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Joint Pain Triggers: Sun, Hot Tubs, and More

Posted on July 26, 2023

It can be frustrating when an attempt to relieve your lupus symptoms backfires — like ending up with more joint pain after soaking in a hot tub. “I hear many of you talk about taking hot baths for relief of pain. For me, hot water makes me much worse. Does that happen to anyone else?” asked one member of MyLupusTeam.

If you have systemic lupus erythematosus (SLE), a chronic inflammatory autoimmune disease and the most common type of lupus, you’re likely no stranger to the sometimes head-to-toe joint pain and inflammation. “I have pain in my shoulders, neck, back, hips, knees, feet, and hands,” shared one MyLupusTeam member.

Just as the cause of lupus flares may vary by person, what relieves one person’s joint pain might worsen another’s. Environmental factors like light and heat can play a significant role in lupus symptoms. In this article, we explore some common environmental triggers for joint pain — sun exposure, overheating, and more.

Sun Exposure and Lupus

Sun exposure is a well-known trigger of joint pain and inflammation in people with lupus. Ultraviolet (UV) radiation from the sun can lead to skin lesions, rashes, and an increased risk of flare-ups in people with SLE and cutaneous lupus erythematosus (skin lupus). The UV rays can stimulate the immune system to cause an inflammatory response, leading to joint swelling and pain. This is why so many people with SLE experience photosensitivity, in which UV light causes skin and systemic reactions.

People with lupus should take precautions to protect themselves from the sun’s harmful effects. Wearing broad-spectrum sunscreen with a high SPF is important, as it helps shield the skin from UVA and UVB rays. Additionally, wearing protective clothing, such as long sleeves, wide-brimmed hats, and sunglasses, as well as using an umbrella, can provide further defense against the sun’s rays. On hot and sunny days, limit your time outdoors, and be sure to avoid activities such as tanning.

Overheating and Lupus

Excessive heat — whether from being out in hot weather in summer months, overexercising, or using hot tubs, saunas, or hot baths — can trigger joint pain and inflammation in individuals with lupus. Heat sensitivity is a common lupus symptom, and it can lead to flare-ups and increased discomfort.

“I have noticed that I cannot go in hot tubs without suffering the next day,” one member said. Another avoids hot showers: “I can’t handle a hot shower. For me it hurts my joints and causes my skin to itch.”

Some people experience only joint pain, whereas others also notice swelling. “On days when it is hot and I am not in air conditioning, I experience extreme swelling in my fingers, hands, feet, and ankles,” one member said.

Being overheated triggers a series of events that can activate your body’s immune system and promote inflammation. To help manage this trigger, it’s essential to stay cool and hydrated, limiting your time in hot environments. Seeking shade, using fans or air conditioning, and avoiding hot tubs or saunas can help minimize the risk of overheating and developing joint pain.

It’s important to remember that triggers differ among people with lupus. For some people, heat therapy helps reduce joint pain. “Hot baths help me, but everyone is different,” one member noted. “If hot water does bother you, try lukewarm or cool water and see what happens.” Continue to do what works best for you to manage your symptoms and keep your lupus in check.

Other Environmental Triggers

Although sun exposure and overheating are prominent triggers, other environmental factors can also contribute to joint pain in lupus. Again, these triggers vary in impact — what affects one person may not be a problem for you. That said, here are a few additional triggers reported by members of MyLupusTeam.

Cold Weather

Cold temperatures can cause joint stiffness and increased pain in people with lupus. One member shared, “I have pain in all of my joints, no matter if they are large or small joints. They all hurt all the time, but rainy and sleeting days are the worst.”

Another member wrote, “I’m wondering if the cold weather is a trigger for the flares that I’m currently experiencing.”

Cold temperatures, such as during winter, can increase your body’s sensitivity to pain, and exposure to extreme cold can cause muscle spasms and heighten joint pain. Try to regulate your body temperature by wearing layers of clothing, using heating pads or warm compresses, and staying active indoors to help manage symptoms during colder months.

Humidity

High humidity levels can make joint pain more pronounced for some individuals. One member shared, “I am never ever in the sun — I avoid it at all cost. But then I started to get lupus joint pain in the summer. So it does make sense to me that it’s the humidity at this time of year.”

Running dehumidifiers, fans, or air conditioning can help reduce humidity indoors and help provide relief.

Stress

Emotional stress has been known to trigger lupus flares and joint pain. Engaging in stress-management techniques such as meditation, yoga, and counseling may help minimize the impact of stress on symptoms.

Chemical Irritants

Some chemicals, such as certain cleaning products or perfumes, may trigger joint pain and inflammation in sensitive individuals. One member asked, “Does anyone else have a strong reaction to chemicals in cleaning products?” Opting for fragrance-free, nontoxic products and ensuring proper ventilation can help reduce your exposure.

Lack of Mobility

Staying still for long periods or having an inactive lifestyle can worsen joint pain in some people. “The swelling I have the most is in my hands and my knees. My knees started hurting as I worked at a desk at every job,” reported one member. “I was tied to a phone cord, so there was no chance to get up and move around.”

Inactivity allows inflammatory substances to build up in the joints, which is why people with lupus and other rheumatologic conditions also have pain and stiffness first thing in the morning. If your joints feel stiff when you sit for a long time, make sure to get up and walk around every 30 to 60 minutes. You may choose to integrate mobility exercises, such as stretches and strengthening workouts, into your daily routine, as one member described: “My exercise is walking and stretching even when I feel awful — I can move accordingly.”

Excessive Activity

On the other hand, moving too much can lead to sore muscles and worse joint pain. Check with your doctor before beginning a new exercise program or physical activity, and ease into it gradually to build endurance. Know your limitations, and consider working with a certified trainer to improve your overall physical health.

Tracking Your Triggers

Unfortunately, joint pain and inflammation are common, painful symptoms that reduce the quality of life for people living with lupus and many other autoimmune disorders. Keeping a diary of what you believe is triggering your joint pain is a good start to preventing future flare-ups. Be sure to note any new, reappearing, or long-lasting symptoms. Share your symptom journal with your doctor so that they can adjust your lupus treatment as needed and offer personalized medical advice to prevent joint pain. Together, you and your health care team can determine the best ways to help keep lupus symptoms at bay.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Does the sun or heat trigger your lupus joint pain? What lifestyle modifications can you recommend to others living with lupus who experience joint pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on July 26, 2023
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Prakruthi Jaladhar, M.D., DNB completed her medical education at Mysore Medical College, followed by an internal medicine residency at Kempegowda Institute of Medical Sciences (KIMS) in Bangalore. Learn more about her here.
Scarlett Bergam, M.P.H. is a medical student at George Washington University and a former Fulbright research scholar in Durban, South Africa. Learn more about her here.

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