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Ulcerative Colitis and Joint Pain

Reviewed by Michael W. Smith, MD on June 19, 2020

Ulcerative colitis (UC) is a disease that mainly affects the gut. It can affect other parts of the body, too, including the skin, eyes, and bones. The most common non-digestive issue for people with UC is joint pain.

What’s the Link?

UC is a type of inflammatory bowel disease (IBD). It causes long-lasting inflammation in the digestive tract, mainly in the innermost lining of your large intestine, also called the colon, and your rectum.

Symptoms can vary, based on which part of your colon or rectum has the inflammation and how severe it is. But they can include:

Up to 30% of people who have those symptoms also have arthritis -- joints that are painful, swollen, and less flexible.

It’s not completely clear why people with UC also have arthritis. When the body’s immune system overreacts, it seems that this inflammation spreads to the joints and other parts of the body. Experts believe that both conditions could be linked to triggers in a person’s environment, genetic factors, or changes in the immune system.

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People with UC can have a few types of arthritis:

Peripheral arthritis. This usually affects the large joints of the arms and legs, including the elbows, wrists, knees, and ankles. The pain and stiffness you feel may “move” from one joint to another, and last for a few days or up to several weeks (if you don’t treat it). Fortunately, peripheral arthritis usually doesn’t cause any lasting damage to your joints. Treating your UC usually improves your joint issues as well.

Axial arthritis. This is also called spondylitis or spondyloarthropathy. It causes pain and stiffness in your lower spine and sacroiliac joints. Sometimes people have these joint symptoms months or even years before gut symptoms appear, especially if you’re young. Axial arthritis may cause lasting damage if the bones of the spine fuse together. That means you’ll have less range of motion in your back.

Ankylosing spondylitis. This is a less common and more severe form of spinal arthritis. It can also cause inflammation of the eyes, lungs, and heart valves. Although doctors don’t know the cause, most people who have it share a common genetic marker. It typically affects people under age 30 (mainly adolescent and young adult men).

Diagnosis and Treatment

Sometimes it’s hard to know whether your joint pain is related to UC. Your doctor may diagnose you by ruling out other joint conditions, like rheumatoid arthritis. The good news is that arthritis symptoms usually improve once you get treatment for your UC.

Treatment for joint pain usually involves taking pain relievers like ibuprofen or aspirin. But these drugs often irritate the stomach lining when you take them for a long time, so they may not be right for people with UC. Instead, your doctor may prescribe a drug to treat your UC, such as prednisone or sulfasalazine. Once you’ve finished this treatment, you may find your joint pains have disappeared. You may also take a biologic drug or one that calms your immune system. These medicines treat UC as well as inflammation in your joints.

Physical therapy is another way to ease arthritis symptoms. A physical therapist shows you stretching and strengthening exercises to relieve joint problems.

Regular exercise is also key for living with joint pain. It makes you stronger and more flexible. Without it, joints become stiff and even more painful. Plus, it will give you more energy and help you control your weight. You can try simple low-impact exercises like walking, swimming, or riding a bike.

WebMD Medical Reference

Sources

SOURCES:

Mayo Clinic: “Ulcerative Colitis.”

CDC: “Inflammatory Bowel Disease.”

Crohn’s and Colitis Foundation: “Extraintestinal Complications of IBD,”  “Fact Sheet: Arthritis and Joint Pain.”

Crohn’s and Colitis UK: “Joints.”

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