Fatigue and joint pain are common symptoms that can be caused by a variety of medical conditions. In many cases, fatigue and joint pain occur together, making it difficult to pinpoint the underlying cause. This article provides an overview of some of the most common diseases and conditions that list fatigue and joint pain among their symptoms.
Autoimmune Diseases
Autoimmune diseases occur when the immune system begins attacking the body’s own healthy tissues and organs. Several autoimmune diseases frequently cause fatigue and joint pain.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease that mainly attacks the joints. In RA, the immune system targets the synovium, a thin membrane that lines the joints. This causes inflammation, swelling, stiffness, and damage over time. The joints most often impacted are those in the hands, wrists, and knees.
Fatigue occurs in about 80% of people with RA. The fatigue may result from the immune system chemicals that cause inflammation or from the joint pain and stiffness interfering with sleep. The fatigue ranges from mild to severe and can significantly disrupt daily life.
Lupus
Systemic lupus erythematosus (SLE), also called lupus, is an autoimmune disorder that can affect any part of the body. With lupus, the immune system creates antibodies that attack the body’s own tissues and organs, especially the skin, joints, kidneys, heart, lungs, blood vessels, and brain.
About 90% of people with lupus experience debilitating fatigue. Joint pain and swelling are also very common and occur in about 90% of people with lupus. The joint pain is typically worse in the morning. The small joints in the hands and wrists are most often affected.
Sjögren’s Syndrome
Sjögren’s syndrome is an autoimmune disorder in which the immune system attacks the glands that produce tears and saliva. This leads to dry eyes and dry mouth. Sjögren’s syndrome can also affect other parts of the body, including the joints, lungs, kidneys, blood vessels, and nerves.
The most common symptoms of Sjögren’s syndrome are fatigue and joint pain. The fatigue ranges from mild to disabling. The joint pain is typically felt in the shoulders, knees, hands, ankles, feet, and hips.
Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, involve chronic inflammation of the digestive tract. While these diseases mainly cause digestive symptoms, they are systemic conditions that can affect other parts of the body too.
Crohn’s Disease
Crohn’s disease causes inflammation anywhere along the digestive tract, most often the end of the small intestine. Besides digestive issues, Crohn’s disease can cause joint pain, fatigue, and skin rashes.
The joint pain associated with Crohn’s most often affects the knees, elbows, wrists, and ankles. Low-grade fevers and fatigue are also very common symptoms.
Ulcerative Colitis
Ulcerative colitis causes long-lasting inflammation and ulcers in the innermost lining of the large intestine and rectum. Symptoms include abdominal pain, diarrhea, rectal pain and bleeding.
Some people with ulcerative colitis experience joint pain and arthritis. The arthritis is usually in the knees, ankles, wrists, and elbows. Fatigue affects about 20% to 50% of people with ulcerative colitis.
Chronic Fatigue Syndrome
Chronic fatigue syndrome (CFS), also called myalgic encephalomyelitis, is a complex disorder characterized by extreme fatigue lasting 6 months or longer. The fatigue worsens with physical or mental exertion but does not improve with rest.
Joint pain is one of the most common symptoms of CFS, occurring in 75% to 90% of patients. The joint pain tends to migrate from one joint to another and commonly affects the knees, hips, shoulders, and hands. Headaches, muscle pain, impaired memory, and unrefreshing sleep are other common symptoms.
Fibromyalgia
Fibromyalgia is a disorder characterized by widespread chronic pain, fatigue, sleep disturbances, and cognitive difficulties. While fibromyalgia is not an autoimmune disease, researchers believe it may have an autoimmune component.
The hallmark symptom of fibromyalgia is pain and tenderness throughout the body, especially in the muscles, joints, and soft tissues. The pain ranges from a mild achiness to more intense pain. Fibromyalgia pain often occurs in the neck, shoulders, back, hips, arms, and legs.
Profound fatigue affects nearly all individuals with fibromyalgia. The fatigue worsens after physical exertion or inadequate sleep. People with fibromyalgia describe the fatigue as feeling drained and completely exhausted.
Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune disease that damages the protective covering surrounding the nerve fibers in the brain, spinal cord, and eyes. This interferes with communication between the brain and body, leading to various symptoms.
Fatigue occurs in about 80% of people with MS. The fatigue is often one of the most debilitating symptoms and can significantly impair quality of life. Muscle stiffness and joint pain are also common in MS.
