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Lupus is an autoimmune disease that causes the body's immune system to attack its own tissues and organs. The disease affects everyone differently, and symptoms can vary in severity and combination. While muscle spasms are not a common symptom of lupus, some people living with the condition experience twitching that may be linked to medication side effects, nutritional deficiencies, or lupus flares.
| Characteristics | Values |
|---|---|
| Muscle spasms caused by lupus | Rare |
| Lupus myositis | Affects central muscles like those in the neck, hips, thighs, and shoulders |
| Muscle spasms causes | Peripheral neuropathy, lupus flares, medication side effects, nutritional deficiencies |
| Muscle weakness causes | Myositis, medication side effects |
| Muscle pain causes | Myalgia, myositis |
| Muscle pain treatment | Physical therapy, exercise |
| Muscle weakness treatment | Adjusting medications |
| Muscle weakness medications | Prednisone, other corticosteroids, drugs to lower cholesterol, hydroxychloroquine |
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What You'll Learn
Lupus myositis
Myositis is characterised by persistent invalidating muscular weakness combined with increased levels of creatine phosphokinase (CPK) and abnormal electromyography (EMG). In a study of 1701 lupus patients, 44 (2.6%) were found to have myositis. It is more commonly observed in younger SLE patients and those with a shorter disease duration.
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Peripheral neuropathy
Lupus is an autoimmune disease that causes inflammation throughout the body. It makes the immune system damage organs and tissues instead of protecting them. Lupus affects different people in different ways, but most people with lupus experience problems with their joints, muscles, or bones.
Lupus can cause muscle spasms through peripheral neuropathy, which is a problem with the peripheral nervous system. The peripheral nervous system sends signals to and from the muscles. Peripheral neuropathy can manifest in different ways, including:
- Neuropathy of the motor nerves, leading to weakness, cramps, and twitching.
- Neuropathy of the sensory nerves, leading to pain, tingling, and numbness.
The prevalence of peripheral neuropathy in patients with systemic lupus erythematosus (SLE) was found to be 1.5% in one study, while another study found a higher prevalence of 14%. Polyneuropathy was the most frequent type of peripheral neuropathy in both studies. Peripheral neuropathy may be associated with a decreased quality of life in patients with SLE, despite rarely impacting the risk of death.
In addition to peripheral neuropathy, lupus can also cause muscle spasms through lupus myositis, which is inflammation in the muscles. Lupus myositis mostly affects central muscles such as those in the neck, hips, thighs, and shoulders. The most common symptom of myositis is muscle weakness.
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Medication side effects
While muscle spasms are not a common symptom of lupus, they may be linked to medication side effects. The medications used to treat lupus include steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs, immunosuppressants, and biologics. Each of these drug categories has its own set of potential side effects that patients should be aware of.
Steroids, such as prednisone and methylprednisolone (Medrol), are often used to control serious inflammation associated with lupus. However, long-term use of high doses of steroids can lead to avascular necrosis (AVN), a condition that causes bone tissue death due to reduced blood flow. AVN can result in pain, stiffness, and limited movement in the affected joints, which may include the hips, knees, or shoulders.
NSAIDs, such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB), are commonly used to treat pain, swelling, and fever associated with lupus. However, side effects of NSAIDs may include stomach bleeding, kidney problems, and an increased risk of heart issues.
Antimalarial drugs like hydroxychloroquine (Plaquenil) are used to reduce autoantibodies and decrease the risk of lupus flares. While hydroxychloroquine has relatively few side effects, it may cause stomach upset, digestive problems, and, in rare cases, damage to the retina.
Immunosuppressants, such as azathioprine (Imuran, Azasan) and mycophenolate (Cellcept), are used in serious cases of lupus to suppress the immune system. Side effects of immunosuppressants may include an increased risk of infection, liver damage, decreased fertility, and an increased risk of cancer.
Biologics, such as belimumab (Benlysta), are another type of medication used to reduce lupus symptoms. Side effects of biologics can include nausea, diarrhea, and infections. In rare cases, they may also lead to a worsening of depression.
It is important for patients taking medications for lupus to be aware of the potential side effects and to consult their healthcare providers if they experience any adverse reactions.
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Lupus arthritis
It is important to distinguish lupus from arthritis, as they are different conditions with distinct causes and treatments. While arthritis is caused by inflammation or wear and tear of the joints, lupus is an autoimmune disease that results in widespread inflammation throughout the body. This distinction is crucial for accurate diagnosis and treatment.
Lupus can also cause muscle spasms, although this is less common. Peripheral neuropathy, a condition affecting the peripheral nervous system, can lead to muscle spasms in people with lupus. Additionally, certain medications used to treat lupus, such as steroids, can contribute to muscle weakness and joint issues.
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Avascular necrosis
Systemic lupus erythematosus (SLE) is an autoimmune disease that causes the immune system to attack healthy tissue and organs throughout the body. The symptoms of lupus vary widely, affecting the skin, joints, blood, kidneys, brain, heart, lungs, and muscles.
Lupus can cause muscle pain, or myalgia, and less commonly, inflammation of the muscles, or myositis. Myositis usually affects the hips, thighs, shoulders, and upper arms, causing muscle weakness and stiffness. Lupus can also cause joint pain (arthralgia) and inflammation, resulting in problems like arthritis, tendonitis, and carpal tunnel syndrome.
Lupus patients are also at an increased risk of developing bone problems, such as osteoporosis and avascular necrosis (AVN). Avascular necrosis is a rare complication of SLE, affecting around 8-9% of patients, and is more common in females. It is characterised by reduced blood flow and increased pressure within a portion of the bone, leading to bone weakening, tiny breaks, and eventually, collapse of the bone surface. The causes of AVN are not well understood, but it is associated with long-term use of high doses of corticosteroids, alcohol abuse, sickle cell anaemia, and trauma, among other factors. In lupus patients, AVN is almost always a result of corticosteroid use. The most common symptoms of AVN are pain, stiffness, and muscle spasms in the hips, knees, or shoulders, which can worsen with movement. Advanced AVN can cause pain at rest, especially at night.
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Frequently asked questions
While it’s rare, systemic lupus can cause muscle spasms because it affects the nerves and muscles. Lupus has many effects on the nervous system, including the peripheral nervous system, which sends signals to and from your muscles.
Lupus symptoms usually come and go in waves called flare-ups. During a flare-up, the symptoms can be severe enough to affect your daily routine. Symptoms include joint pain, muscle pain, chest pain, rashes, mouth sores, fatigue, shortness of breath, swollen glands, and swelling in your arms, legs, or face.
Lupus can cause myalgia, or aches and pains in the muscles. Less often, lupus can cause myositis, or inflammation in the muscles — usually in the hips, thighs, shoulders, and upper arms. The most common symptom of myositis is muscle weakness.
Treatment options for muscle spasms caused by lupus include staying active, staying hydrated, checking magnesium levels, or adjusting medications. Doctors may refer patients with lupus to rheumatologists, who specialize in diagnosing and treating conditions affecting the joints, muscles, tendons, and bones.
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