Joint Function and Lupus

Joint pain or arthritis is experienced by 95% of people with lupus at some time during the course of their disease. In fact, joint pain is usually the first symptom of lupus. Unlike rheumatoid arthritis, the arthritis of lupus tends to be temporary. It is also less damaging to the joints. The joints most commonly involved are those of the fingers, wrists, and knees. Elbows, ankles, and shoulders are not affected as often. When a particular joint is affected on one side of the body, the same joint on the other side of the body is usually affected as well.

Arthralgia:

Arthralgia means “joint pain.” Morning stiffness, swelling, or heat in the joints can also occur.

Myalgia or myositis:

Myalgia means "pain in the muscles"; myositis means “inflammation of the muscle.” These may include overall muscle pain and tenderness, especially in the upper arms and upper legs. They are common in 40–80% of people with lupus, especially during a flare.

Other joint complications:

Several types of joint complications occur rarely in lupus. They include osteonecrosis (damage to the hip joint that leads to severe arthritis), development of nodules in the small joints of the hands, tendinitis, tendon rupture, and carpal tunnel syndrome. Your doctor or nurse can give you more information about these problems.

Taking Care of Your Joints

If you have joint or muscle problems, the first goal is to keep pain at a tolerable level. You can do this in several ways:

• Apply heat or cold to the affected joints.
• Support the affected joints with pillows, blankets, or splints (if ordered by your doctor).
• Rest the affected joints as much as possible and keep them elevated to help reduce swelling.
• Follow your doctor’s plan for managing pain and using anti-inflammation medication.

Your second goal is to maintain joint function and increase muscle strength. You can do this by using the following techniques:

• Take warm showers or baths to lessen stiffness.
• Don’t put any weight on an acutely inflamed joint. Sit or lie down. Avoid strenuous activity and avoid any activity that causes increased pain, swelling, tenderness, or heat to the affected joint.
• Ask a physical therapist or trained family member or friend to gently move the inflamed joint in all the directions it can be moved (this is called passive range of motion [ROM]).This will help prevent stiffness. Your doctor can let you know when and how often this should be done.
• Gently move the affected joint yourself when the acute inflammation is over.
• Talk with your doctor or nurse about physical or occupational therapy if you are having trouble regaining joint strength and motion or if activities of daily living (cooking, cleaning, bathing, etc.) are still difficult.
• Hire a housekeeper or someone to help care for yourself or your children until you feel better.

When you are feeling better and your physical condition has improved, your doctor will probably recommend an exercise program tailored to your needs. Although rest and protecting joint function are extremely important, exercise is also necessary to keep muscles, bones, joints, and tendons strong and healthy. A well-planned exercise program combined with other aspects of your care will help you maintain joint function and improve your overall fitness.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, January 1999