That is so frustrating.
I guess your body recognizes them as invaders and neutralizes them.

Sorry I am not more help but I do understand and you are not alone.

I had severe Charlie horse in my legs after I had foot reconstruction surgery in 2009. Sometimes I would get spasms in the muscles on both sides of the calf or thigh, meaning I couldn't stretch it out. My husband would have to massage it out, usually sometime in the middle of the night. I wonder if he even remembers doing it?

Anyway, when I got back on my bike, it was always worse on the days I was riding outside. Someone recommended electrolytes, and sure enough they helped tremendously. I was already taking a lot of minerals but these are released really quickly. The days I forgot to take it after a ride, I was in agony at night.

After a few years, it stopped, or I remembered to take the electrolytes. But this year, since everything has failed in treatment, I was getting horrific foot cramps the minute I took my feet off the ground at the end of the day.

A chiropractor recommended magnesium gel, and it really helped left foot. I don't get the cramps at all. The right foot is still a work in progress.

So, like Buddhacat, minerals were the answer for me. I hope you find the cause and some way to treat it, lots of good suggestions here.

I'm in full agreement with Sally on how docs view RA.
I was told years ago by a doctor I highly respect that inflammation can cause so much more then most doctors acknowledge.
I'm awful at this but I'll try to pass on how he explained it to his patients.
Inside the body is like a puzzle with just enough room for each piece.
The pieces fit as they should leaving little room for anything else.
Throw in inflammation & it's going to effect anything around it.
Now RA is the master of inflammation. So everything is going to have added pressure. Not just the joints. Sure would explain all the damage RA can do to the body inside & out.
Perhaps thinking of it like a domino effect, which is how I see it.
If my RA is out of control all my other CP problems are aggravated.
Nueropathy, Myofascial damage, disc problems cervical & lumbar.
So yes I'll get spasms. Legs, feet, neck, shoulder....
Legs & feet will wake me up gasping in pain.
I'd have to D tested to. I do take magnesium/potassium. It's worse if I don't.
That's my 2 cents for what it's worth.
I'll add this doctor did explain doctors do not have the training to deal with CP, causes & treatments. The education most doctors required in the past was very little.
That is evident in our medical community today.
My opinion of course. Hope you get some relief.
Good to hear from you, sorry it's under these circumstances.
Sammy