Lupus Pain and Arthritis

Reviewed by: HU Medical Review Board | Last reviewed: January 2020

Lupus is not a form of arthritis, but painful, swollen joints are one of the most common symptoms. When inflammation has lasted long enough or been severe enough to damage the joints, it is called lupus arthritis.

More than 95 percent of people with lupus experience joint pain or arthritis at some time during their lives. Joint pain is the first symptom recognized by more than 50 percent of people who go on to be diagnosed with lupus.1-2

Why does lupus causes painful, swollen joints?

Inflammation is the most common reason for painful, swollen joints in people with lupus. Once inflammation causes permanent weakening of the cartilage and bone of the joints, it is called lupus arthritis. However, arthritis can have other causes, such as being overweight, sports injury, or other autoimmune diseases.

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

People with lupus are more susceptible to developing carpal tunnel syndrome, which causes tingling, numbness, and pain in the fingers, hands, and wrists. Carpal tunnel syndrome is caused by inflammation or pressure on the median nerve in the wrist.

A related symptom of lupus, muscle, and tendon pain may also cause joint pain.

What are the symptoms of lupus arthritis?

The symptoms of arthritis caused by lupus include:

  • Pain
  • Swelling
  • Stiffness, especially after waking
  • Tenderness
  • Warmth
  • Redness

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.2

Common areas of lupus arthritis in people with lupus

The most common areas of the body where arthritis develops in people with lupus are in the small joints furthest from the body, including:

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

Usually, several joints develop arthritis, and it is mirrored in joints on both sides of the body.

How is lupus arthritis diagnosed?

An x-ray and physical examination of the joints in question will tell your doctor whether the inflammation caused by lupus has damaged your joints. Ultrasound and magnetic resonance (MRI) are used less often to diagnose lupus arthritis but may be more useful in people with very mild symptoms.3

How is lupus arthritis treated?

Lupus arthritis is treated along with the other symptoms of lupus with a combination of drugs, exercise, and alternative therapy. Treatments for lupus arthritis include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, can help relieve pain and reduce inflammation.
  • Warm showers in the morning may help loosen the synovial fluid in the joints and reduce stiffness.
  • Antimalarial medicines may reduce inflammation.
  • Certain immunosuppressants and steroids may be used for severe lupus arthritis.
  • Fluid build-up in a joint may require drainage.

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