Lupus is an autoimmune disease that can cause inflammation and pain throughout the body, including in the back and hips. While back and hip pain are not considered primary symptoms of lupus, many people with lupus do experience these symptoms. Understanding the link between lupus and back/hip pain can help patients find effective treatments.
Quick answers
- Back and hip pain are common complaints among lupus patients, though not considered primary lupus symptoms.
- Inflammation from lupus can cause pain in joints, muscles, and soft tissues in the back and hips.
- Lupus medications like corticosteroids may also contribute to bone and joint problems leading to back/hip pain.
- Managing lupus actively with medications can help reduce back/hip pain flares.
- Physical therapy, exercise, hot/cold therapy, massage, and over-the-counter pain medications can also help alleviate back and hip pain.
How common is back/hip pain with lupus?
Many studies have found back and hip pain to be relatively common among lupus patients, though estimates vary:
- A 2012 study found that 46% of lupus patients reported chronic lower back pain.
- Estimates for chronic hip pain among lupus patients range from 6% to as high as 36% in some studies.
- A 2015 study found that lupus patients reported significantly more intense back pain than healthy controls.
So while back and hip pain may not occur in all lupus patients, it is a frequent complaint. Lupus tends to cause flares of symptoms like pain that come and go over time. During lupus flares, back or hip pain may worsen before improving again.
What causes back/hip pain with lupus?
There are a few possible reasons why lupus can trigger pain in the back and hips:
- Joint inflammation – Lupus can cause inflammation in joints, the sacroiliac joints in the lower back, and hip joints, leading to arthritis and pain.
- Muscle pain – Lupus myositis causes muscle inflammation and weakness that may affect the back and hip flexor muscles.
- Soft tissue inflammation – Bursitis or tendinitis caused by lupus can result in back or hip pain.
- Bone tissue death – Avascular necrosis from lupus corticosteroid use can cause hip joint collapse.
- Nerve pain – Inflammation can compress nerves in the back and hips, causing numbness or neuropathic pain.
Additionally, factors like obesity, trauma, normal wear-and-tear, poor posture, stress, and Fibromyalgia can contribute to back and hip pain problems in some lupus patients. But the underlying inflammation and pain processes of lupus itself usually play a central role. Controlling the autoimmune inflammation is key to managing this pain.
Lupus treatments that impact back/hip pain
Many medications used to treat lupus may also influence back and hip pain in both positive and negative ways:
Corticosteroids
Corticosteroids like prednisone reduce lupus inflammation and pain symptoms. But long-term use can cause side effects like osteoporosis, bone death (avascular necrosis), and weakened cartilage that may worsen back or hip pain.
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen directly reduce inflammation and pain. These may relieve back/hip pain from lupus arthritis. Long-term NSAID use does have risks like gastrointestinal bleeding or kidney problems in some patients.
Antimalarial drugs
Antimalarial medications like hydroxychloroquine can reduce lupus flares and may lower the chances of back and hip inflammation or avascular necrosis. This can reduce related pain.
Immunosuppressants
Drugs that suppress the immune system like methotrexate and azathioprine help control overall lupus disease activity. By preventing flares and reducing inflammation, they may minimize back/hip pain.
Biologics
Newer biologic drugs like belimumab (Benlysta) have been shown to reduce lupus pain and steroid use. Fewer steroid side effects could mean less risk for back/hip osteoporosis, necrosis, and degeneration over time.
Overall, keeping lupus well-controlled with medications tailored to the individual helps prevent flares that could worsen back and hip pain. Doctors also monitor for medication side effects that may contribute to painful problems.
Treating back and hip pain related to lupus
When back or hip pain does occur with lupus, additional treatments can provide relief and prevent complications:
- Physical therapy – Exercises can strengthen muscles, improve flexibility, and reduce pain.
- Chiropractic care – Spinal manipulation aims to improve alignment and mobility.
- Braces – Can provide extra support and stability for unstable joints.
- Heat/cold therapy – Alternating hot and cold packs can relieve sore muscles and joints.
- Massage – Helps relax tight muscles that may spasm painfully.
