Lupus isn’t only an autoimmune disease; it’s often classified as a connective tissue disease. What are connective tissues? They’re the muscles, ligaments and tendons that support and connect other structures, like bones and other organs.
People with lupus might experience muscle aches and pains (myalgia) and have inflammation of muscles (myositis). When this happens there is tremendous loss of strength in the muscles. This extreme muscle weakness is often what takes people to the doctor, where they may be diagnosed with lupus.
About 90% of the people with lupus have these aches pains, stiffness and weakness in their muscles and joints. There are times when their intensity waxes and wanes: flares. That’s why lupus is called a disease of remissions and exacerbations.
Because the most common symptom of lupus is inflammation and that inflammation is all over the body (systemic), it is referred to as systemic lupus erythmatosous.
When this inflammation involves the joints, symptoms of lupus arthritis result: joint pain, stiffness, tenderness and warmth. These joint symptoms are often found in fingers and the wrists, hips, knees and ankles. Because of inflammation, muscle atrophy can result. How? If inflammation causes enough pain, then you're not going to want to use muscles and joints and when they're not used they get weak.
No mention of the effects of lupus on muscles is complete without mentioning tendonitis and bursitis. Tendonitis is irritation of a tendon and bursitis is the irritation of a bursa.
What's a bursa? The bursa is a sack filled with fluid that is near a joint, and that fluid makes tendons, ligaments, muscles and bones move more easily.
Tendonitis and bursitis can be quite painful. They are both treated with rest, physical therapy, acetaminophen or non-steroidal anti-inflammatory medications. Occasionally, cortisone injections are needed.
Sometimes drugs, such as prednisone, or even the Plaquenil® used to treat lupus can cause this muscle weakness. Usually, withdrawing these medications decreases or eliminates the weakness.
Another musculoskeletal disorder associated with lupus is osteoporosis. We all know osteoporosis as a disease know in which bones weaken, become brittle (sometimes like Swiss cheese) and on occasion break.
Hormone levels are related to musculoskeletal problems. As they fluctuate, they can predispose patients to osteoporosis. In addition, if there is not enough vitamin D and calcium in a woman’s body osteoporosis can develop.
Another factor predisposing one to osteoporosis is lack of enough exercise to strengthen muscles, tendons and ligaments. The same lack of exercise can cause another musculoskeletal disorder: osteonecrosis.
Osteonecrosis is a disorder of the bones in which bones don’t get oxygen-carrying blood so they die.
As you can see, lupus can have quite an effect on our muscles and the bones. One of the best preventative measures of musculoskeletal disorders is to make exercise a regular part of your day; because that exercise strengthens the tendons, ligaments and muscles that support the bone.