Is Joint Pain a Symptom of Lupus?
Joint pain is one of the most common symptoms that people with lupus experience. In fact, more than 90 percent of people diagnosed with lupus will have joint pain at some point during their illness[2]. This makes joint pain one of the hallmark signs that doctors look for when trying to diagnose lupus in their patients.
What Is Lupus?
Before we talk about joint pain specifically, it helps to understand what lupus is. Lupus, which doctors call Systemic Lupus Erythematosus or SLE, is a chronic autoimmune disease[3]. This means that the body’s immune system, which normally protects us from infections and diseases, mistakenly attacks the body’s own tissues and organs instead. This attack causes inflammation and damage throughout the body.
Lupus is unpredictable and can affect many different parts of the body. It can damage the skin, joints, kidneys, lungs, heart, and even the brain[3]. The disease often comes and goes, with periods when symptoms get worse, called flare-ups, followed by periods when symptoms improve, called remission[3].
How Common Is Joint Pain in Lupus?
Joint pain is extremely common in lupus patients. Medical experts have found that arthritis and joint pain affect more than 90 percent of people with lupus[2]. This makes it one of the most frequent symptoms of the disease. The joint pain typically affects multiple joints at the same time and is usually symmetrical, meaning it affects the same joints on both sides of the body[2].
The joints most commonly affected by lupus are the small joints in the fingers, the carpal joints in the wrists, and the knees[2]. People with lupus often describe this pain as arthritis, which is inflammation of the joints. The pain can range from mild to severe and can come and go over time.
What Does Lupus Joint Pain Feel Like?
When lupus affects the joints, people typically experience what doctors call symmetrical polyarthritis[2]. This is a fancy medical term that simply means pain and inflammation in multiple joints that affects both sides of the body equally. For example, if someone has pain in the joints of their right hand, they will usually have similar pain in the joints of their left hand.
People with lupus often describe their joint pain as similar to arthritis pain. They may feel stiffness in their joints, especially in the morning. The joints may feel swollen or tender to the touch. Some people also experience muscle pain, which doctors call myalgia, along with their joint pain[2].
The joint pain from lupus can be unpredictable. Some days the pain might be worse than other days. Some people experience periods where their joint pain is severe, followed by periods where it improves. This unpredictable nature of lupus symptoms makes it challenging for patients to manage their condition[3].
Other Symptoms That Come With Joint Pain
Joint pain in lupus rarely occurs by itself. It usually comes along with other symptoms. One of the most recognizable symptoms of lupus is a rash on the face that looks like a butterfly, called the malar rash or butterfly rash[1]. This rash typically appears across the cheeks and nose.
People with lupus also commonly experience constitutional symptoms, which is a medical term for general body symptoms[1]. These include fatigue, fever, and weight loss[2]. Many people with lupus say that the fatigue is one of the most bothersome symptoms they deal with.
Other common symptoms include sensitivity to sunlight, which can trigger or worsen lupus symptoms[3]. Some people develop Raynaud’s syndrome, which causes the fingers and toes to turn white or blue in response to cold or stress[4]. Hair loss is another symptom that some lupus patients experience[5].
How Doctors Diagnose Lupus
Because lupus can affect so many different parts of the body and has so many different symptoms, there is no single test that can diagnose lupus[6]. Instead, doctors look at a combination of symptoms, medical history, and special blood tests[6].
When a doctor suspects someone might have lupus, they will order several blood tests. The most important test looks for antinuclear antibodies, which are often called ANAs[1]. These are antibodies that the body produces when it has lupus. Doctors also test for specific antibodies like anti-dsDNA antibodies and Smith antigen antibodies[1].
Doctors will also order a complete blood count, which checks the number of red blood cells, white blood cells, and platelets in the blood[1]. They may check kidney function by measuring BUN and electrolytes[1]. They will also do a urinalysis to check for kidney problems[1].
In addition to blood tests, doctors may order imaging studies to look for organ damage. These might include chest X-rays, ECGs to check the heart, or ultrasounds[1]. A rheumatologist, which is a doctor who specializes in joint and autoimmune diseases, typically evaluates patients with suspected lupus[3].
The diagnosis of lupus is considered a clinical diagnosis, which means doctors make the diagnosis based on the overall picture of symptoms and test results rather than on one specific test[2]. Doctors are careful to rule out other diseases that might cause similar symptoms before diagnosing someone with lupus[2].
Why Does Lupus Cause Joint Pain?
Lupus causes joint pain because the immune system attacks the tissues in and around the joints. This causes inflammation, which leads to pain, swelling, and stiffness. The inflammation can affect the synovial fluid that lubricates the joints, making movement more difficult and painful.
The joint pain in lupus is different from the joint damage seen in some other types of arthritis. In lupus, the joint pain is usually caused by inflammation rather than permanent damage to the joint structure. This means that with proper treatment, the pain can often be controlled and the joints can continue to function well.
Managing Joint Pain in Lupus
There is currently no cure for lupus, but doctors can manage the symptoms and prevent organ damage[3]. For joint pain specifically, one of the first treatments doctors try is nonsteroidal anti-inflammatory drugs, which are called NSAIDs[7]. These medications work by reducing inflammation and pain. NSAIDs usually start working within a few days and are the most common treatment for typical lupus symptoms like fever and joint pain[7].
Beyond medications, people with lupus can manage their joint pain through lifestyle changes. Avoiding sunlight, which can trigger lupus flare-ups, is important[3]. Managing stress is also helpful, as stress can worsen symptoms[3]. Getting adequate rest and sleep helps the body heal and can reduce pain.
Physical therapy and gentle exercise can help maintain joint function and reduce pain.
