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Can Gluten Cause Muscle and Joint Pain?

Can Gluten Cause Muscle and Joint Pain?

In today’s world, muscle and joint pain are widespread problems. They tend to be chronic, debilitating, and can significantly reduce your quality of life.

Your pain may be dull and achy or sharp and throbbing. It may be felt locally in one area or throughout your body. Muscle pain may also include spasms, while joint pain can include stiffness and tenderness.

Sometimes people are told muscle and joint pain are just a normal part of the aging process or that it’s in their head. Other common causes cited by mainstream medicine are typically injury, overuse, or lack of use. These are definitely potential triggers. But what most doctors fail to acknowledge is the role your diet and lifestyle play in the development and progression of muscle and joint pain and related disorders.

This is why treating these conditions with anti-inflammatories, steroids, and pain killers isn’t a long term solution. These drugs may help alleviate pain, but as you soon as you stop taking them, your symptoms will likely return. Plus, these medications can contribute to intestinal permeability (AKA – Leaky Gut), hinder your immune system, and/or lead to addiction among other things.

So if you want to get to the root of the problem and live a pain-free life, you must take a closer look at the food on your plate. In fact, for decades I have helped countless patients relieve their pain by changing their diet. And gluten and grains are two of the biggest pain triggering components of our modern diet that I’ve found. Can gluten cause muscle and joint pain? Let’s take a closer look…

Inflammation, Cortisol, and Pain

Inflammation caused by gluten can also raise your cortisol, a stress hormone secreted by your adrenal glands. In acute situations, cortisol is a good thing. It actually helps regulate inflammation. It also raises your blood sugar to ensure you have enough energy to overcome imminent threats.

However, chronic inflammation leads to chronically high cortisol, which can have negative effects. For example, your cells may stop responding to cortisol. This creates many problems, including the uninhibited release of corticotropin-releasing hormone (CRH), which may activate inflammatory immune cells. CRH may also bind to cells in the brain and cause pain in the absence of tissue damage.

When cortisol is high, it’s also more likely to bind to the wrong receptors on your cells, which can set off a cascade of events that ultimately creates more inflammation.

As I just mentioned, cortisol raises your blood sugar. This is helpful in the short term. But over time, high blood sugar can lead to type 2 diabetes and more pain. For example, nerve damage is a common side effect of diabetes, which can cause bone and joint pain, numbness, cramps, tingling, and burning sensations. Diabetes is also associated with weight gain and obesity, which can put more pressure on your joints and cause pain.

Elevated cortisol levels can also lead to muscle wasting (a.k.a. muscle atrophy), which can cause muscle weakness and pain. Essentially, it can cause muscle proteins to be degraded and converted into glucose in an effort to keep your blood sugar high. Thus, elevated cortisol may also prevent muscle building.

Gluten Is Connected to Many Forms of Autoimmune Arthritis

Can gluten cause muscle and joint pain? For genetically susceptible individuals, the intestinal damage caused by gluten in combination with an overactive immune system and chronic state of inflammation leads to celiac disease.

Celiac disease is an autoimmune condition that causes your immune system to attack your intestines, which creates even more damage and inflammation. But as I mentioned, the inflammatory effects aren’t limited to your gut. Which is why celiac disease is associated with many other autoimmune conditions. And several of them cause your immune system to attack your muscles and joints, which causes pain.

Gluten and Rheumatoid Arthritis

With rheumatoid arthritis (RA), your immune system attacks joint tissue commonly found in your hands, wrists, and knees. Swelling and inflammation occur, which leads to joint tissue damage. The tissue damage ultimately causes chronic pain, stiffness, and sometimes deformity.

Several studies have linked RA with celiac disease. And researchers have even suggested that it may start in the gut and be triggered by food antigens, such as gluten.

In this case report, a 50-year old man presented with chronic diarrhea for two months. He also lost weight and his feet and legs were swollen. Antibodies for gluten proteins were found in his blood and damage to the lining of his small intestine was confirmed.

The patient was diagnosed with celiac disease and treated with a gluten-free diet. After three months, his initial symptoms improved significantly. However, he soon started to experience pain in his joints and laboratory tests confirmed he had RA.

In this study, 42 children with juvenile RA were tested for celiac disease even though they didn’t have the usual symptoms. And it turned out that almost 43% of the group had antibodies for gluten proteins in their blood, which means their immune systems were reacting to gluten.

