Joint and Muscle Pain

Introduction

More than 90 percent of people with SLE will experience joint and/or muscle pain at some time during the course of their illness. At the onset of the disease, the major complaint of more than half of SLE patients is pain in the joints.

The major cause of joint pain in SLE is inflammation of the joints. The term for this is arthritis. In the affected joint, arthritis can cause:

• pain
• swelling
• tenderness
• a feeling of warmth
• fluid collection.

Pain in and around the joints is not always due to lupus arthritis. It also can be due to other medical disorders that may complicate or co-exist with SLE, including:

• fibromyalgia
• avascular necrosis of bone
• bursitis and tendonitis,
• other types of arthritis
• infection.

Inflammation of skeletal muscle also may develop in people with SLE. This condition, called myositis, causes progressive weakness and loss of strength of the extremities.

Lupus Arthritis
Lupus arthritis causes pain, stiffness, swelling, tenderness, and warmth of joints, and several joints are involved at one time. Joints farthest from the trunk of the body are affected most commonly, such as:

- fingers
- wrists
- elbows
- knees
- ankles
- toes


• The inflammation is symmetrical in distribution, which means it affects similar joints on both sides of the body.
• Generalized stiffness that occurs upon awakening in the morning will gradually improve as the day goes on
• Later in the day, joint pain and fatigue may return.
• Puffiness of the hands can occur.
• Recurrent attacks of arthritis are experienced by one-third of those with lupus.

Compared to rheumatoid arthritis, lupus arthritis is less disabling and it usually does not cause severe destruction of the joints. Fewer than 10 percent of people with lupus arthritis will develop deformities of the hands and feet. These are associated with weakening of cartilage and bone and can be seen in the x-ray of the joints. Referred to as "Jaccoud-type deformities," these are reversible conditions.