Joint pain is one of the many possible symptoms of Sjogren’s syndrome, an autoimmune disorder in which dry mouth and dry eyes are the hallmark symptoms.
Though Sjogren’s syndrome is considered a disease of dryness, it can affect the whole body, including the joints.
Physicians who deal with Sjogren’s syndrome are often rheumatologists (joint specialists).
A smart question is how common joint pain exists among patients with Sjogren’s syndrome.
“Over 80 percent of patients with Sjogren’s syndrome suffer from joint pain and/or stiffness,” says Ali D. Askari, MD, Professor of Medicine – Case Western Reserve University; Chief, Division of Rheumatology – University Hospitals Case Medical Center; Director, Rheumatology – University Hospitals Case Medical Center.
“In most patients this is the first manifestation of the disease, and most of the time not diagnosed to be on the basis of Sjogren’s syndrome.”
This condition affects two to four million Americans, and 90 percent of patients are women. It is not known why the vast majority of SS patients are women.
“Over time it has been noted that patients with Sjogren’s syndrome are not diagnosed with the disease for a few years,” continues Dr. Askari.
“This is mainly because the symptoms of dryness of the eyes and mouth are interpreted as to being related to age, medicines, conditions such as diabetes, etc.”
In Sjogren’s syndrome (pronounced show-grens), the dry mouth and dry eyes result from decreased production of salivary glands and lacrimal glands, respectively. The cause is not known.
“Joint pain and swelling can take a symmetrical form and be diagnosed as rheumatoid,” says Dr. Askari.
“Most of the time, however, synovitis or joint swelling in Sjogren’s syndrome is asymmetric and involves the larger joints rather than smaller ones.
“Contrary to this is when patients with rheumatoid arthritis (a third of the time) or systemic lupus (a third of the time) develop Sjogren’s syndrome.
“In both conditions the joint swelling involves the small joints of the hands and is symmetrical.
“Destructive changes of the bone and other parts of the joint usually are not the norm in Sjogren’s syndrome as opposed to rheumatoid arthritis.
“The blood tests for rheumatoid and lupus could be positive in primary Sjogren’s syndrome, but other findings associated with these two diseases are not typical in Sjogren’s syndrome.”
There is no cure for this systemic disease, though for some patients, the malady can be accurately summed up as a chronically annoying condition.
But for others, serious complications can result, such as lung infections and problems with the heart, liver and kidneys. However, with vigilant management, the patient should survive SS; it’s considered a nonfatal disease.
“Joint pain responds to treatment of synovitis with non-steroidal anti-inflammatory and at times disease modifying drugs, so-called DMARD’s.
“It is therefore important for patients who do have arthritis, swelling and stiffness in different joints, to be asked regarding the dry syndromes, either in the mouth or eyes or both, and tests for Sjogren’s syndrome and connective disease in general.”