Sixteen of the children with gluten protein antibodies had intestinal biopsies performed and celiac disease was confirmed in all cases. So the children were treated with a gluten-free diet, which reduced their joint-related symptoms as well as improved their growth.

This is a really important study because it proves those with RA (and other pain-related conditions) should be tested for celiac disease and gluten sensitivity. Because unless grains are removed from the diet, permanent pain relief may be impossible in many cases.

In fact, science has shown that a change in diet is equally as effective as prednisone, a standard steroid medication used to treat the symptoms of RA. In this study, 72% of participants consuming a pre-formulated liquid diet (without gluten or grains) and 78% of participants eating their normal diet while taking prednisone experienced an improvement greater than 20% in regard to their pain, morning stiffness, and joint tenderness. But, when the patients went off the liquid diet or prednisone, the progress they made was lost.

This tells us that treatment must be long-term. However, chronic steroid use is not a good option. Steroids have serious side effects that can affect your body physically as well as emotionally. On the other hand, eating grain-free for the rest of your life is safe and will benefit your body in many ways.

Gluten and Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease that causes the immune system to attack connective tissue, including cartilage and the lining of blood vessels. Since it can affect multiple organs and systems in the body, symptoms are widespread and may be unique to each individual. However, fatigue, muscle weakness, and muscle and joint pain are common manifestations.

Similar to rheumatoid arthritis, SLE is associated with celiac disease. Likely caused by inflammation and an overactive immune system.

One hospital reported 5 cases in a period of 4 years. The onset of SLE and celiac disease occurred at the same time with one patient. Celiac disease occurred before SLE with another patient. And SLE occurred before celiac disease with the remaining 3 cases. Only three of the five patients experienced abdominal symptoms. However, all five patients responded favorably to a gluten-free diet.

This study set out to determine the risk of patients with biopsy-confirmed cases of celiac disease developing SLE. They concluded those with celiac disease were 3 times more likely to be diagnosed with SLE than the general population. However, since celiac disease only affects 1 – 2% of the population, the chance (a.k.a. absolute risk) of someone with celiac disease developing SLE was relatively low (17 cases/100,000 person-years).

Interestingly, there have also been patients that were falsely diagnosed with SLE and later correctly diagnosed with gluten sensitivity.

One case was a 20-month-old girl. She wasn’t gaining weight as expected. She was irritable. She didn’t sleep well. And she had skin rashes, including a mild case of eczema. Blood tests given at the time suggested the presence of inflammation as well as autoimmunity. Based on her symptoms and test results, she was diagnosed with SLE and treated with steroids.

At age 4, she started experiencing side effects from the steroids. Thus, another drug called azathioprine was prescribed. At age 17, she went to an adult SLE clinic. At the time, she was only experiencing a skin rash. Due to her history, she was tested for gluten sensitivity. And sure enough, they found gluten protein antibodies in her blood as well as small intestinal damage.

So the doctor took her off all medications and prescribed a gluten-free diet. After 6 months the girl was symptom-free, her rash was gone, and all signs of inflammation diminished.

Another woman was diagnosed with SLE when she was 20. She was experiencing headaches, extreme fatigue and weakness, and heaviness in her legs. She was prescribed aspirin. Then, a few years later, she developed joint pain throughout her body and continued to have debilitating headaches.

She was finally tested for gluten sensitivity. They found no small intestinal damage, but she did have gluten protein antibodies in her blood, which occurs in 90% of those with gluten sensitivity.

She was diagnosed with gluten sensitivity and told to follow a strict gluten-free diet. After 6 months, her headaches diminished and she was able to stop her medications.

The important point here is that those diagnosed with SLE should also be tested for gluten sensitivity. A person may have both. Or gluten sensitivity may be presenting as SLE. Because clinical symptoms of gluten sensitivity include pain and fatigue.

Gluten and Fibromyalgia

Fibromyalgia (FM) is a syndrome that’s accompanied by chronic pain and fatigue, although the complete list of symptoms is broad and symptoms vary among individuals. Since prescription medications don’t provide much relief, many diagnosed with FM feel hopeless and depressed. Plus, many find it hard to work as well as socialize with friends and family.

However, science has shown that following a gluten-free diet can alleviate symptoms of FM and even put patients in remission. For example, in this study, researchers prescribed a gluten-free diet to 20 patients diagnosed with FM even if celiac disease was ruled out. And here’s what they reported:

  • Chronic pain was dramatically reduced in all 20 patients
  • 15 patients went into complete remission
  • 15 patients were able to resume living a normal life and return to work
  • Patients that were taking opioid pain medications were able to quit using them
  • Other symptoms (e.g., fatigue, abdominal discomfort, migraines, and depression) also improved
  • 2 patients went into remission for other concurrent arthritic conditions

What’s also interesting is that chronic pain returned for eight patients when they introduced gluten back into their diet. And the pain went away after starting a gluten-free diet again.

