Chronic joint pain and fatigue

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

There are many causes of this combination of symptoms, I will discuss only a few of the more common ones.

Rheumatoid arthritis and related conditions are among the most common causes of joint pain and fatigue. The joint pain is accompanied by joint swelling, morning stiffness, and laboratory abnormalities including elevated erythrocyte sedimentation rate, positive rheumatoid factor, and elevated anti-cyclic citrullinated peptide.

Systemic lupus erythematosus ("lupus")and its close cousin, Sjogren's disease, are common autoimmune diseases that affect several hundred thousand Americans. Ninety per cent of those affected are women. This condition is often misdiagnosed or undiagnosed.

In addition to joint pain and fatigue, patients may have rashes, low grade fevers, mouth sores, abnormal blood counts, muscle aches, and in the worst cases, severe damage to the kidneys, brain, heart, and lungs.

The diagnosis is based on clinical features as well as the results of laboratory tests looking at the levels of specific autoantibodies in the serum.

While there is no cure for lupus, treatment can help control the symptoms and prevent further organ deterioration

For joint pain or other serious symptoms, treatment may include:

•Corticosteroids (such as prednisone), which are used to relieve muscle and joint inflammation but can have serious side effects, including osteoporosis, weight gain, glaucoma, and diabetes.
•Disease-modifying antirheumatic drugs (DMARDs), also known as slow-acting antirheumatic drugs (SAARDs). These medications manage the symptoms of joint and muscle pain and dry skin from both lupus and Sjögren's disease. DMARDs that may be prescribed include hydroxychloroquine sulfate (Plaquenil) or methotrexate. In more severe cases, azathioprine, cyclophosphomide, and mycophenolate mofitil may be required.
•Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs may provide relief from inflammation, but people with Sjögren's syndrome may be more susceptible to gastroesophageal reflux disease (GERD)so NSAIDS could be a problem In addition, NSAIDS have an adverse effect on kidney function and should be used cautiously in patients with autoimmune disease.
•Biologic therapies. These drugs target specific cells and cellular messengers called cytokines. Their use has not been impactful despite the FDA approval of a drug for lupus that targets B lymphocytes. Effects on disease are modest at best.

Hypothyroidism (an underactive thyroid gland) causes aches and pains as well as chronic fatigue, dryness of the eyes and mouth, sluggishness, memory deficits, and other disturbing symptoms.

Lyme disease, an infectious form of arthritis, caused by the spirochete Borrelia burgdorferii, causes joint pains, fatigue, low grade fever, rash, and usually responds to antibiotic therapy if diagnosed early and treated promptly.

Polymyalgia rheumatica (PMR) is another form of inflammatory arthritis that presents with severe diffuse aching in both muscles and joints. It also may be accompanied by fatigue. It typically affects patients older than 50 years of age and the hallmark of the disease is the presence of a markedly elevated sed rate.

Sarcoidosis, a pulmonary disease with autoimmune roots, also causes joint pain and fatigue. The chest x-ray will be abnormal showing enlarged lymph nodes. Sarcoidosis can also affect the brain, eyes, and heart.

Another condition that causes joint aches and pains along with dry eyes and dry mouth is fibromyalgia. This is felt to be due to disorder of central neurotransmitter function. In addition to aches and pains that affect the soft tissues as well as the joints, a patient may complain of fatigue, dryness of the eyes and mouth, irritable bowel or bladder, shortness of breath, headaches, memory issues, and chest pains.

Fibromyalgia is a diagnosis of exclusion and other conditions need to be considered. The treatment for fibromyalgia is highly individualized and is discussed elsewhere on this website.

Unfortunately, malignancies can occasionally present in this fashion. Lymphomas may cause fatigue, and be accompanied by aches and pains. Lymphoma is a complication of Sjogren's disease.

The point is that this group of symptoms are relatively common and have multiple possible diagnoses. A thorough evaluation by an experienced clinician is advisable.

Get more information about chronic joint pain and fatigue and related conditions as well as...

• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!

• Devastating ammunition against low back pain... discover 9 secrets!

• Ignored remedies that eliminate fibromyalgia symptoms quickly!

• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!

• The stiff penalties you face if you ignore this type of hip pain...

• 7 easy-to-implement neck pain remedies that work like a charm!

• And much more...

Click here Second Opinion Arthritis Treatment Kit

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