Celiac Disease Symptoms: Arthritis & Joint Pain

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Joint pain is a common complaint among older people, though it can happen to a person of any age. Most joint pain is due to overuse or old age, though a chronic condition can cause it. In this article, you’ll learn about joint pain, its leading causes, and its relationship to celiac disease.

First, let’s establish the basics.

Joint: A joint is where two bones meet. Think of the elbow joint, where your upper and lower arms connect. If your arm were just one long bone, it wouldn’t bend. Joints allow you to move, twist, bend, and jump. Your shoulders, elbows, fingers, hips, and ankles all have joints.

Cartilage: Cartilage is a tough but flexible material in between your bones. It prevents the bones from hitting or grinding against each other when you move. Your ears and nose are also made out of cartilage. When joints don’t have enough cartilage, it can hurt to move and cause joint pain.

Arthritis: Arthritis is a general term for long-term health conditions with a primary symptom of joint pain. There are many kinds of arthritis, with different causes and affecting various body parts.

Both joint pain and arthritis can feel like:

Pain when moving
Stiffness
Swelling at the joints (such as elbows, fingers, knees, ankles)
Redness at joints (such as elbows, fingers, knees, ankles)

Symptoms: A symptom is caused by celiac disease and should ease up or go away entirely on a gluten-free diet.

Related Conditions: A related condition is a disease or illness entirely separate from celiac disease, but having celiac disease can put you at greater risk of getting the other condition.

Pain in joints can be a symptom of celiac disease that goes away on a strict gluten-free diet, but it could also caused by a related condition, such as rheumatoid arthritis.

Joint Pain as a Symptom of Celiac Disease

Multiple studies suggest that 20-30% of individuals with celiac disease experience joint pain. However, it’s uncommon for joint pain to be the only symptom.^1-3 People with celiac disease experience joint pain in various ways, including early morning stiffness, pain in multiple joints (polyarthralgia), and pain in the back, lower back, and pelvis (sacroiliitis).

The exact cause of joint pain in those with celiac disease remains unknown. One theory suggests that ingesting gluten causes inflammation in these patients, contributing to joint discomfort.⁴ In patients with celiac disease, joint pain often goes away once the person is on a strict gluten-free diet.

Arthritis and Other Join Disorders as Related Conditions of Celiac Disease

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disease that causes joint inflammation and can lead to severe joint damage over time. People with celiac disease have a higher prevalence of RA compared to the general population.

Symptoms of RA include general pain and swelling at the joints, as well as:

Warm and tender joints
Fatigue
Loss of appetite
Fever

Some people with RA have symptoms all the time. Others shift between flares (when symptoms are present and painful) and remissions (when symptoms decrease or disappear).

Without treatment, RA can cause deformed joints, osteoporosis (weak bones), fused bones, and general mobility loss.

Thankfully, there are options for treating RA, including prescription drugs, over-the-counter drugs, physical therapy, and regular exercise.

If you want to get tested for RA, speak with your doctor. It’s as simple as getting a blood test. Your doctor may also want to do a physical examination or tests to examine your joints and bones, such as x-rays and ultrasounds.

Juvenile Idiopathic Arthritis

Juvenile Idiopathic Arthritis (JIA) is an autoimmune disorder. Although researchers do not know the cause of JIA, it seems related to genetic and environmental factors.

Symptoms of JIA include:

Joint inflammation, swelling, stiffness, and tenderness
Inability to bend or straighten joints
Fatigue and decreased physical activity
Weakness in muscles
Fever
Skin rash
Enlarged lymph nodes

This type of arthritis affects young people, as it first appears before age 16. This condition affects approximately 249,000 children in the US and is more common in females.⁵

What is the Connection between Juvenile Idiopathic Arthritis and Celiac Disease?

Research has estimated that celiac disease is about seven times more common in children with JIA than in the general population.
Celiac disease and JIA share common risk genes.
The start of JIA usually occurs before celiac disease is diagnosed and treated with a gluten-free diet.

Other Joint Disorders

Celiac disease is also associated with other joint conditions, including:

Ehlers–Danlos Syndrome (EDS): Research suggests a correlation between celiac disease and connective tissue disorders such as EDS, particularly the hypermobility type. Individuals with EDS may experience joint hypermobility, chronic pain, and a range of gastrointestinal symptoms. Some studies have indicated a higher prevalence of celiac disease among those with EDS, suggesting a potential link between these conditions. Learn More about EDS
Osteoarthritis: Osteoarthritis is a joint condition caused mainly by wear and tear on cartilage. It usually affects older adults. It is not an autoimmune condition. According to researchers at the University of Frederica II of Naples, celiac disease patients are four times more likely to have early signs of arthritis in the lower limbs than the general public. However, patients who have been on a gluten-free diet have a decreased risk of osteoarthritis compared to those newly diagnosed.
Enthesitis: A 2013 study published in the journal Rheumatology was the first to show an increased risk of connective tissue inflammation (enthesitis) in celiac disease patients who had no prior musculoskeletal or arthritis-like symptoms.
Psoriatic Arthritis: Psoriatic arthritis is an inflammatory joint condition associated with psoriasis, an autoimmune skin disease that causes red, scaly skin patches. Studies have shown a connection between celiac disease and psoriasis, but that connection is still under investigation. Learn more about psoriasis.

Sources:

Di Stefano M, Pennazio M, Castellani F, et al. World J Gastroenterol. 2016;22(29):6646–6655.
Lubrano E, Ciacci C, Ames PR, et al. Rheumatology (Oxford). 2004;43(12):1584–1589.’
Green PH, Jabri B. The Lancet. 2003;362(9381):383–391.
For more on the inflammatory pathways linking gluten intake to joint discomfort in celiac disease, see Article in PubMed Central (PMCID: PMC9237855).
Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–392.

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