Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by recurrent painful nodules, abscesses, and tunnels under the skin. These typically appear in areas where skin rubs together, such as the armpits, groin, and buttocks. Many individuals with HS experience symptoms that extend beyond these visible skin lesions, prompting questions about other associated conditions. This raises a common question: does HS cause joint pain?
Understanding HS Beyond the Skin
HS is a chronic inflammatory disease with systemic effects, impacting various body systems beyond the skin. It involves immune system dysregulation, leading to an overactive inflammatory response. Inflammation originates in hair follicles, where keratinocytes react abnormally to skin bacteria, releasing pro-inflammatory cytokines. These inflammatory cells and cytokines then circulate throughout the body, promoting persistent systemic inflammation. This widespread process explains how HS connects to symptoms in other body parts, including joints.
How HS Directly Affects Joints
The chronic systemic inflammation characteristic of HS can directly target and affect joints, leading to a condition known as inflammatory arthritis. This type of arthritis is often referred to as HS-associated arthritis or spondyloarthritis. In people with HS, the immune system’s overactivity can mistakenly attack healthy joint tissues, causing pain, stiffness, and swelling.
Research shows individuals with HS have a significantly increased risk, about three times higher, of developing inflammatory arthritis. This includes a higher risk for spondyloarthritis, such as ankylosing spondylitis (AS), and rheumatoid arthritis (RA). These conditions primarily affect the spine and larger peripheral joints, often appearing concurrently with HS due to shared underlying mechanisms.
Other Reasons for Joint Pain in HS
Beyond the direct inflammatory link, individuals with HS may experience joint pain due to other factors. One reason is mechanical pain, arising from large, painful skin lesions in areas like the armpits or thighs. These lesions and resulting scar tissue can restrict movement or alter gait, straining nearby joints and causing discomfort.
HS also frequently co-occurs with other inflammatory or autoimmune conditions that independently cause joint pain. For instance, inflammatory bowel diseases like Crohn’s disease, psoriatic arthritis, and rheumatoid arthritis are more common in people with HS. Their higher prevalence means joint pain could stem from these associated health issues.
Addressing Joint Pain When You Have HS
If you are living with HS and experience joint pain, it is important to consult a healthcare professional, such as a dermatologist or rheumatologist, for a thorough evaluation. A comprehensive diagnosis is necessary to differentiate the specific type of joint pain, whether it is directly related to HS or another co-occurring condition. This evaluation may involve a physical examination, imaging studies, and blood tests to assess inflammation markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
General management for joint pain in HS involves pain management strategies and anti-inflammatory medications. Treating underlying HS can also alleviate joint symptoms, as both conditions respond to therapies that reduce systemic inflammation, such as certain biologics. Lifestyle adjustments, including gentle exercise and applying heat or cold therapy, can also provide relief. Treatment plans are individualized, considering the specific type of joint pain and overall health.