Based on these results, the researchers concluded that gluten sensitivity may be the root cause of fibromyalgia.

Psoriatic Arthritis and Gluten

Psoriatic arthritis (PA) is an autoimmune condition that affects the joints of those with the skin-related autoimmune condition known as psoriasis. PA causes pain, stiffness, and swelling among other things.

Similar to above, PA is associated with gluten-related disorders. One study found that those with celiac disease are at a greater risk of developing psoriasis before and after their diagnosis. Another study found that psoriasis and celiac disease have some genetic and inflammatory factors in common.

In this case report, a 56-year-old man previously diagnosed with PA was experiencing debilitating pain in his feet, ankles, hands, and knees. He had trouble walking. He had psoriasis patches on his knees, behind his ears, and on his feet. Plus, he had reflux, recently gained 15 pounds, and was depressed sporadically.

Over the course of his disease, his doctor prescribed a pain killer and two immunosuppressive drugs. He was also given antibiotics on multiple occasions and he took aspirin daily. However, his symptoms continued to get worse.

His normal diet was filled with gluten and grains. He frequently ate oatmeal for breakfast and pasta for dinner. Plus, he snacked on cookies throughout the day.

Eventually, a new doctor ruled out celiac disease, but he was diagnosed with gluten sensitivity due to extensive laboratory testing and his presenting symptoms. He was put on a strict gluten-free diet filled with nutrient-rich, low-carb foods including healthy fats and quality proteins. He was also given anti-inflammatory and immune-boosting supplemental nutrients, such as Omega-3 fish oil and vitamin D.

After 5 months, this gentleman returned for his follow-up visit and told the doctor he never felt so good. His pain was reduced by 80%. He was walking with ease. He was no longer stiff in the morning. His hands were no longer swollen. And he was able to go off all but one medication. However, he was able to significantly reduce his dose.

Almost all of his other symptoms were gone, including migraines, reflux, and constipation. Plus, he was no longer depressed.

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Other Autoimmune Arthritic Conditions

There are several other pain-causing autoimmune conditions associated with celiac disease and gluten sensitivity, which include scleroderma, migratory arthritis, reactive arthritis, dermatomyositis, and ankylosing spondylitis among others.

For example, in this study, researchers found 83% of patients with celiac disease had symptoms associated with scleroderma. Symptoms were also statistically more severe in those with gluten sensitivity. Plus, patients reported an improvement in muscle pain soon after a gluten-free diet was implemented.

Another research study found that patients with back pain, ankylosing spondylitis, fibromyalgia, and uveitis experienced dramatic improvements in pain after removing gluten from their diets.  The re-introduction of gluten caused their pain to return.

Multiple published case reports have also linked non celiac gluten sensitivity to ankylosing spondylitis and other autoimmune arthritities.

Gluten Induced Nutritional Deficiencies

Because gluten causes gut damage, digestion and nutrient absorption are commonly hindered in those with gluten sensitivity and celiac disease. Which is why nutrient deficiencies are common. And not getting an adequate supply of certain nutrients can contribute to poor joint health, weak muscles, and pain.

For starters, amino acids are the building blocks of protein. They are used to build muscles as well as collagen, which is the most abundant protein in your body. It’s found in your tendons, ligaments, cartilage, bones, skin, and blood vessels among other places. So if your body isn’t efficiently digesting and absorbing protein, joint and muscle-related problems are possible.

Vitamin C is also necessary to build and repair collagen, and a deficit is common among those with gluten sensitivity. Plus, scurvy is a muscle and joint pain disease caused by a vitamin C deficiency.

study found that those with muscle pain are often deficient in selenium and zinc. And it’s suggested that selenium and zinc play a role in both reducing inflammation and preventing tissue damage.

Animal studies have found that vitamin B12 may help regenerate nerves as well as prevent pain signaling in the brain. Clinical human trials have also found vitamin B12 to be an effective treatment for lower back pain and neuralgia (nerve-related pain).

Omega-3 fatty acids are known to block inflammation. However, they’re not found in grains or processed foods made with them. So deficiencies are common.