Rheumatological Conditions
Besides autoimmune arthritis like RA, other rheumatological conditions commonly cause joint pain and fatigue.
Osteoarthritis
Osteoarthritis is a degenerative joint disease in which the protective cartilage in the joint breaks down over time. This causes pain, stiffness, swelling, and loss of motion in the affected joints. The joints most often impacted are in the knees, hips, hands, and spine.
Chronic pain and stiffness from osteoarthritis can lead to fatigue. Difficulty sleeping due to joint discomfort can also worsen fatigue.
Gout
Gout is a form of inflammatory arthritis caused by high uric acid levels in the blood. The uric acid forms needle-like crystals that deposit in the joints, leading to sudden attacks of excruciating pain, redness, and swelling.
The pain is often described as the worst pain ever felt. Gout attacks most typically affect the big toe joint. Fatigue commonly accompanies gout attacks.
Polymyalgia Rheumatica
Polymyalgia rheumatica causes muscle pain and stiffness, mainly around the shoulders and hips. Severe fatigue occurs in up to 50% of individuals with this condition. Low grade fever, joint pain, and weight loss can also occur.
Hypothyroidism
Hypothyroidism is an endocrine system disorder in which the thyroid gland does not produce enough thyroid hormone. Thyroid hormone regulates metabolism and many body functions.
Fatigue and joint pain are among the most common symptoms of hypothyroidism. The joint pain is often described as stiff, achy, and occurring symmetrically on both sides of the body. The knees, shoulders, elbows, and hips are most often affected.
Diabetes
Diabetes is a metabolic disease that causes blood sugar (glucose) levels to become too high. Type 1 diabetes is caused by the immune system destroying insulin-producing cells in the pancreas. Type 2 diabetes occurs when the body develops resistance to insulin.
Fatigue is a frequently overlooked symptom of both type 1 and type 2 diabetes. The fatigue results from cells not getting adequate glucose for energy. Joint pain is also a common complaint, especially in the shoulders, hips, hands, and knees.
Cancer
Both fatigue and joint pain are common symptoms in people with cancer. Up to 90% of cancer patients experience fatigue, described as feeling weak, exhausted, and unable to function normally.
The joint pain tends to be diffuse, rather than isolated to particular joints. It may result from the cancer itself or from chemotherapy drugs. Chronic fatigue syndrome sometimes develops after cancer treatment.
Kidney Disease
Chronic kidney disease causes a gradual loss of kidney function over time. End-stage renal disease occurs when the kidneys can no longer function at the level needed for day-to-day life.
Fatigue is one of the most frequently reported symptoms in patients with kidney disease. Joint pain typically occurs later in kidney disease and becomes more common as kidney function declines. The joint pain often affects the shoulders, knees, and hips.
Lyme Disease
Lyme disease is caused by a bacterial infection transmitted through the bite of an infected blacklegged tick. The disease progresses in stages, with early symptoms including fever, chills, headache, fatigue, and muscle and joint pain.
If left untreated, Lyme disease can progress to cause joint swelling and severe, recurring joint pain. The knees are most commonly affected. Chronic Lyme arthritis can lead to permanent joint damage. Intense fatigue is another hallmark symptom.
Viral Infections
Viruses are a common source of joint pain and fatigue. Viral joint pain, or arthralgia, results from inflammation caused by the infection. Viruses known to frequently produce joint pain include hepatitis C, HIV, parvovirus B19, and rubella.
Fatigue develops as the immune system works hard to fight off the virus. Symptoms like fever, body aches, and nausea can also worsen fatigue. Rest is important during recovery from a viral infection.
Bacterial Infections
Bacterial infections like tuberculosis, gonorrhea, and Lyme disease can also produce inflammation leading to joint pain and arthritis. The fatigue occurs as the body combats the infection.
Septic arthritis is a bacterial infection within a joint space. It causes sudden, severe joint pain, swelling, fever, and chills. Antibiotics are needed to treat the infection and prevent permanent joint damage.
Medications
Numerous medications list joint pain and fatigue as potential side effects. Examples include:
- Cholesterol-lowering statins
- Blood pressure medications
- Antidepressants
- Antibiotics like ciprofloxacin and azithromycin
- Osteoporosis drugs like alendronate
- Aromatase inhibitors used in breast cancer, like anastrozole
The mechanism behind drug-induced joint pain is not always clear. The pain may result from drug interactions or from the drug’s effects on muscle tissue. Switching medications can often resolve the side effects.
