Ulcerative colitis is a form of inflammatory bowel disease. In addition to gastrointestinal symptoms, people with this condition often experience painful and swollen joints.
Doctors call this IBD-associated arthritis, and they may treat it differently from arthritis that is not linked to IBD.
IBD-associated arthritis may appear differently to arthritis without IBD, but both pain and joint inflammation are common to both.
In this article, learn about the link between ulcerative colitis (UC) and joint pain, including how to manage and treat the pain.
Both arthritis and UC can involve joint pain and inflammation, but the conditions are different.
While most of the common symptoms of UC are gastrointestinal, such as bloating, diarrhea, and bloody stool, this disease can also affect other parts of the body. Joint pain is one of the most common symptoms of UC not related to the stomach and intestines.
Two forms of joint pain may affect people with UC. Arthralgia, which is only joint pain, is a symptom of arthritis. Arthritis, on the other hand, covers joint pain, inflammation, swelling, and redness.
People with UC usually have a different experience of arthritis than those with an arthritis diagnosis but no IBD. They may develop it at a younger age but not have long-term joint damage.
Joint pain tends to occur during a UC flare and disappear in periods of remission, along with other symptoms.
Several types of arthritis can affect those with UC:
This form of arthritis affects certain parts of the body, including those below:
The pain may move from one joint to another. It is the most common form of joint pain in people with UC.
The level of inflammation in the joints generally corresponds to the extent of the inflammation in the colon. The symptoms of peripheral arthritis usually disappear without causing long-term damage once UC symptoms are in remission.
Also known as spondylitis or spondyloarthropathy, axial arthritis causes pain in the lower spine and sacroiliac joints.
Joint pain from axial arthritis may occur months or years before UC symptoms appear.
This condition can lead to parts of the spine fusing, which can decrease a person’s range of motion and result in permanent damage.
Ankylosing spondylitis is a more severe form of arthritis that affects 2–3% of people with IBD. It is more likely to affect people who have Crohn’s disease than those with UC and often appears before the age of 30 years.
Symptoms can cause long-term damage, and include inflammation in:
- the spine and sacroiliac joints, which are in the pelvis
- the lungs, eyes, and heart valves
- the intersection where a tendon meets the bone, known as enthesitis
- the fingers and toes known as dactylitis
- the heel, leading to plantar fasciitis
- the back of the ankles, resulting in Achilles tendonitis
Other types of arthritis
It is essential that people visit a rheumatologist for a proper diagnosis so they can get the best treatment and learn techniques for managing their symptoms.
People with peripheral arthritis but without UC can usually manage pain and swelling with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin.
However, doctors do not usually recommend these medications to people with UC because they can irritate and further inflame the intestines.
Instead, the following medications may be necessary to manage both the joint and intestinal inflammation and pain:
- immune-suppressing drugs
- disease-modifying antirheumatic drugs
- biologic drugs
Biologic drugs can also treat axial arthritis and ankylosis spondylitis.
In addition to medical treatments, people can try home remedies to help alleviate pain. These include:
- using heating pads
- applying a warm, wet compress
- stretching and doing range-of-motion exercises
- icing painful areas of the body
- elevating the affected joint
People with UC can reduce their risk of arthritis and joint pain by:
- Eating a varied and balanced diet: A registered dietitian can help create a suitable diet plan.
- Avoiding certain foods: Some foods may aggravate UC symptoms, such as dairy products and high-fiber, high-fat, or spicy foods.
- Managing stress: Limiting exposure to stressful situations, seeing a therapist, and learning relaxation techniques, such as meditation, may help.
- Taking medication as prescribed: Taking all medication as directed can help minimize the risk of complications.
Here are some questions people often ask about UC and joint pain.
Does ulcerative colitis cause joint pain?
Up to 30% of people with UC experience joint pain.
What are the signs of worsening ulcerative colitis?
As UC worsens, bleeding may occur more regularly, and a person may experience other symptoms throughout their body. However, joint pain may occur months or years before other signs of UC appear.
Can ulcerative colitis cause back and hip pain?
If axial arthritis occurs with UC, a person may experience pain in the lower back and the sacroiliac joints, where the hips join the pelvis.
Can intestinal inflammation cause joint pain?
Inflammatory bowel disease (IBD) includes Crohn’s disease and UC, and it involves intestinal inflammation. Joint pain can affect people with these conditions.
Ulcerative colitis is a form of IBD. Along with gastrointestinal symptoms, it can cause painful and swollen joints.
The level of joint pain in people with UC often correlates with the extent of intestinal inflammation. Any inflammation of the joints does not usually result in long-term damage.
A doctor can provide advice on treating both UC and any associated joint pain.