Studies revealed that 90% of people with lupus experience joint and/or muscle pain at some time during this illness.Very often, the aching pain in joints and muscles can determine the patient believe he has a viral or flu-like illness, while other patients may have symptoms similar with those produced by arthritis. There exist also another category of patients with intense muscle inflammation, and they can also experience progressive weakness and loss of strength.
It must be said that muscle and joint pains are symptoms of lupus but usually it’s not the systemic lupus erythematosus responsible for them. They are more frequently caused by other illnesses.
Usually, the joint pain caused by lupus arthritis comes, may last for days or weeks, and then disappear, returning at a later time. It is known that the joints farthest from the trunk of the body are most frequently affected. Characteristic to lupus is stiffness and pain in the morning which improves during the day and can return later in the day when the person is tired, and also the fact that the pain is usually symmetrical, similar joints on both sides of the body are affected. It is good to know that even if a person has been diagnosed with lupus, there can appear pains that have nothing to do with this disease. For example, backaches or neck pains, a single, chronically painful are not provoked by lupus.A fact that also should be remembered is that usually, lupus arthritis doesn’t cause deformities or destruction of the joints.Best clues in order to determine if the pain is caused by the systemic lupus erythematosus is the pattern of joint pain and the setting in which it occurs.There can be made X-ras of the painful joints and an examination of the synovial fluid within a swollen joint, to rule out other possible causes for the joint. It is known that if arthritis is the only symptom of lupus, diagnosis can be extremely difficult.It is good to mention that sometimes, performing the anti-nuclear antibody test and the test for rheumatoid factor can be helpful.
For treating lupus arthritis, there are usually used non-steroidal, anti-inflammatory medications like ibuprofen, naproxen or aspirin. Usually, these medications have effect, but if this therapy is not effective, there can be added antimalarial drugs such as hydroxychloroquine.In rare cases, if the joints remain swollen and painful despite other treatment, there begins the treatment with corticosteroids.It is important that people learn joint protection procedures in order to rest the joints during flares of lupus arthritis, and another fact that must be known is that cytotoxic medications should not be used to treat only lupus arthritis.
It is known that the systemic lupus erythematosus can seriously damage the muscles, and as a result, there can appear muscle weakness and loss of strength. Inflamed muscles can be painful and tender to the touch, but the most common symptom that lupus myositis shows is muscle weakness. Usually, the muscles at he trunk of the body are affected , such as neck, pelvic girdle and thighs, shoulder girdle and upper arms.
There are some tests that can determine the severity of muscle involvement. These tests measure the level of some chemical enzymes in the blood. Normally, that enzymes are being concentrated within muscle fibers. They escape into the blood circulation when the muscle fibers are being damaged by inflammation.There can also be made an electromyogram to determine the character of muscle damage in lupus myositis, and also biopsy may be performed in order to confirm the presence of inflammation and to identify how severe it is.
As a treatment, corticosteroids are used initially in high doses, to keep the inflammation under control, and then, after it subsides, it is gradually reduced. Most of the patients responde well to this treatment, but there are rare cases when it is necessary to add cytotoxic or immunosuppressive medications.A well directed exercise program should be started after the inflammation passed, in order to regain normal muscle strength and function.
It may happen when the patient is prescribed high doses of corticosteroids with or without cytotoxic agents to appear bone damage and muscle weakness. These complications in rare cases appear due to the effects of the medications alone, they usually come because of a combination of factors.It was found that patients with systemic lupus erythematosus which took steroids for a long time can develop ischemic necrosis of bone. Altered blood flow to a portion of bone causes the death of that area, and as the bone repairs the area, a weakening of the bone occurs and a portion of the bone surface may collapse. Most affected are the hips, shoulders and knees.The first symptom of ischemic necrosis is pain when the joints are being moved or bearing weight, and the pain can be felt even when the person is resting, at night, when the condition progresses.Osteoporosis can also appear if a patient uses corticosteroids for a long time. Having osteoporosis means that the bone mass is decreased and a higher risk of bone fracture and compression of vertebrae in the spine appears. It is known that women are at a higher risk of developing osteoporosis and using calcium and vitamin D in addition to regular exercise may help prevent osteoporosis.
It is important to remember that people with lupus myositis should take a regular, well-designed exercise program in order to prevent muscle weakness.
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