Calcium is a mineral responsible for muscle contractions, while magnesium is a mineral necessary for relaxing your muscles. Thus, magnesium deficiency may cause muscle cramps.

In animal studies, magnesium has been shown to block pain signals. And in humans, it’s been shown to help relieve both acute and chronic pain.

Finally, vitamin D plays a role in bone, muscle, and joint health. Deficiencies have been associated with inflammatory pain. And treatment with vitamin D shows promise for those with muscular pain when deficiencies are present.

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Grains, Weight Gain, and Pain

Grains are high carbohydrate foods, which can lead to weight gain and obesity when consumed in excess.

First, when you eat more calories than your body can burn at any given time, the excess energy is stored as fat. And many people frequently eat excess calories from high carbohydrate, grain-based foods, such as pasta, bread, cereal, cookies, crackers, and so on.

Second, eating a high carbohydrate diet can raise your blood sugar and your insulin. Over time, these abnormalities can lead to weight gain, insulin resistance, obesity, and type 2 diabetes.

As I mentioned earlier, weight gain and obesity can put more pressure on your joints and cause more wear and tear than normal. These things can cause pain. And pain can prevent you from exercising, which can cause you to gain more weight and experience more pain.

Studies have found that pain is a common complaint among obese adults, adolescents, and children. For instance, it’s been reported that obese patients are 4 times more likely to experience pain than normal-weight individuals.

Similarly, those with pain disorders are commonly overweight or obese. For example, a study found that 60% of female patients with fibromyalgia were overweight and over 30% were obese.

Obesity is also associated with the development and severity of osteoarthritis. And the CDC lists obesity as a risk factor for rheumatoid arthritis.

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Can Gluten Cause Muscle and Joint Pain?

I can’t stress enough how important your diet is when it comes to muscle and joint pain. The connections are strong and clear, based on scientific evidence as well as decades of my own professional experience working with patients.

So if you’re experiencing any sort of pain or if you’ve been diagnosed with a chronic pain disorder or autoimmune arthritis, I strongly urge you to get tested for gluten sensitivity–even if you don’t have abdominal symptoms. Because there’s a good chance that a grain-free diet will significantly reduce or even completely eliminate your pain if give you enough time. You may even be able to avoid or stop taking medications that only mask your symptoms and cause harmful side effects. What do you have to lose? Can gluten cause muscle and joint pain? Yes – it absolutely can.

A greater summary of the connection between gluten and chronic pain of the muscles, joints, and nerves can be found in my book, No Grain No Pain, published by Simon & Schuster. The book includes a 30 day diet strategy.

Did going gluten free resolve or help your pain? Comment below.

18 Responses

  1. Without a doubt. I had what I thought was chronic symptoms of lyme disease. I had years of back pain and joint pain accompanied by headaches, brain fog, alcohol sensitivity, fatigue, muscle wasting and on and on. My functional medicine doctor put me on an elimination diet with no gluten, dairy or eggs (i had already stopped sugar). I also tested positive for antibodies to gluten. I also was found to be in stage 4 adrenal fatigue. She treated my leaky gut and offered natural remedies for adrenal failure. At 62 I am now feeling better than I did 40 years ago. I am performing well athletically as well. If I slip up and eat some gluten, I pay dearly and it can take 4 weeks of gluten free diet to get back on track. As an aside, I suffered from depression regularly. Once my diet changed, i never got depressed again.

      1. I went gluten free over 6 years ago after reading a blog on inflammation. I had severe back and knee pain for about 10 years and when hip pain was added and I could barely walk, I went to physical therapy which didn’t help. I felt less pain 5 days after going gluten free and each day less pain. I’m also lactose free and vegan since that bothers me, too. I’m 64 and can hike 7 miles up and down mountain trails if I stick to being gluten, and vegan. If I eat even a tiny bit of gluten I will have pain, bloating and headaches.

    1. I am dealing with the same thing right now at the age of 61. Muscle and joint pain, my skin hurts to the touch, diarrhea. Found out last August I have celiac, and struggling to stay gluten free. Your Testimony gives me hope! Thank you.

  2. Wow, I didn’t even know that gluten can affect our health in so many ways, I knew that gluten can affect our gastrointestinal tract, but not a joint disease. For many years I have suffered from joint pain and I would like to somehow get rid of it. I wonder what my doctor will say about this. I’ll show him this article, thanks for sharing this information. Good luck!

    1. Just wondering why you relinquish your own health to your doctor and don’t take the autonomy to make your own decisions to try a diet? In other words, why would you need to ask your doctor before trying a diet?

