Although most people consider celiac disease and non-celiac gluten sensitivity to be maladies that mainly affect your gastrointestinal tract, the long lists of celiac symptoms and symptoms of gluten sensitivity include plenty that fall far outside the digestive system. Joint pain is one of these symptoms.
People with celiac disease seem to experience high levels of joint pain, although there haven't been any medical studies documenting just how high. The most common locations seem to be the knees, back, hips, wrists and shoulders; if you have an old injury in a joint, that joint might act up first (I experience this problem myself, in my left shoulder).
In some cases, joint pain symptoms appear before any digestive symptoms in people who haven't yet been diagnosed with celiac disease. However, it's difficult to use the symptom as an indication that you should be tested for celiac. Many people — the Centers for Disease Control and Prevention estimates about one-third of all Americans — experience joint pain for various reasons as they get older.
For those with non-celiac gluten sensitivity, joint pain also is common ... possibly even more common than in people with celiac disease.
Arthritis, Inflammation Cause Joint Pain
When your joints hurt, it could be due to arthritis, which involves the breakdown of cartilage in the joints themselves. It also could be due to inflammation of muscles and cartilage that make up that joint. Joint pain occurs more frequently as you get older, especially if you're overweight.
However, it's not entirely clear what triggers the joint pain in people with celiac disease. The pain occurs in people of every age, including children, and frequently waxes and wanes, depending on gluten ingestion.
Since the intestinal damage in celiac causes malnutrition, the pain could stem from nutritional deficiencies. It also could stem from overall inflammation provoked by gluten ingestion, which could be what's happening in gluten sensitivity.
Gluten or Rheumatoid Arthritis?
People with rheumatoid arthritis — an autoimmune form of arthritis that can strike at any age — have a higher risk of also being diagnosed with celiac disease. This isn't surprising, since having one autoimmune disease, such as celiac disease, places you at higher risk of being diagnosed with another.
However, researchers in at least one study have speculated that some rheumatoid arthritis patients might actually have celiac disease instead.
The clinicians, located in Guadalajara, Mexico, used several different celiac blood tests to screen rheumatoid arthritis patients, and found abnormal levels of antibodies in nearly half of them. They concluded that doctors should consider celiac disease, even if a patient meets the criteria for a rheumatoid arthritis diagnosis.
There's also some evidence that a gluten-free diet might help rheumatoid arthritis patients, even if they don't have celiac disease. In a study published in the journal Rheumatology, researchers found that patients who followed a gluten-free vegan diet for nine months saw improvements in their rheumatoid arthritis symptoms, even though medical imaging continued to show joint damage.
Joint Pain Cure: A Strict Gluten-Free Diet
Again, there haven't been many studies on this, but anecdotal reports indicate that once you've been diagnosed with celiac disease or non-celiac gluten sensitivity and begin following the gluten-free diet, your joint pain should begin to dissipate.
However, you may find it comes back in full force (or only in specific joints) if you accidentally ingest gluten — even a minute amount of gluten. This effect is common in those with gluten sensitivity, as well.
To keep the pain at bay, you'll need to stay as gluten-free as possible. This means sticking to a completely gluten-free diet at home, carefully avoiding cross contamination if you share a kitchen with gluten eaters, and taking no chances when dining out gluten-free.
If you do all this and still find you're getting some joint pain and other glutening symptoms, you may need to cut back on "gluten-free" labeled foods, many of which still contain tiny amounts of gluten.
If your joint pain is a reaction to the gluten in your diet, that should take care of the problem.
However, it's quite possible to get joint pain that's not a reaction to gluten, even if you have celiac disease or gluten sensitivity. In that case, consider taking over-the-counter pain relievers to relieve the pain. Alternatively, your physician might be able to recommend other treatments, possibly including injections into the joint itself or surgery, that can improve your joint pain.
Castillo-Ortiz J.D. et al. [Anti-transglutaminase, antigladin and ultra purified anti-gladin antibodies in patients with a diagnosis of rheumatoid arthritis]. Reumatología Clinica. 2011 Jan-Feb;7(1):27-9. Epub 2010 Jun 23.
Hafström I. et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
University of Chicago Celiac Disease Center. Follow-Up Testing. Accessed Sept. 21, 2011.