Joint pain after flu
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.
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Flu-like symptoms are common in a number of arthritis syndromes.
For instance, Lyme disease, an infectious arthritis due to a spirochete, often presents with headache, fever, fatigue, malaise, and joint pain before causing arthritis. The patient may or may not remember having a tick bite.
Drugs such as procainamide, penicillin, and sulfa drugs may cause flu-like symptoms as well.
Sarcoidosis, an autoimmune disease that affects the lungs, heart, brain, as well as the joints often presents with flu-like symptoms.
The various spondyloarthopathies such as Reiter’s disease also can start with flu-like symptoms.
The most likely culprits though that cause flu-type symptoms before causing joint pain are infectious agents.
If bacteria or viruses get into the joint space, an "infectious" arthritis can occur. These kinds of arthritis require immediate attention, as the infection can spread to other parts of the body. The infection can also destroy the affected joint, with particularly virulent strains of staphylococcus (staph), the joint may be seriously damaged in a few days.
Common bacteria that can cause this kind of arthritis are:
o staphylococcus (staph)
o gonoccocus (GC)
Viruses can also cause this kind of arthritis.
Common viruses such as measles, mumps, rubella, and influenza all may cause joint pains.
There are two main features of a new arthritis that make your doctor consider a viral cause. The first are symptoms in addition to the joint pain and swelling... in particular rashes, a sore throat, muscle aches and pains, or a runny nose. The second feature is potential exposure to the virus.
Parvovirus causes slapped cheek syndrome in children and epidemics of this mild illness often occur in child care facilities. Parvovirus infection in adults causes a flu-like illness with joint swelling in the hands and wrists. A rash may or may not occur. Parvovirus is the commonest viral arthritis in city dwellers.
Rubella (German Measles) can cause arthritis with a typical red rash. Arthritis may also occur after rubella immunization. It is generally a benign form of viral arthritis.
A number of viruses are transmitted via blood and blood products, including Hepatitis B and C and Human immunodeficiency virus (HIV that causes AIDS). Each of these viruses may be associated with arthritis that occurs soon after the infection has begun. A flu-like illness and rash may accompany the joint symptoms.
The viral arthritis of Hepatitis B and C, Rubella and HIV is present for a few weeks and rarely longer. Some individuals have joint pain for years but in truth may have rheumatoid arthritis or a similar inflammatory arthritis. Parvovirus arthritis may also last months but generally settles fairly quickly.
The majority of people who have viral arthritis will require little if any treatment. If the joint swelling and pain are severe then anti-inflammatory medication may be necessary for a few weeks.
There is no direct proof that a specific virus causes rheumatoid arthritis. It is generally considered that rheumatoid arthritis occurs in a genetically predisposed host as the result of an environmental trigger and bad luck. Triggers such as stress and viral illnesses may be important. Rheumatoid arthritis may start with flu-like symptoms and therefore cause a confusing picture.
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