Can lupus cause difficulty walking?

Table of Contents

Quick Answer

Yes, lupus can cause difficulty walking due to joint pain, muscle weakness, and nerve damage. Lupus is an autoimmune disease that causes widespread inflammation and can affect any part of the body, including the joints, muscles, and nerves. Joint inflammation from lupus arthritis and muscle weakness from lupus myositis commonly lead to walking problems. Lupus vasculitis that damages the nerves supplying the legs is another potential cause of difficulty walking. With proper treatment, many people with lupus are able to manage symptoms and continue walking independently.

What is Lupus?

Lupus is a chronic autoimmune disease where the immune system mistakenly attacks the body’s own healthy cells and tissues, causing widespread inflammation and organ damage. There are several types of lupus:

Systemic Lupus Erythematosus (SLE): The most common type that can affect any part of the body.

Cutaneous Lupus: Affects only the skin.
Drug-induced Lupus: Caused by certain medications.
Neonatal Lupus: A rare form that affects newborn babies.

In SLE, nearly all parts of the body can be impacted, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. When lupus leads to inflammation in a specific area, symptoms develop in that region of the body. Difficulty walking can occur when lupus affects the joints, muscles, nerves, or blood vessels in the legs.

How Does Lupus Cause Problems Walking?

Lupus can make walking difficult through several mechanisms:

Lupus Arthritis

Over 90% of people with lupus experience joint pain and swelling due to lupus arthritis. Like rheumatoid arthritis, lupus arthritis causes inflammation in the lining of joints, most often in the hands, wrists, knees, ankles, and feet. This leads to joint stiffness, pain, and limited mobility that can interfere with normal walking. The hips, knees, ankles, and feet are crucial for smooth and pain-free walking, so lupus arthritis in any of these areas can cause limping, instability, and loss of balance.

Lupus Myositis

Up to 40% of lupus patients develop inflammation of muscles called lupus myositis. Myositis leads to muscle weakness, pain, and atrophy. Commonly affected areas include the shoulders, hips, thighs, and upper arms. Having weak hip, thigh, and leg muscles on one or both sides of the body can make it difficult to walk properly. People with lupus myositis often struggle to get up from a seated position, climb stairs, or walk long distances.

Lupus Vasculitis

Lupus vasculitis occurs when lupus causes inflammation of blood vessels, restricting proper blood flow. This can damage the nerves that supply the muscles in the legs due to ischemia. Peripheral neuropathy resulting from vasculitis presents as numbness, tingling, burning, sharp pains, or weakness in the feet and legs. Damage to sensory nerves leads to reduced proprioception (body awareness) and sensation. Motor nerve damage causes leg weakness and loss of reflexes. All this can significantly impact balance and coordination when walking.

Other Causes

Certain lupus medications like steroids, immunosuppressants, and NSAIDs can sometimes cause muscle weakness or pain as side effects. Severe fatigue and deconditioning due to lupus itself can also contribute to functional decline and walking difficulties. Any combination of the above factors tends to exacerbate mobility problems in lupus patients.

Signs That Lupus Is Affecting Your Ability to Walk

Here are some common signs and symptoms that suggest lupus is causing walking impairment:

Joint pain, swelling, or stiffness in the knees, ankles, hips, or feet
Muscle weakness or atrophy in the legs

Numbness, tingling or burning pain in the legs or feet
Trouble standing up from a chair or getting out of bed
Difficulty climbing stairs

Instability or balance issues
Limping or altered gait
Foot drag or reduced reflexes

Fatigue, shortness of breath or needing to rest while walking short distances
Tripping or falls

Even mild walking problems due to lupus should be evaluated quickly before they progress and start impacting your independence and quality of life.

Tests to Diagnose the Cause

If lupus is suspected to be the reason behind your walking issues, your doctor will perform a comprehensive physical exam and order certain laboratory and imaging tests to confirm the diagnosis. These may include:

Blood tests: To check for inflammatory markers, antibodies, and signs of lupus activity or flare-ups.
Urinalysis: To look for excess protein, blood cells, or cellular casts which can indicate lupus nephritis.

Muscle enzyme tests: CPK and aldolase levels may be elevated in lupus myositis.
Nerve conduction studies: Measures how well nerves transmit electrical signals and can detect peripheral neuropathy.
EMG (electromyography): Records electrical activity of muscles and is useful in diagnosing myopathy.

