Joint Pain with Sjögren’s Syndrome
Joint pain is a very common symptom of Sjögren’s syndrome. Multiple joints are painful, usually episodically with periods of joint pain, known as “flares”, followed by periods of little or no joint pain. Tenderness and swelling of the joints, when present, are indicative of an inflammatory arthritis. In Sjögren’s, this type of arthritis usually affects the fingers, wrists and ankles. The shoulders, hips and knees may also be painful. Joint inflammation occurs in about one third of people, affecting the same joints that rheumatoid arthritis affects, but the joint inflammation of Sjögren’s syndrome tends to be milder and is usually not destructive.
Some patients with SS may have joint pain as a result of fibromyalgia. In general, the pain of fibromyalgia arises from the muscles although it may be perceived as coming from the joints. Fibromyalgia and joint pain related to SS may be hard to differentiate. Fibromyalgia pain is present on a nearly daily basis, with flares of increased pain triggered by exertion, lack of sleep and stress.
Non steroidal anti-inflammatory drugs (NSAIDs) are sometimes recommended to ease joint pain caused by Sjogren’s syndrome. NSAIDs such as ibuprofen, which are available without a prescription, may be more effective in relieving pain when combined with other medications that treat Sjogren’s syndrome, such as immunosuppressive medications.
Non-pharmacologic measures are also important aspects of the therapeutic program. Maintaining a healthy lifestyle is a critical part of any Sjögren’s syndrome treatment plan. Poor diet, lack of exercise, and high levels of stress may make disease activity worse, so healthy eating, appropriate levels of aerobic and strengthening exercise, and relaxation are highly recommended.
The application of moist heat to the hands with a paraffin bath can help relieve stiffness of the fingers and wrists in the morning. Gentle exercise, including Tai Chi, yoga and dancing, can serve to strengthen muscles and preserve joint range of motion. Nutritional supplements, such as glucosamine or fish oils, may also help some patients. Finally, experimenting with one’s diet may reveal certain foods that aggravate the joint pain. This is variable, but elimination of dairy, bread products, or excessive salt can reduce joint pain in some individuals.
*article excerpts courtesy of hopkinssjogrens.org and jointhealth.org