- Over-the-counter pain medication – Acetaminophen, topical ointments, etc. may ease mild pain.
- Low-impact cardio exercise – This strengthens bones and muscles impacted by steroids.
- Joint injections – Corticosteroids injected into arthritic hips or spinal joints can provide symptom relief.
- Surgery – Severely damaged joints may need surgical repair or replacement.
Lifestyle measures like weight loss, proper posture, stress reduction, and quitting smoking may also benefit back and hip health. Doctors can prescribe stronger prescription pain medications if over-the-counter options are inadequate for managing lupus-related back/hip pain.
Outlook for back & hip pain with lupus
While concerning and uncomfortable, back and hip pain related to lupus is usually manageable. Close monitoring by a rheumatologist helps detect problems early. Being diligent about medications, physical therapy, and lifestyle changes can often control pain and prevent permanent damage. Interventions like joint injections, braces, or surgery may offer relief when more conservative measures fall short. With a multi-pronged approach, most lupus patients can find sufficient comfort, mobility, and quality of life despite back and hip inflammation.
When to seek emergency back or hip pain care
In most cases, back and hip pain due to lupus improves with routine treatment. But some circumstances require prompt emergency medical care, including:
- Sudden severe pain or inability to move the back or hip – This may indicate a fracture, muscle tear, or disc herniation pressing on nerves.
- Loss of bowel/bladder control – Can signal spinal cord compression or cauda equina syndrome requiring urgent surgery.
- Fever over 101°F with back/hip pain – Could mean an infection like sepsis, especially if on immunosuppressants.
- Unrelenting pain despite treatment – Seek evaluation to rule out rare complications like osteonecrosis.
- Difficulty breathing – Back/hip pain accompanied by chest pain and breathlessness can indicate a blood clot in the lung.
With urgent back and hip pain, call 911 or go to the nearest Emergency Room. Prompt treatment may prevent permanent nerve damage or disability in rare cases.
Frequently asked questions about lupus back & hip pain
Can lupus cause lower back pain?
Yes, lupus commonly causes lower back pain. Up to 46% of lupus patients have chronic lower back pain. Inflammation around the sacroiliac joints in the lower back, along with muscle pain, frequently lead to back pain.
Does lupus cause hip pain at night?
Lupus may cause hip pain at night. Late in the day, joints tend to become more stiff and painful due to immobility. Hip arthritis or bursitis from lupus can especially hurt at night. Pain may disrupt sleep.
Can lupus cause hip joint pain?
Definitely. Lupus often causes pain deep in the hip joint rather than just external muscle soreness. This occurs due to inflammation of the synovial hip joint lining. Hip arthritis is also more common in lupus patients.
Can lupus cause pinched nerves in back?
It is possible. Lupus can sometimes cause inflammation in the spinal joints and disks. This may compress or pinch local nerves, leading to numbness, tingling, or radicular nerve pain down the legs.
Does lupus cause upper back pain?
Lupus can generate upper back pain, though less often than lower back pain. Upper back problems may arise from inflammation around the thoracic vertebrae, ribs, chest muscles, or shoulders.
Can lupus cause back muscle pain?
Yes, lupus myositis causes painful inflammation directly within the back muscles. Upper, mid, and low back muscle groups may all be affected. Weakened muscles may spasm painfully.
Can lupus cause spinal cord compression?
In rare cases, yes. Severe lupus spine inflammation could potentially lead to a compressive myelopathy. This spinal cord compression requires urgent surgery for treatment.
Can lupus cause sciatica?
It is uncommon, but possible. Compressed spinal nerves from lupus inflammation may irritate the sciatic nerve. This typically causes burning pain down the back of the leg.
The takeaway
While not a primary symptom, back and hip pain are common complaints for many lupus patients. Managing lupus disease activity with medications can help prevent painful flares in these areas. Physical therapy, chiropractic care, hot/cold therapy, braces, joint injections, and sometimes surgery may also provide relief. With a comprehensive treatment plan, most patients can find sufficient comfort and mobility despite lupus-related back and hip pain.
