Scleroderma impacts the joints primarily through a combination of inflammation, fibrosis (scarring), and vascular changes that affect the tissues around and within the joints. This autoimmune disease causes the immune system to become overactive, leading to excessive production of collagen and other connective tissue components. As a result, skin thickening and tightening occur, which can extend over joints and restrict their normal movement.
One of the earliest joint-related symptoms in scleroderma is nonspecific joint pain or arthralgia. Patients often experience discomfort not only in their joints but also in tendons and muscles surrounding those joints. Over time, this can develop into arthritis characterized by swelling, stiffness, and reduced range of motion. The small joints of the hands are particularly vulnerable because skin thickening limits flexibility there more than elsewhere.
Fibrosis plays a major role in joint problems by causing contractures—permanent tightening or shortening—of tendons and ligaments around affected joints. This leads to flexion deformities where fingers or other parts bend inward abnormally because they cannot fully straighten anymore. Such contractures commonly affect fingers, wrists, elbows, knees, and sometimes larger body joints as well.
Calcinosis is another feature that affects joint function in scleroderma patients; it involves calcium deposits forming lumps under the skin near or around joints like elbows or knees. These deposits can be painful themselves but also contribute mechanically to limiting joint mobility.
Vascular involvement adds complexity: Raynaud’s phenomenon frequently accompanies scleroderma causing blood vessels in fingers and toes to constrict excessively when exposed to cold or stress. This reduces blood flow leading not only to color changes but also pain that may worsen with movement involving these digits.
Muscle weakness (myopathy) may develop either from direct disease effects on muscle tissue or as side effects from treatments used for scleroderma; this further impairs joint stability and function since muscles support proper joint mechanics.
In summary:
– **Joint pain** begins often as vague aches progressing toward arthritis.
– **Skin thickening** overlying joints restricts motion.
– **Fibrosis causes contractures**, permanently limiting extension especially in hands.
– **Calcinosis deposits** near joints add mechanical hindrance.
– **Raynaud’s phenomenon** induces painful ischemic episodes affecting finger/toe mobility.
– **Muscle weakness** compounds functional impairment around affected areas.
Together these factors lead many people with scleroderma to experience significant difficulties using their hands for daily tasks due to stiffness, deformity, pain, and loss of dexterity caused by combined skin changes plus musculoskeletal involvement. Joint symptoms vary widely among individuals depending on disease subtype severity but are common enough that managing them is an important part of overall care for those living with this complex autoimmune condition.