Managing Joint Pain When You’re Living With Ulcerative Colitis

Ulcerative colitis is a long-term condition that causes inflammation in your colon. That can create a range of gastrointestinal symptoms, like cramping and irregular or intense bowel movements.

But did you know you 34% of people living with ulcerative colitis also experience joint pain as a side effect of the disease?

Gastroenterologist Suresh Pola, MD, explains the link between joint pain and ulcerative colitis and what you can do to find relief.

Why ulcerative colitis can cause joint pain

Ulcerative colitis is a type of inflammatory bowel disease. It happens when your immune system becomes dysregulated and affects your colon, leading to inflammation. Because your immune system impacts your whole body, it can also cause problems in other areas, like your:

• Skin
• Eyes
• Joints

Not everyone living with ulcerative colitis experiences joint pain. But Dr. Pola says those who do tend to feel it in their:

• Knees
• Hips
• Shoulders
• Back
• Hands and feet
• Ankles

“The same immunology and genetics that cause inflammation in your gut can also cause inflammatory arthritis in your joints,” he confirms.

How do you know if there’s a connection between your joint pain and ulcerative colitis?

Joint pain associated with ulcerative colitis can vary in a few ways.

If your joints hurt whenever you have an ulcerative colitis flare, it should go away once you treat the flare itself. But that’s only if there’s actually a connection between the two, which isn’t always the case.

“Sometimes, with smaller joints, like the ones in your hands, inflammation and pain may become more persistent and be completely independent of the disease itself,” explains Dr. Pola.

Plus, there are lots of different types of joint pain that people with ulcerative colitis might experience that aren’t associated with the disease, including:

• Osteoarthritis
• Bursitis
• Medication side effects
• Infections
• Soft-tissue injuries

That’s what makes joint pain tricky to diagnose. It often requires careful evaluation of your symptoms — when and how they surface — and additional testing or input from other specialists, like a rheumatologist.

Management and treatment

If you have ulcerative colitis and you’re dealing with joint pain, over-the-counter medications like Tylenol® can provide some relief. That’s true whether you’re in remission or having a flare-up.

But be careful about the medications you take.

“Nonsteroidal anti-inflammatories (NSAIDs) might trigger an ulcerative colitis flare-up, so I encourage people to avoid taking them,” warns Dr. Pola.

Beyond that, it’s important to work with your care team to make sure you’re doing what you can to prevent flare-ups. As you treat ulcerative colitis, you may find that you have less joint pain.

“If we treat the colitis and your bowels get better and the joint pain subsides, you may not need anything more than that,” he adds. “Sometimes, we use biologics (targeted medications) to treat ulcerative colitis. Or if it’s a really bad flare-up, we can use steroids like prednisone. Those should help both the joint pain and the ulcerative colitis.”

Your healthcare provider can guide you toward other treatments, too, especially if your joint pain is unrelated to ulcerative colitis. Those include:

• Alternating ice and heat therapies
• Topical gels, patches and creams
• Cortisol injections
• Physical therapy
• Low-impact exercises

“Our goal is to help you feel better, so we’ll do whatever we can to treat both conditions so your quality of life improves,” advocates Dr. Pola.