Joint Pain in Lupus: Why, Where, and How to Manage
Most people with lupus experience joint pain, usually in smaller joints like fingers and toes. Some lupus medications may already help with joint pain, but a doctor may recommend other medications, exercise, or dietary changes.
When you think of joint pain, the first connection is often arthritis. But lupus, an autoimmune condition, also commonly affects the joints. In fact, almost 90% of people with lupus experience some degree of joint pain, and up to 50% experience it before any other symptom.
For some people with lupus, the joint pain (arthralgia) may be mild. Others may experience more severe symptoms. Some types of lupus may even increase your risk of developing arthritis.
If you received a diagnosis of lupus and are curious about why you’re experiencing joint pain, read on to learn the causes, symptoms, and potential treatment options.
Like other autoimmune diseases, lupus can cause your body to mistakenly attack healthy cells and tissues. Through a complex chain of events, lupus activates antibodies as if you were mounting an immune response to a disease. This can affect your joints, skin, blood vessels, and internal organs.
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As part of this chain of events, your body releases proteins called cytokines, which help activate your immune system. The cytokines released in 50% to 75% of people with lupus are the same that your body releases in response to a virus. Many people with lupus describe their achy joints as similar to joint pain that co-occurs with a viral infection.
In some autoimmune diseases, like rheumatoid arthritis (RA), the release of cytokines triggers inflammation, causing pain. But in lupus, you can have pain with or without inflammation.
Joint pain in lupus usually appears in one of three ways:
Nonerosive arthritis
Lupus may cause a small amount of inflammation in or around your joints. But this isn’t like the inflammation in RA.
Joint pain in lupus typically does not lead to a loss of cartilage or any structural changes in your joints. You may not even experience hallmark symptoms of inflammation, like swelling or erythema (skin color changes).
According to a 2018 research review , people with lupus most often develop symmetric polyarthritis. That means it affects the same joints on both sides of your body, such as your knees or knuckles.
Jaccoud’s arthropathy
Jaccoud’s arthropathy (JA) is a more severe form of arthritis that can affect your hands, particularly the knuckles. JA can lead to structural changes, but a clinician can usually manually correct them. JA is also nonerosive.
About 3% to 13% of people with lupus develop JA.
‘Rhupus’
Some people with lupus experience joint pain that looks similar to RA, but this happens rarely. These cases may lead to structural changes.
While there’s no clear definition of “rhupus,” studies estimate it affects 0.1% to 9.7% of people with lupus.
