Scleroderma, a chronic connective tissue disease marked by hardened and thickened skin, and scarring, can affect many organs and tissues, including muscles and joints.
Symptoms of muscle and joint involvement
Scleroderma and its manifestations vary greatly among patients, but in general, if scleroderma affects the muscles, symptoms like muscular pain and muscle weakness are likely.
If the joints are affected, patients may experience symptoms that are arthritis-like in their nature, including pain, stiffness, swelling, warmth, and tenderness.
Diagnosing muscle and joint involvement
Joint involvement is relatively easy to diagnose, as arthritis can be detected in a physical examination.
Muscle involvement is harder, because a person may experience no symptoms until muscular weakness is evident. Measuring the serum concentration of muscle enzymes that leak from muscle tissue in cases of injury — creatine kinase (CK), aldolase, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) — can help to diagnose muscle damage, especially if it is related to autoimmune-mediate inflammation or fibrotic changes, or weakness stemming from digestive difficulties and resulting malnutrition.
Specialized tests may also be requested, such as an electromyography, where the electrical activity of muscle tissue is recorded and examined. Likewise, a muscle biopsy may be needed.
Treatment of muscle and joint complaints
Non-pharmacological approaches, such as regular stretching exercises under the supervision of a physical or occupational therapist, or learning to perform differently daily tasks that strain muscles and joints, such as lifting and carrying objects, may help to reduce the muscle and joint pain caused by scleroderma.
These approaches can also help to minimize further damage and reduce the possibility of skin ulcers and infections.
Anti-inflammatory medication, medicines that suppress the immune system, and anti-fibrotic agents may be needed by some patients to address muscle and joint pain associated with scleroderma.
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