Rheumatology

Beyond Joint Pain

  • July 1, 2019
  • 2 minutes read

Not many people realise it, but long-term unexplained chronic pain, swelling and stiffness in the joints may be more than just the aches of everyday activity, but could signal an autoimmune disease – and the risk of other complications.

Autoimmune disease is medical term describing the body’s normally protective immune system mistakenly attacks parts of the body, such as the joints and other organs. This creates inflammation in affected tissues, damaging them so that they become unable to perform their key functions. Some of the common autoimmune conditions that can result in joint pain include:

  • Rheumatoid arthritis (RA)
  • Systemic Lupus Erythematosus (SLE, or lupus)
  • Sjogren’s syndrome
  • Scleroderma

A systemic problem

It is important to note that these autoimmune diseases go far beyond joint pain. The systemic inflammation within the body can compromise other systems and result in a variety of complications known as ‘extra articular manifestation’. This refers to issues in other parts of the body other than the joints. Some of these issues include inflammation of the eye (uveitis), lung (interstitial lung disease), kidney (glomerulonephritis) and blood vessels (vasculitis). SLE, for instance, can damage the kidneys and lead to kidney failure, while scleroderma can cause lung inflammation leading to respiratory failure. Uncontrolled inflammation from autoimmune diseases has been shown to increase the chances of getting strokes and heart attacks.

Rheumatoid arthritis (RA) occurs when the immune system attacks the lining of the joints (synovial lining). This lining plays a role in lubricating, nourishing and protecting the joint cartilage. In RA, the lining becomes inflamed, thickened and swollen, resulting in joint pain and swelling. If left untreated, the lining can destroy the joint tissues, leading to damage, deformity and loss of mobility. The chronic inflammation can affect the skin, eyes and salivary glands as well as other organs such as lungs, kidneys, gastrointestinal and blood vessel system.

Systemic Lupus Erythematosus (SLE, or lupus) is a chronic inflammatory condition where the immune system attacks and destroys healthy tissues across the body, including the skin, joints, blood cells, lungs, kidneys and nervous system. It is a system-wide, or systemic, autoimmune disease. Joint pain – together with a rash on the face shaped like a butterfly because of the sunlight-sensitive nature of the rash – is considered a ‘classic’ presentation of the disease. But the rash is in fact a minor problem. If not controlled well, SLE can result in a wide range of serious complications. These include damage to the kidneys, brain, nervous system and lungs.

Sjogren’s syndrome is a disease in which the immune system attacks the mucous membranes and moisture-secreting glands, particularly in the eyes and mouth. Apart from dry eyes and mouth, the immune system can also attack the joints, causing swelling and stiffness. Other organ tissues that can be affected include the kidneys, lungs and nerves. Sjogren’s syndrome often accompanies other immune system disorders, such as RA and lupus.

Scleroderma refers to a group of diseases where the autoimmune system attacks the skin and other organs. The result is the hardening and tightening of skin in the torso and limbs. These patches can become so tight that they appear shiny and even restrict movement. The damage and tightening to the tissues can also extend to the digestive system, lungs and kidneys, causing these tissues to harden and lose their function.

Risk factors

These autoimmune diseases can affect people of all ages, but usually between the ages of 20 and 50. One risk factor is gender as more women than men are likely to develop conditions such as RA, SLE, scleroderma and Sjogren’s syndrome. There is also a genetic link to the disease although they are not strongly inherited. If you suspect you have an autoimmune disease, it is important to seek help early as the disease can have devastating effects if left untreated in the early stages.

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