When you think of arthritis, you think of inflammation. Inflammation is a process in which the body's white blood cells and chemicals help protect us from infection and foreign substances such as bacteria and viruses.

In some diseases, however, the body's defense system (immune system) triggers an inflammatory response when there are no foreign substances to fight off. In these diseases, called autoimmune diseases, the body's normally protective immune system causes damage to its own tissues. The body responds as if normal tissues are infected or somehow abnormal.

What Diseases Are Associated With Inflammation?

Some, but not all types of arthritis, are the result of misdirected inflammation. Arthritis is a general term that describes inflammation in joints. Some types of arthritis associated with inflammation include:

The most common form of arthritis called osteoarthritis (also known as degenerative arthritis) is a bit of a misnomer. It is not believed that inflammation plays much or any role in osteoarthritis. Other painful conditions of the joints and musculoskeletal system that are not associated with inflammation include fibromyalgia, muscular low back pain and muscular neck pain.

What Are the Symptoms of Inflammation?

Inflammation is characterized by:

Redness
Swollen joint that's tender and warm to touch
Joint pain
Joint stiffness
Loss of joint function

Often, only a few of these symptoms are present.

Inflammation may also be associated with general "flu"-like symptoms including:

Fever
Chills
Fatigue/loss of energy
Headaches
Loss of appetite
Muscle stiffness

What Causes the Symptoms of Inflammation?

When inflammation occurs, chemicals from the body are released into the blood or affected tissues. This release of chemicals increases the blood flow to the area of injury or infection and may result in redness and warmth. Some of the chemicals cause a leak of fluid into the tissues, resulting in swelling. This process may stimulate nerves and cause pain.

What Are the Results of Joint Inflammation?

Increased blood flow and release of these chemicals attract white blood cells to the sites of inflammation. The increased number of cells and inflammatory substances within the joint can cause irritation, wearing down of cartilage (cushions at the end of bones) and swelling of the joint lining (synovium).

How Are Inflammatory Diseases Diagnosed?

Diagnosis of inflammatory diseases consists of all or some of the following:

Complete medical history and physical exam.
The location of painful joints.
Presence of joint stiffness in the morning.
Evaluation of other symptoms.
Results of X-rays, blood tests, and other studies.

Can Inflammation Affect Internal Organs?

Yes. Inflammation can affect organs as part of an autoimmune disorder. The type of symptoms depends on which organs are affected. For example:

Inflammation of the heart (myocarditis) may cause vague chest pain or fluid retention.
Inflammation of the small tubes that transport air to the lungs (bronchiolitis) may cause shortness of breath similar to an asthma attack.
Inflammation of the kidneys (nephritis) may cause high blood pressure or kidney failure.
Inflammation of the large intestine (colitis) may cause cramps and diarrhea.
Inflammation of the eye (iritis or uveitis) may cause pain or decreased vision.
Inflammation of the muscles (polymyositis) may cause achiness or weakness.
Inflammation of the blood vessels (vasculitis) may cause rash, headaches, or internal organ damage.

Pain may not be a main symptom since many organs do not have many pain-sensitive nerves. Treatment of organ inflammation is directed at the cause of inflammation whenever possible.

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WebMD Medical Reference provided in collaboration with the Cleveland Clinic

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Do You Have Fibromyalgia Pain?

Cymbalta is approved for the management of fibromyalgia.

Important Safety Information

Cymbalta^® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

You should also know that:

Suicide is a known risk of depression and some other psychiatric disorders.
Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
Cymbalta^® is not approved for use in patients under age 18.

Who should NOT take Cymbalta?
You should not take Cymbalta if:

You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (an eye disease)
You are taking Mellaril^® (thioridazine)

What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:

about all of your medical conditions, including kidney problems, glaucoma, or diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, tell your healthcare provider:

if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.

Safety Information and Boxed Warning | Prescribing Information | Medication Guide