When people hear the word arthritis, they often think of joint pain, stiffness and swelling. But arthritis can be associated with many different conditions, and for people living with lupus, joint symptoms can be an important part of the condition.
Lupus is a chronic autoimmune condition, and there are several different types of lupus. The most common type is systemic lupus erythematosus (SLE). Lupus occurs when the immune system, which normally protects the body from infection, becomes overactive and attacks the body’s own tissues. It can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood and nervous system. 
For many people with systemic lupus erythematosus (SLE), joint pain and inflammation are among their most noticeable symptoms.
What is lupus?
Lupus is a long-term autoimmune condition that can affect people in very different ways. Some people experience relatively mild symptoms, while others may have inflammation affecting several parts of the body.
Lupus can also change over time. People may experience periods when their symptoms become more active, known as a flare, followed by periods when symptoms improve or settle, known as remission. Flares can be unpredictable and may vary in severity.
There is currently no cure for lupus, but there are a range of treatments that can help control inflammation, reduce symptoms, prevent or manage flares and reduce the risk of complications.
How does lupus affect the joints?
Joint pain and inflammation are common symptoms of lupus. Lupus-related arthritis can cause:
- Painful or swollen joints.
- Joint stiffness, particularly in the morning.
- Pain and stiffness that may come and go.
- Reduced movement or difficulty using affected joints.
- Symptoms that become worse during a lupus flare.
The hands, wrists, knees and feet are among the joints that can be affected.
Unlike osteoarthritis, which is associated with changes and wear within a joint, lupus-related joint symptoms are driven by inflammation associated with the immune system. This distinction is important because the underlying cause and treatment approach are different.
If you have ongoing joint pain or swelling, your doctor or rheumatologist can help determine what may be contributing to your symptoms.
Lupus can cause more than joint symptoms
One of the challenges of living with lupus is that symptoms can extend well beyond the joints. Some people may experience:
- Fatigue.
- Skin rashes, including rashes that can be triggered or worsened by sunlight.
- Mouth or nose ulcers.
- Hair loss.
- Headaches.
- Fevers.
- Muscle aches.
- Swollen glands.
- Raynaud’s phenomenon, where fingers or toes change colour in response to cold or stress.
- Chest or abdominal pain.
In some people, lupus can also affect organs such as the kidneys, heart or lungs. This is why ongoing medical monitoring is an important part of managing lupus. Not everyone with lupus will experience all of these symptoms, and symptoms can change over time.
What causes lupus?
There isn’t one known cause of lupus. Researchers believe that a combination of genetic, environmental and other factors can contribute to the development of the condition. Lupus is not contagious, and having joint pain alone does not mean that someone has lupus.
Because many lupus symptoms can also occur with other conditions, diagnosis can sometimes be challenging. There isn’t one single test that can diagnose lupus. Doctors consider a person’s symptoms and medical history, physical examination and laboratory results. Blood tests, including tests for certain antibodies, may be used as part of the diagnostic process.
How is lupus treated?
Treatment for lupus depends on the symptoms a person is experiencing and which parts of the body are affected. Treatment may include medicines to reduce inflammation and pain, medicines that help regulate the immune system, corticosteroids and other disease-modifying treatments. Antimalarial medicines are also commonly used in lupus and can help with symptoms such as joint pain, fatigue and skin symptoms, as well as helping to reduce flares. Your rheumatologist will work with you to develop a treatment plan based on your individual circumstances. Regular monitoring is important because lupus can affect different parts of the body, sometimes even when you aren’t experiencing obvious symptoms.
Never stop or change prescribed medication without speaking with your healthcare team.
Understanding lupus flares
A flare is a period when lupus symptoms become more active or severe. Everyone’s experience of a flare is different, but possible warning signs can include:
- Increased fatigue.
- Increased joint pain or swelling.
- A new or worsening rash.
- Fever.
- Headaches.
- Abdominal symptoms.
Learning to recognise your own early warning signs can help you discuss changes with your healthcare team and develop a plan for managing your condition. Some people find that factors such as stress, illness, overexertion, or exposure to sunlight can contribute to worsening symptoms. Keeping track of your symptoms can help you identify patterns and provide useful information to your healthcare team.
Looking after your joints and your overall health
Living with lupus isn’t just about managing medications. There are also practical things you can do to support your overall health and wellbeing.
Keep moving
Regular physical activity can help maintain muscle strength, flexibility, fitness and joint function. The type and amount of exercise that is appropriate will depend on your symptoms and overall health.
During periods when your symptoms are more active, you may need to reduce the intensity of your activities and allow yourself more time to rest. A physiotherapist or exercise professional can help you develop an appropriate exercise plan.
Find a balance between activity and rest
Fatigue can be one of the most challenging symptoms of lupus. Trying to push through severe fatigue can make it harder to manage your day-to-day activities. Planning your day, prioritising important tasks, taking regular breaks and allowing time for rest can help you manage your energy.
Protect yourself from the sun
For some people with lupus, exposure to sunlight can trigger or worsen symptoms. Your healthcare team may recommend strategies such as sunscreen, protective clothing, hats and limiting direct sun exposure, depending on your individual circumstances.
Look after your emotional wellbeing
Living with a chronic condition can affect your emotional wellbeing as well as your physical health. Pain, fatigue, uncertainty and changes to your usual activities can all be difficult to manage.
If you’re feeling anxious, low or overwhelmed, speak with your GP or healthcare team. Connecting with other people who understand what it’s like to live with lupus or another chronic condition can also provide valuable support.
Working with your healthcare team
Lupus is a condition that benefits from ongoing medical care. A rheumatologist is usually involved in managing lupus, with other healthcare professionals becoming involved depending on the symptoms and organs affected. It can be helpful to keep track of your symptoms, medications, appointments and questions for your healthcare team. This can help you notice changes and make the most of your appointments.
If you’re experiencing new or worsening symptoms, don’t assume that they are simply part of your lupus. Let your healthcare team know so they can assess what may be causing them.
Living well with lupus
A lupus diagnosis can feel overwhelming, particularly when symptoms are unpredictable. However, treatment and monitoring can help many people manage their condition and continue participating in the activities that are important to them.
Understanding your symptoms, learning to recognise your triggers and working closely with your healthcare team can all help you take an active role in managing lupus. Most importantly, you don’t have to navigate lupus alone. Support from your healthcare team, family and friends, and other people living with lupus or arthritis can make a real difference.
If you are experiencing ongoing joint pain, swelling or other symptoms that concern you, speak with your GP or rheumatologist for individual medical advice.
Additional Resources:
- Lupus Foundation of Australasia: https://www.lupusfoundationaustralasia.org/
References:
NSW Government. The Sydney Children’s Hospital Network. Lupus (systemic lupus erythematosus) factsheet. Available from: https://www.schn.health.nsw.gov.au/factsheets/lupus-systemic-lupus-erythematosus
Lupus Foundation of Australasia. What is Lupus Factsheet. Available from: https://www.lupusfoundationaustralasia.org/_files/ugd/58903d_bb2c83072b814866af06c85463c6e084.pdf
