Joints

Stiff, painful, swollen joints are some of the most common symptoms of lupus. Sometimes the inflammation lasts long enough or is severe enough to damage the joints. This is called lupus arthritis.

More than 95 percent of people with lupus experience joint pain or arthritis at some point. About half of people with lupus said joint pain was the first symptom they noticed. People with lupus often feel joint pain long before swelling or damage becomes noticeable.1-3

How does lupus cause joint damage?

Lupus causes inflammation that can damage the bones and tissues of the joints. Eventually, this inflammation may weaken the cartilage and bone of the joints. When the damage progresses to this stage it is called lupus arthritis.

However, arthritis may also be caused by obesity, sports injury, and other autoimmune diseases.

People with lupus sometimes also develop carpal tunnel syndrome. Carpal tunnel syndrome causes hand weakness, and tingling, numbness and pain in the fingers, hands, and wrists. It is caused by inflammation or pressure on the central nerve in the wrist.

People with lupus are more likely to develop severe joint damage if they also have:

  • Sjogren’s syndrome
  • Positive anti-Ro antibodies
  • High levels of C-reactive protein
  • Positive rheumatoid factor3

Common sites of joint damage in people with lupus

The most common places where joint damage develops in people with lupus are:

  • Fingers
  • Wrists
  • Elbows
  • Knees
  • Ankles
  • Toes

With lupus, joints on both sides of the body tend to swell and hurt. This is called mirroring. Several joints may develop lupus arthritis. A related symptom of lupus, muscle and tendon pain, may also cause joint pain.1-3

Lupus arthritis tends to be less disabling and damaging than rheumatoid arthritis. Less than 10 percent of people with lupus arthritis will develop serious deformities of the hands and feet.1

What are the symptoms of lupus arthritis?

The symptoms of arthritis caused by lupus include:

  • Pain
  • Swelling
  • Stiffness, especially after waking
  • Tenderness
  • Warmth
  • Redness
  • Muscle weakness at the joint

These symptoms usually appear in 5 or more joints. The joint pain caused by lupus tends to be worse in the morning and gets better as the day passes.1-2

How is lupus arthritis diagnosed?

An x-ray of the painful joints will tell your doctor whether lupus inflammation has damaged your joints. Ultrasound and magnetic resonance (MRI) are used less often to diagnose lupus arthritis. However, these tests seem to be more accurate in diagnosing people in the early stages of arthritis.4

Sometimes, your doctor may drain fluid from a swollen joint and have that fluid tested for signs of infection or antibodies.3

How is lupus arthritis treated?

Drugs, exercise, surgery, and alternative therapies may be used to treat lupus arthritis.

Treatments for mild joint damage include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, to relieve pain and reduce inflammation
  • Warm showers in the morning to get fluid in the joints moving and to reduce stiffness
  • Exercise to reduce stiffness
  • Heat or cool packs
  • Antimalarial medicines to reduce inflammation
  • Splints to correct finger or toe deformities1-3

Treatments for serious joint damage include the same options as mild arthritis, plus:

  • Certain immunosuppressants and steroids to reduce inflammation
  • Drainage if fluid builds up in a joint 
  • Joint replacement surgery or tendon surgery1-3

Joint damage can be painful and make some activities more difficult. However, only about 5 percent of people with lupus develop a severe joint problem called Jaccoud’s arthropathy. This condition can change the shape of the joints so that they become overly flexible.5

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Written by: Jessica Johns Pool | Last reviewed: January 2020