Aging
Getting older naturally leads to some degree of fatigue and joint pain. Age-related fatigue occurs as metabolism slows and energy requirements and output decrease. Older adults also have more trouble falling and staying asleep.
Joint pain results from the gradual wearing down of cartilage that comes with aging. Osteoarthritis caused by aging most often affects the knees, hips, hands, and spine. Staying active can help reduce severity of age-related joint symptoms.
Injuries
Injuries like fractures, sprains, and dislocations can lead to acute and chronic joint pain. An injury may damage structures inside like cartilage, ligaments, and tendons. Arthritis can develop post-injury.
Recovering from injuries often involves resting the joint and limiting activity, which can result in fatigue. Working with a physical therapist can help rehabilitate injuries and restore joint function.
Overuse
Repeated overuse of joints during sports, work, or daily activities can cause joint pain. Fatigue sets in as exertion is too physically demanding. This type of joint pain is considered an overuse injury.
Examples of overuse injuries leading to joint pain include runner’s knee, tennis elbow, golfer’s elbow, swimmer’s shoulder, and jumper’s knee. Letting overused joints rest is key to recovery.
Obesity
Carrying excess body weight strains the joints, especially weight-bearing joints like the hips and knees. This extra pressure causes inflammation, accelerates cartilage breakdown, and leads to joint pain. Moving with excess weight also requires more effort, resulting in fatigue.
Losing weight through dietary changes and exercise is one of the best ways to relieve joint pain associated with obesity. Even losing just 10-15 pounds can make a big difference in joint comfort.
Depression
Depression commonly causes vague physical symptoms like fatigue, headaches, stomachaches, and muscle and joint pain. The joint pain associated with depression is typically described as achy and is not confined to particular joints.
The physical symptoms of depression are believed to stem from interactions between mood, stress, inflammation, and neurotransmitters that influence pain perception. Treating the depression can help resolve the physical symptoms.
Anxiety Disorders
Anxiety and joint pain often co-occur as well. An estimated 15-35% of people with joint disorders like RA and lupus also have an anxiety disorder. It is not clear whether the joint disease causes anxiety or vice versa.
Experts theorize that anxiety could directly influence joint pain by increasing muscle tension and inflammation. The anxiety itself may also focus attention on physical symptoms like joint pain.
Poor Sleep
Disrupted sleep decreases quality of life and leaves people feeling depleted. Joint discomfort at night often interferes with falling and staying asleep. Fatigue then worsens the perception of joint pain, creating a vicious cycle.
Good sleep habits like limiting electronics before bed, keeping a consistent sleep schedule, and making the bedroom comfortable and dark can improve sleep quality. Some people find relief sleeping with a pillow between the knees.
Nutrient Deficiencies
Deficiencies in certain nutrients can contribute to widespread muscle aches and joint pain. Potentially implicated deficiencies include:
- Vitamin D – Essential for bone and muscle health
- Magnesium – Needed for energy production and nerve function
- Vitamin B12 – Important for nerve health and red blood cell formation
- Iron – Carries oxygen in the blood to cells
Correcting any deficiencies through diet changes or supplements may help reduce muscle and joint symptoms.
Hormonal Changes
Shifts in hormones can alter inflammation and pain perception levels in the body. Hormone changes during menopause and perimenopause often lead to increased joint pain, achiness, and fatigue.
The onset of fatigue and joint discomfort in puberty is another example of pain sensitivity being influenced by hormonal fluctuations. Making healthy lifestyle choices can offset some of the effects.
Stress
High stress levels raise inflammation and also make the body more sensitive to pain signals. Chronic stress can thus directly worsen joint pain and achiness. Exhaustion builds as the stress continues without relief.
Managing stress through techniques like meditation, exercise, social connection, and therapy can reduce inflammation and help break the stress-pain cycle. Getting good sleep is also essential.
Conclusion
Joint pain and fatigue can stem from a wide range of medical conditions, from autoimmune diseases to hormonal shifts. Often times, multiple overlapping factors contribute to cause the symptoms.
Keeping a symptom journal and tracking factors like activity, diet, mood, and sleep can help pinpoint what is driving your particular symptoms. This provides a starting point for determining the appropriate treatments to reduce the joint pain and fatigue.
Seeking prompt medical attention for unexplained or persistent fatigue and joint pain is always advisable, as it could indicate a more serious underlying condition. Working closely with your healthcare providers can ensure you get the proper care and relief needed to improve your health.