Lupus Symptoms Diagnosis Joint Muscle Pain

Joint and muscle pain are lupus symptoms commonly seen in women in their childbearing years. The prevalence of joint and muscle pain in lupus makes the disease difficult to diagnose since the symptoms are shared with so many other illnesses, including rheumatoid arthritis, influenza or other infections. While joint and muscle pain affect 90 percent of patients with lupus, other symptoms related to lupus must be present to diagnose lupus with any certainty.

Symmetric Pain

Pain of the joints or muscles can occur at any time during systemic lupus erythematosus (SLE). As a chronic disease, SLE is characterized by flare-ups. Flare-ups can occur at any time and can last for days or weeks, and are then followed by a period of remission in which sysmptoms ate latent. For many, those flare-ups include pain of the joints or muscles. Like rheumatoid arthritis pain, lupus pain is symmetric. If pain occurs in the joints on one side of the body, similar pain typically appears on the other side.

Joint Deformities in SLE

Systemic lupus erythematosus patients can develop joint deformities similar to those in people with rheumatoid arthritis. The joint pain in lupus is likely to occur in the joints farthest from the trunk such as the fingers, wrists, elbows, knees and ankles.

Lupus vs. Rheumatoid Arthritis

On an x-ray, the joints of SLE patients look normal and do not undergo erosion, unlike patients suffering from rheumatoid arthritis.

Approximately ten percent of patients with SLE develop deformities in their finger joints. One type of deformity, known as the swan neck deformity, is the bending of the top knuckle of the thumb or finger. In another type of deformity known as ulnar deviation, the fingers are shifted and point off to the outside.

Treatment of Joint Pain

Lupus joint pain can be treated with non-steroidal anti-inflammatory medications such as aspirin or ibuprofen. If these medications are not effective, anti-malarial drugs may be used to decrease inflammation. In the worst cases, corticosteroids may be used, but only if other medications are not effective and the joints remain swollen and painful. Corticosteroids are associated with serious side effects like osteoporosis, which can further destroy the joints.

Muscle Pain in SLE

Muscle aches (myalgia) frequently occur in systemic lupus erythematosus and affect the tendons where muscles attach to bone. The muscles most commonly affected by myalgia are the muscles nearest the trunk such as the neck, pelvis, thighs, shoulder and upper arms. Myalgia can lead to serious muscle weakness and muscle damage.

Treatment of Myalgia

Unlike joint pain, muscle pain is treated with corticosteroids such as prednisone. Prednisone dampens the immune system’s response, which slows antibodies that attack the body’s own cells. This, in turn, reduces inflammation. Once the inflammation subsides, the dose of corticosteroid is tapered off until the patient no longer needs medication. Corticosteroids should never be stopped abruptly.

Resources

Beers, M.H.