For many, lupus remains an enigma—a complex autoimmune disease with myriad symptoms that can affect multiple parts of the body. Among these symptoms, musculoskeletal complaints are common, with knee pain emerging as a frequent concern for many lupus patients. But what is the connection between lupus and knee pain, and how can one effectively manage and mitigate its effects? In this blog, we delve into the intricate relationship between lupus and knee pain, exploring the causes, treatment options, and ways to improve quality of life.
Does Lupus Cause Knee Pain?
Yes, lupus can cause knee pain. Lupus, or systemic lupus erythematosus (SLE), is an autoimmune disease where the immune system mistakenly attacks its own tissues, causing inflammation and damage. This can affect many different body systems including the joints, skin, kidneys, blood cells, brain, heart, and lungs.
Joint pain and arthritis are among the most common symptoms of lupus. Here’s how lupus can be related to knee pain:
- Arthritis in Lupus
About 90% of people with lupus will experience some form of joint pain or arthritis. The knee is a common joint that can be affected. The arthritis seen in lupus can be different from other forms like osteoarthritis or rheumatoid arthritis. Lupus arthritis is often less damaging to the joints than rheumatoid arthritis, but it can still cause significant pain and discomfort.
Lupus can lead to inflammation in the joints, including the knee. This inflammation can cause pain, swelling, and stiffness.
- Muscle Inflammation
Apart from joint inflammation, lupus can cause inflammation of the muscles (myositis). That can result in pain and tenderness. This can also contribute to discomfort around the knee area.
- Tendonitis and Bursitis
Lupus patients may also develop inflammation of the tendons (tendonitis) or inflammation of the bursa (bursitis), both of which can contribute to knee pain.
Some people with lupus may develop osteonecrosis, a condition where there’s a reduced blood supply to the bones. Eventually, leading to bone tissue death. If this happens in the bones around the knee, it can lead to knee pain.
It’s important to note that while knee pain can be a manifestation of lupus, it can also arise from other causes. If someone with lupus experiences new or worsening knee pain, they should seek medical evaluation to determine the exact cause and appropriate treatment.
How Do I Know If My Joint Pain Is Lupus?
Determining whether joint pain is due to lupus or another condition can be challenging because many causes of joint pain have overlapping symptoms. However, there are some specific characteristics and accompanying signs and symptoms that may hint at lupus. If you suspect your joint pain is related to lupus, consider the following factors:
1. The Pattern of Joint Pain
Lupus arthritis tends to be symmetrical, meaning it often affects the same joints on both sides of the body. The pain might be migratory, moving from one point to another.
2. Affected Joints
Lupus most commonly affects the small joints of the hands, wrists, and knees.
3. Nature of the Pain
In lupus, the joints might feel stiff and painful, but they usually aren’t deformed. That can be a characteristic of other conditions like rheumatoid arthritis.
4. Other Symptoms
Lupus is a systemic disease and can present with a variety of symptoms apart from joint pain, such as fatigue, fever, skin rashes (especially the malar or “butterfly” rash over the cheeks and bridge of the nose), chest pain, hair loss, sun sensitivity, mouth ulcers, and kidney problems.
5. Duration of Symptoms
While many conditions can cause joint pain that comes and goes, a more prolonged duration of symptoms might be more suggestive of an underlying systemic condition like lupus.
6. Lab Tests
Blood tests can help in the diagnosis. People with lupus often have certain autoantibodies in their blood, such as anti-nuclear antibodies (ANA). Other tests might include anti-double-stranded DNA (anti-dsDNA), anti-Smith (anti-Sm), and complement levels. It’s important to note that while these tests can support a diagnosis of lupus, they are not definitive on their own. Lupus is often diagnosed based on a combination of clinical signs and laboratory findings.
7. Response to Medications
If your joint pain significantly improves with medications commonly used to treat lupus, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or antimalarials like hydroxychloroquine, it might be another clue.
If you suspect that your joint pain may be due to lupus, it’s essential to see a rheumatologist or a relevant medical specialist.
What Does Lupus And Knee Pain Feel Like?
