Lupus arthritis is the most common cause of joint pain in people with lupus. Joint and muscle pain is perhaps the commonest symptom of lupus and about 90 percent of people with lupus have joint and muscle pain.
Lupus is an autoimmune disease in which rather than just attacking foreign substances, such as bacteria and viruses, your immune system attacks your healthy tissues as well. This causes inflammation and damages various organs of your body, like the joints, skin, kidneys, heart, lungs, blood vessels and brain. The cause of autoimmune diseases, such as lupus is not known, but probably a combination of your genetics and your environmental factors lead to lupus.
Features of joint pain in Lupus Arthritis are:
The joints that are commonly affected in lupus arthritis include the fingers, hands, wrists, elbows, knees, ankles, feet and toes. Lupus arthritis usually affects joints in a symmetrical pattern i.e. the same joints are affected on both sides of the body.
Pain in joint normally starts in the morning, disappears for some time, and again returns later in the evening.
Lupus arthritis generally does not affect the neck and spine (axial skeleton).
Joints are stiff upon waking up in the morning and gradually the stiffness decreases as the day progresses.
Besides joint pain and fatigue may also occur.
Unlike rheumatoid arthritis lupus arthritis does not cause destruction of the joints.
Tests and diagnosis
Joint pain is usually the first sign that you have the disease. Your doctor will investigate for other signs and symptoms to confirm or exclude whether you have lupus. If you have only joint pain confirming if you have lupus can be a difficult task. Joint problems in lupus patients are usually considered to be lupus arthritis, even if the symptoms don't fit. People with lupus can have concurrent rheumatoid arthritis, fibromyalgia, bone necrosis, bursitis and tendinitis. Determining the exact cause of your joint problem is essential to start appropriate treatment. You may need several tests before a confirmed diagnosis of lupus arthritis can be made. Your doctor will ask for blood tests, X-rays, and if needed MRI scan of the joint, and examination of the joint fluid.
Blood tests to detect markers of inflammation such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Tests to rule out RA such as Immunologic tests for levels of rheumatoid factor (RF), antinuclear antibodies (ANA), and possibly other antibodies (anti-RA33, anti-CCP).
X-rays are usually normal in lupus arthritis even in painful joints
Joint fluid tests usually show evidence of low-grade inflammation.
Lupus arthritis is very treatable (even if it cannot be cured), if you take your medicines as advised by your doctor. Your treatment plan will consist of measures to ease your pain, prevent damage to your joints, and help you lead a normal life.
Nonsteroidal antiinflammatory drugs (NSAIDs): Pain of lupus arthritis is managed with a non-steroidal anti-inflammatory drug. The commonly used NSAIDs include ibuprofen, naproxen, ketoprofen, piroxicam, and diclofenac. These drugs can cause potentially serious adverse effects in the digestive tract such as stomach upset, stomach pain, and bleeding.
If NSAIDs are not effective in relieving your pain antimalarial agents such as hydroxychloroquine are added.
Corticosteroids (such as prednisone) may be needed if the joints remain swollen and painful despite other treatment.
Nondrug approaches for include the following:
Physical therapy: This can preserve and improve range of motion, increase muscle strength, and significantly decrease pain.
Heat and cold treatments: These can relieve pain and reduce inflammation. Some people benefit with heat application where as others may benefit from ice application.
Occupational therapy: This teaches you how to use your body efficiently to reduce stress on your joints.
Several complementary approaches are used for relieving pain, these include:
Acupuncture, hydrotherapy, and massage can help to relieve pain.
Mind-body therapies such as relaxation techniques, meditation can teach you to relax and relieve pain.
Complementary and alternative treatments commonly used for lupus are:
Fish oil supplements which are rich in omega-3 fatty acids.
Flaxseed is rich in a fatty acid called alpha-linolenic acid. This may decrease inflammation in the body.
Before starting these supplements consult your doctor as they can possibly interfere with your medications.
Home care measures for management of lupus arthritis include:
Be physically activity as this can limit the progression of symptoms. Do regular exercises.
Avoid physical exertion as it can strain your joints and aggravate pain.
Adapt healthy lifestyle such as; maintain healthy weight, eat a diet with plenty of fruits and vegetables, lean proteins, and low-fat dairy products, quit smoking.
Heat application can help to ease pain and joint swelling. Try soaking in a warm tub or placing a warm compress on the painful joint to ease pain.
Currently there is no known way to lupus or its complications like lupus arthritis. Aggressive and appropriated treatment of lupus can slow the progression of the disease.