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.

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

Probably many more people suffer with these disease than have been diagnosed. Lupus is an autoimmune disease. These disease are due to the abnormal production of autoantibodies in the blood which turn against various tissues in the body.

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 the clinical presentation as well as the results of select laboratory tests looking at the levels of certain autoantibodies in the serum.

There is no cure for lupus. However, 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, glaucoma, and diabetes.
• Disease-modifying antirheumatic drugs (DMARDs), also known as slow-acting antirheumatic drugs (SAARDs). These medications may be prescribed by themselves or in combination to manage the symptoms of joint and muscle pain and dry skin from Sjögren's syndrome. DMARDs that may be prescribed include hydroxychloroquine sulfate (Plaquenil) or methotrexate.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may provide relief from inflammation, but people with Sjögren's syndrome may be more susceptible to developing gastroesophageal reflux disease (GERD) after taking NSAIDs.
• Biologic therapies. These drugs target specific cells and cellular messengers called cytokines.

Hypothyroidism (an underactive thyroid gland) can not only cause aches and pains but also lead to chronic fatigue, dryness of the eyes and mouth, sluggishness, memory problems, and other disturbing symptoms. If undiagnosed it may be life-threatening.

Another condition that causes joint aches and pains along with dry eyes and dry mouth if 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, 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 affect the glands that produce secretions, cause fatigue, and be accompanied by aches and pains.

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.

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