Lupus-related knee pain can vary from person to person due to the diverse nature of the disease. However, there are some common descriptions and characteristics associated with it:
- Achy or Throbbing Pain: Many describe the pain associated with lupus as a persistent ache or throbbing sensation in the joint.
- Stiffness: Stiffness is often felt after resting or upon waking up in the morning. This can improve somewhat with gentle movement. But it’s not uncommon for the stiffness to last for extended periods.
- Swelling: Inflammation in the joints due to lupus can lead to visible swelling. The knee may appear puffy or enlarged.
- Warmth: The affected joint might feel warm to the touch due to inflammation.
- Migratory Pain: For some lupus patients, joint pain can move from one joint to another. This means you might feel pain in one knee one day and then in another joint on a different day.
- Range of Motion: In some cases, the pain and stiffness can limit the range of motion of the knee. Activities like bending the knee, walking, or climbing stairs might become challenging.
- Pain Aggravation: The pain might worsen with certain activities or during a flare of the disease.
- No Deformities: Unlike some other types of arthritis, lupus-related arthritis rarely results in deformed joints. However, prolonged inflammation can lead to some damage over time.
It’s also important to note that lupus can have systemic effects. Therefore, in addition to knee pain, an individual might also experience other symptoms such as fatigue, rashes, fevers, or general malaise. If someone believes they’re experiencing lupus-related knee pain, it’s crucial to seek a medical evaluation.
How Do You Treat Lupus Knee Pain?
Treating lupus and knee pain involves a combination of medications, lifestyle adjustments, and, in some cases, physical therapies. It’s essential to address both the underlying lupus activity and the specific symptoms of knee pain.
Here’s a broad overview of the treatment options:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter drugs like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce inflammation and alleviate pain.
- Antimalarials: Hydroxychloroquine (Plaquenil) is often used to treat lupus itself, and it can help manage arthritis symptoms.
- Corticosteroids: Prednisone or other corticosteroids can be effective in controlling severe joint inflammation. They might be used short-term or in low doses long-term, depending on the situation.
- Immunosuppressants: Medications like methotrexate, azathioprine, or mycophenolate mofetil can be used in cases where lupus is affecting multiple body systems, or when other treatments aren’t effective.
- Biologics: These newer treatments, like belimumab (Benlysta), target specific parts of the immune system involved in lupus.
A physical therapist can help improve joint function, maintain or increase range of motion, and strengthen the muscles surrounding the knee. This can help alleviate pain and prevent further joint problems.
3. Joint Protection Techniques
Wearing protective gear, using assistive devices, or learning ways to perform daily tasks without putting extra strain on the affected joint can help.
4. Heat and Cold Therapy
Warm compresses can help relieve joint pain and relax and soothe muscles. Cold compresses can reduce inflammation and numb the affected area.
Low-impact activities like swimming, walking, or cycling can help maintain joint function and reduce pain. It’s essential to talk to a doctor or physical therapist about which exercises are best and how to do them correctly.
While being active is vital, it’s equally important to recognize when to rest. Balancing activity with periods of rest can help manage flares and prevent excessive joint strain.
7. Complementary Therapies
Acupuncture, massage, or tai chi might help some people manage their lupus-related knee pain. Always consult with a healthcare provider before starting any complementary therapy.
8. Dietary Considerations
Some people with autoimmune conditions report benefits from dietary changes, such as eliminating inflammatory foods. While there’s limited scientific evidence on diet and lupus, it’s worth discussing with a doctor or nutritionist.
Regular check-ups with a rheumatologist and proactive management are crucial for anyone with lupus. Treatment may require adjustments over time, based on symptom progression and the presence of any side effects.
In understanding the nuanced relationship between lupus and knee pain, it becomes evident that lupus is not just a singular ailment but a complex web of symptoms that intersect with various aspects of one’s life. Effective management requires a holistic approach, blending medical interventions with lifestyle adaptations, and a commitment to staying informed. By recognizing the signs, seeking timely medical consultation, and adopting supportive therapies, individuals with lupus can navigate their journey with resilience and hope.
Through knowledge and proactive care, a better quality of life is not just a possibility—it’s an achievable goal. If you’re experiencing Knee pain, physical therapy for knee pain at PhysioMantra can help: Book an online physical therapy session.