Lupus Not Just A Pain In The Neck!

[dropcap]M[/dropcap]ay is Lupus awareness month. Lupus is an autoimmune disease that causes the body’s immune system to attack its own tissues, causing inflammation and tissue damage. There are currently around five million people worldwide suffering from some form of Lupus, and statistics show it is more common in people from ethnic backgrounds. Lupus often gets misdiagnosed as rheumatoid arthritis as they share many of the same symptoms. However, there are some distinct differences.

Lupus causes inflammation but, unlike RA, which mainly affects the smaller joints and may cause deformity, Lupus does not cause deformity; it can also affect the skin, brain, lungs, kidneys and blood vessels. There are several types of Lupus but the most common is Systemic Lupus Erythematosus (SLE). When people talk about Lupus, they are usually referring to SLE.

FORMS OF LUPUS

• SLE, which is more common in women than men, causes chronic inflammation of the joints, skin and kidneys but can also affect the cardiovascular and nervous system.

• Lupus of the skin is further subdivided into three categories: chronic cutaneous Lupus, also known as Discoid Lupus; subacute cutaneous Lupus and timid Lupus.

• Drug-induced Lupus: There are certain drugs that can cause Lupus-type symptoms in people who test negative for Lupus.  This type of Lupus is temporary and symptoms usually subside after the medication is stopped.

• Neonatal Lupus: Babies whose mothers carry certain antibodies can be born with Lupus even if the mother does not herself have the disease. It normally only affects the skin and can disappear without treatment.  A small percentage of infants may suffer from a congenital heart block and may need to have a pacemaker implanted.

• Childhood Lupus: This is similar to SLE in adults but affects boys more than girls and tends to affect the kidneys more; the incidence of kidney disease in children is two times greater than in adults.

SYMPTONS

The symptoms of Lupus can vary significantly among individuals; some people only present with a few symptoms while others have many. The symptoms of SLE may present suddenly or over a period of time and may reduce, only to flare up again. The most common symptoms are:

• Joint pain, stiffness and swelling

• Unexplained fever

• Fatigue

• Pain in the chest when breathing deeply

• A butterfly shaped rash across the cheeks and nose or rashes anywhere on the body

• Hair loss

• Sensitivity to light

• Headaches, confusion and memory loss

• Fingers and toes that turn white or blue when cold or suffering from stress.

DIAGNOSIS

Lupus can be difficult to diagnose as the symptoms can vary and often overlap with other disorders such as RA. In order to confirm Lupus, a combination of blood and urine tests together with the signs and symptoms are used, as there is not one definitive test available.

TREATMENT

At present there is no cure for Lupus and treatment focuses on controlling symptoms through lifestyle changes and medication.  Lupus can go through cycles of remission and flare-ups, and the aim of treatment is based on the symptoms.  The type of intervention depends on the symptoms and may include topical creams, anti-inflammatory medication, corticosteroids, immunosuppressants and antimalarial drugs. Many of these interventions come with side effects, so self help to minimise flare-ups is recommended. Taking steps to leading a healthier lifestyle can help reduce symptoms and flare-ups: visit your doctor regularly; avoid ultraviolet light and, when out in the sun, use sun cream; exercise; don’t smoke; eat a healthy diet.

Many people with Lupus suffer from joint pain, stiffness and decreased function; physiotherapy can be an invaluable resource for fighting pain and getting active. After thorough assessment, your physiotherapist can also advise on how to manage your pain and inflammation. He or she can further advise on a suitable exercise regimen and on how to make changes to your work and home environment. There are many resources and organisations that can help you get back on your feet. If you think you may have Lupus, or are currently experiencing a flare-up, visit your healthcare advisor for more information.

Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience. She specializes in musculoskeletal pain and dysfunction, including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy, having worked with local, regional and international athletes and teams treating injuries and analyzing biomechanics to improve function and performance.  She is registered with the Allied Health Council and is a member of PASL. She currently works at Bayside Therapy Services in Rodney Bay,