Lupus affects muscles, tendons and joints

It is common for people with lupus to experience muscle aches (myalgias) or inflammation of certain muscle groups (myositis), which cause weakness and loss of strength. More than 90 percent of people with lupus may experience joint or muscle pain at some point in the course of the disease. More than half of people who develop lupus say joint pain is the first symptom that appears.

Muscle pain and sensitivity, especially during periods when disease activity (breakouts) increases, occurs in up to 50 percent of people who have lupus. Symptoms may have different causes. It is important for your doctor to determine the cause of your symptoms, as treatments are very varied. Rheumatologists are doctors who specialize in joints, muscles, and bones.

Muscle aches and discomfort can be from symptoms that occur when the body is responding to some type of inflammation, muscle atrophy (weakness) or true myositis.

Inflammation

Inflammation is the most common cause of muscle pain. Whenever major inflammation occurs (tonsillitis, hepatitis, cancer, lupus, acute heart attack, etc.), signs and symptoms often show fevers, sweats, chills, fatigue, weight loss and various muscle aches, discomfort and weakness. These nonspecific and non-diagnostic symptoms are signs that the body is unable to cope with the process that is overwhelming it. Because lupus is an inflammatory disease, it can cause some of these problems. These myalgias are a secondary part of the disease in general.

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Lucid arthritis

Lucid arthritis causes pain, stiffness, swelling, tenderness and heat in the joints. The joints that are most affected are the most distal of the midline of the body, such as the fingers, wrists, elbows, knees, ankles and toes. General stiffness when waking, which gradually improves as the day goes on, is a key point of lucid arthritis. However, there may also be joint pain during the day. Several joints are usually involved and inflammation can affect similar joints on both sides of the body.

Compared to rheumatoid arthritis, lucid arthritis is less disabling and less likely to cause joint destruction. Less than 10 percent of people with lucid arthritis develop deformity in the hands and feet from bone or cartilaginous weakening.

Muscle atrophy (loss of muscle strength) may occur if arthritis becomes chronic.

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Miositis lúpica

Some people with lupus develop myositis, an inflammation of the skeletal muscles that causes weakness and loss of strength. Lucid myositis often affects the muscles of the neck, pelvis, thighs, shoulders, and arms. The first symptoms are difficulty climbing stairs and difficulty getting up from a chair. Later symptoms may occur such as difficulty lifting objects and placing them on a shelf, lifting your arm to comb or brush your hair, getting out of the bathtub, and even lifting your head or turning on the bed.

An exercise program overseen by a physical therapist can help restore normal muscle strength and function.

Drug-induced myasthenia

Myasthenia (muscle weakness) may also be a side effect of certain medications used to treat lupus and related diseases, such as prednisone and other corticosteroids, cholesterol-lowering medications, and hydroxychloroquine(Plaquenil®). Therefore, drug-induced muscle disease should be ruled out as a cause of weakness if you are taking any of these medications, as drug-induced myasthenia generally does not produce elevated levels of muscle enzymes as seen in lucid myositis.

You can adjust or stop taking medications that are causing muscle weakness so that there is an improvement in muscle strength.

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Tendinitis and bursitis

A tendon is a strong structure of hard fibers like a rope that binds muscles to bones. A bursa  is a small sac that contains a viscous fluid that is usually located next to a joint and allows muscles, bones and tendons to move easily. Tendinitis (inflammation of a tendon) and bursitis (inflammation of a pouch) usually occur due to damage or overuse of a joint. Pain is the main symptom of both conditions. Different parts of the body may be affected and the most common parts are elbows (tennis elbow), fingers (index finger) and shoulders. In addition, both tendons and  bursas  are aligned with the synovial membrane, which is a target for inflammations in lucid arthritis.

Carpal tunnel syndrome

Pressure on the central nerve of the wrist causes a condition called carpal tunnel syndrome. It is characterized by tingling, numbness and pain in the fingers, and sometimes throughout the hand. Several diseases, including lupus, can cause carpal tunnel syndrome. When carpal tunnel syndrome occurs because of lupus, it’s because inflammation in the wrist is making pressure on the nerves.

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