Causes of Joint Pain: Infectious Disease
Infectious disease and arthritic pain have a dynamic and complex relationship. There are many infectious diseases that can result in inflammation and pain in the joints, or the muscles and tendons around them. At the same time, autoimmune arthritis (like rheumatoid arthritis) and the immunosuppressant drugs used to treat them weaken the immune system; making the arthritis sufferer more susceptible to infection by any and all pathogens. In this article we will discuss some of the most common infectious diseases, how they can bring about an attack of arthritis, and how they can be treated.
Reactive arthritis is a type of autoimmune condition that can cause inflammation of the joints as a result of an infection somewhere else in the body. Though the infections that can trigger this type of arthritis are common, its occurrence is extremely rare. The exact reasons for its affecting some people are unknown, though genetics usually plays a significant role. It most often presents as inflammation of 5 joints or fewer, and almost maliciously often selects the knee as a strike zone. The symptoms can start in one joint and spread out, inflaming additional joints, or migrate to a new joint as one joint recovers.
In addition to the arthritis, reactive arthritis is frequently found alongside other symptoms.These include inflammation and conjunctivitis (extra watering and swelling) in the eyes, lower back pain, and inflammation of the urethra in men and uterine cervix in women, which can cause difficult and painful urination. The infections that most frequently cause reactionary arthritis are those that affect the digestive system or the urinary system and genitals. Infections of the intestines such as Salmonella and Shigella (a foodborne pathogen similar to Salmonella) are the most common triggers of the condition. Chlamydia, an STD that can cause painful urination in men and vaginal discharge in women (often present without any symptoms) is another possible trigger for reactive arthritis.
Diagnosis and treatment of reactive arthritis can be challenging, as the arthritis often appears when the triggering disease has already subsided. This makes drawing a direct link the infection and the arthritis difficult. Until the introduction of modern Regenerative Medicine and Stem Cell Therapies, older treatment methods were geared towards relieving the symptoms of swelling and pain with anti-inflammatory medications or corticosteroids.
Hepatitis B and C:
The Hepatitis C virus is a common viral cause of arthritis. As many as 20% of people with hepatitis C suffer from joint inflammation. The symptoms of arthritis related to Hepatitis C infection are similar to those of rheumatoid arthritis. It most frequently affects multiple small joints like those in the fingers in symmetrical patterns. In rarer cases, hepatitis-induced arthritis will present a single joint, typically a large one such as the knee.
Unlike rheumatoid arthritis though, Hepatitis C related arthritis usually doesn’t cause deformity, bone erosion, or the hard deposits under the skin. However the symptoms in the morning and at night can be quite severe. Approximately two-thirds of people with this type of arthritis will experience pronounced and prolonged morning stiffness that may take an hour or more to relent. The exact causes of hepatitis related arthritis are still unknown. Currently, treatment of Hepatitis C related arthritis is an antiviral mixture of interferon-alpha and ribavirin. In addition to this low doses of oral corticosteroids, non-steroidal anti-inflammatory medications, hydroxychloroquine (an anti-malarial medication), or sulfasalazine (a sulfa drug usually used for conditions of the colon) are used to control the symptoms of the condition. The problem with this course of treatment is that peginterferon and ribavirin have both been shown to trigger arthritis on their own. Both these drugs are common in the treatment of Hepatitis C as well as arthritis related to the virus.
Lyme disease is a bacterial infection that usually infects humans through tick bites. It makes its first appearance as a small, red, usually not particularly painful or itchy rash around the area that was bitten. Once it begins to spread it can cause small lumps around the ears, chest, or groin, muscle pain, distraction and other cognitive problems, and arthritis. Around 60% of the cases of Lyme disease that go untreated in the early stages (localised rash) develop into Lyme arthritis. The bacteria usually attack the knee, but in a minority of cases can show up in other joints around the body. This is another example of direct bacterial invasion of the synovial apparatus, and if it remains untreated it can lead to the same kind of degeneration seen in osteoarthritis.
Usually, if treatment is administered early enough and is thorough, Lyme disease and all related complications (including arthritis) can be treated and eliminated with antibiotics. Anti-inflammatory medications may also be used, these for the treatment of the inflammation and pain.
*Please read: Although the information provided on this page may describe a particular patient experience and/or outcome, readers must understand that each patient presents with a unique medical history and may be recommended a different treatment/surgery by their surgeon to that described above. Individual results may vary between surgery centre/hospital, surgeon, surgery type and patient. Although SkyGen agrees to share all updates from patients at their request, SkyGen does not endorse any physical activities attempted by patients following surgery which do not follow the explicit instructions provided by their surgeon. SkyGen encourages all patients to discuss the risks of such activities with medical professionals before attempting these themselves.