Arthrocentesis: Sample fluid is drawn from affected joints to check for inflammation.
MRI: Provides images of soft tissues like muscles, joints, nerves, and blood vessels in the legs.
Nerve biopsy: Removal of a small part of the nerve for microscopic examination, done in rare cases.

Identifying whether joint inflammation, muscle weakness, neuropathy, or another lupus related problem is causing your walking difficulty allows for optimal treatment.

Medical Treatments for Lupus Walking Problems

While there is no cure for lupus itself, excellent treatments options exist for managing symptoms like pain, inflammation, fatigue and tissue damage that impact mobility. Some key medications used are:

NSAIDs: Non-steroidal anti-inflammatory drugs like naproxen and celecoxib to relieve joint pain and stiffness.

Corticosteroids: Powerful anti-inflammatories like prednisone to reduce swelling and inflammation.
DMARDs: Disease-modifying antirheumatic drugs like methotrexate and hydroxychloroquine help control overall lupus activity.
Immunosuppressants: Azathioprine, cyclophosphamide, and cyclosporine suppress an overactive immune system.

Belimumab: A biologic drug that reduces abnormal antibody production.
Rituximab: Biologic that wipes out autoimmune B cells causing lupus inflammation.
Plasmapheresis: Procedure to filter out autoantibodies from the blood to reduce inflammation.

Doctors also prescribe medications specifically for treating peripheral neuropathy, such as pregabalin, gabapentin, duloxetine, amitriptyline, and opiates for pain relief.

Lifestyle Changes and Home Care

Along with medications, certain self-care strategies and lifestyle modifications can help improve mobility in lupus:

Apply heating pads or cold compresses to ease joint and muscle pain.

Engage in regular gentle stretching and low-impact exercises like walking, swimming or cycling to improve muscle strength and range of motion.
Use orthotics, knee braces, or ankle supports for extra stability when walking.
Rest during flare-ups and lupus fatigue but avoid prolonged inactivity which can worsen stiffness.

Wear proper footwear with adequate arch support and traction.
Use a cane or walker for balance if needed for stability when walking.
Stop smoking and eat a balanced anti-inflammatory diet to improve vascular health.

Join a lupus support group for advice on coping with mobility challenges.

Light physical therapy under an occupational therapist’s guidance also helps improve walking ability without overexertion.

When to See a Doctor

Consult your rheumatologist right away if you experience:

New onset of limping, balance issues or leg weakness.
Sudden sharp joint pain preventing weight-bearing.
Swelling, redness or warmth in the knees, ankles or feet.

Repeated falls or inability to get up from standing.
Tingling, numbness or burning in the lower limbs.
Pain at rest or nighttime discomfort in the joints or legs.

Since walking problems can rapidly progress and lead to loss of independence, timely medical care is essential. Worsening difficulty walking may necessitate physiotherapy, assistive devices, orthopedic consults, or even surgery.

Outlook for Lupus Patients with Walking Difficulty

While lupus can certainly impair mobility, the good news is that with comprehensive treatment tailored to each patient’s specific needs, significant improvement in walking ability is possible in most cases. Lifestyle and rehabilitation measures also enhance functional capacity. With medication, moderate physical activity, joint protection, assistive aids, and self-management, most people with lupus are able to walk independently and maintain a good quality of life.

Some key points to remember include:

Poor walking ability is common in lupus due to joint, muscle, nerve, and vascular inflammation.
Aggressive control of swelling and inflammation can provide substantial symptom relief.
Muscle strengthening and range-of-motion exercises improve mobility.

Assistive devices like braces, shoe inserts, canes, and walkers provide extra support and stability for walking.
Staying active within one’s limitations prevents disability from deconditioning.
Most lupus patients, even with walking deficits, can walk well enough for their daily needs.

While lupus and its effects are unpredictable, optimizing treatment and self-care allows maintaining mobility and quality of life. Monitoring for any new walking issues and seeking prompt medical attention can help prevent permanent disability. With the right treatment plan tailored to one’s specific needs, most people with lupus remain able to walk well.

Conclusion

In summary, lupus is certainly capable of causing varying degrees of walking impairment due to the widespread inflammation it creates in joints, muscles, blood vessels, and nerves. However, with proper diagnosis of the underlying cause and effective anti-inflammatory treatment, many patients experience significant improvement in mobility. Supportive therapies like physical therapy, orthotics, and assistive devices also enable most lupus patients to walk independently and remain actively engaged in their lives. While some patients require lifestyle adjustments to accommodate walking limitations, the outlook for maintaining functional mobility in lupus is generally positive with comprehensive management of the disease.