  3. I went on a strict gluten free diet many years ago to try to put hashimoto’s thyroiditis into remission. It worked wonderfully, after 2 yearsof slowly tapering as I got better and was clearly overdosing on it, I was fully off Armor (it also took removing cow dairy to get fully into remission, but gluten did 90% of the trick). Over the years I also eliminated all dairy as I noticed I would get hay fever if I had any dairy and I am mostly grain-free and refined sugar free. But to my great disappointment, I’m in pain every day. My muscles just ache from just about everything and I am so so frustrated. The only grains I eat are pseudograins (whole buckwheat and quinoa). Over the years I’ve taken supplements to heal my gut (bone broth protein, colostrum, probiotics), but I still have a few food allergies (kiwis, avacados, cantaloupe and egg whites). I also take supplements of Vit D, B complex, C, quercetin, Zinc, Magnesium, Coenzyme Q10, and others at various times. Between anxiety and pain, I’m not a happy camper despite trying various modalities to address both. Any suggestions of what avenues to explore?

      1. Thanks a lot for your response Dr. O! Your article on oxalate issues is also making me think that that might also be a source of problems for me. I think I need to try elliminating buckwheat and some sorces of oxalates and see how I feel. Thanks for all your informative articles!

      2. Hi Dr. O!
        I have been following Dr Daryl Geoffre and his book Get Off Your acid changed my life. That is how I found out about you! Can you tell me your thoughts on Osteoarthritis and gluten? I have been trying to stick with a gluten free mostly plant based lifestyle (dairy free allergy.. no refined sugar) but still dealing with joint degeneration in 7 joints. I am an athlete so its very challenging

  4. Many thanks Dr.very interesting article.
    Me too have been suffering for years from lower left abdominal pain. Had all blood tests done, ultrasound scan, MRI, barium meal & enema, ctscan. Finally a scintigraphy was done in hospital, which reveal spine problems ( hernia bulging discs & a little 7x 4 mm intra medullary cyst, no spondylitis or arthritis etc ) .I am 70 years old, vegetarian for years, very active, walking, gardening, dancing ( even with foot drop ! ). I am now on gluten free diet with lots of vegetables & fruits but eat gluten free oatmeal daily and also pulses, lentils, beans, soya etc.

  5. Very interesting. I have Hashimotos and took Synthroid for 1 yr without improvement but the labs “were in therapeutic range” I changed Dr’s and have been taking Armour Thyroid for 25 yrs. A year ago I started having acute cognitive problems and the MRI and EEG was normal. I began a gluten free diet and in less than one week was about 95% better. Over the past month i have been having intermittent bilateral eyelid twitching and an ache over the left eyebrow, as well as an occasional parietal ache. I have been eating oatmeal almost every morning for a few months now so I am going to stop the oatmeal. I will keep you posted.

  6. Thank you Dr. Fascinating subject.
    I am 58 ( going through the menopause ) and it seems every symptom i have is put down to the menopause!
    I go to the gym, an also a yoga instructor and eat a healthy varied diet. So I am amazed every day that i ache so much, my muscles and joints are constantly sore. Fir example just sitting on my feet causes excessive pain 😥 i dont grumble and i just carry on but it is very frustrating when i continue to work so hard at the gym .
    I have often thought that i may be gluten intolerant and that this prevents my body from absorbing all the nutrients from my food.
    This has been going on for about 3 years. And i just thought it was something i had to put up with. I am now goi g to see if i can get tested for it or even celiac disease?
    Other symptoms i have developed over the last year is carpal tunnel/ganglian and numbness in the side of my feet and in the last few weeks, what appears to be plantur fascillitus! ( not sure if thats spelt right )
    Yes i did say i dont complain 😅 but this is genuinely a list of symptoms i have.
    I do not let this affect my way of life, i lead a very active life and very often i am exhausted…
    Suggestions , be gentle 😂

  7. hi doctor.
    i was struggling with learning disabilities my whole life because of brain fog as well as other things.
    what’s been happening lately is when i eat even the smallest bit of gluten, i can barely walk. the muscles in the back of my legs and butt get really tight and they hurt so bad. then my back joins in the party and i’m almost in a wheel chair. i can barely walk. i stopped the gluten and now i have energy and am able to walk and do things i couldn’t before. but i do have hashimotos and i have been getting headaches lately. my vision sometimes gets blurry. why does gluten almost cripple me and why do i get these headaches. also my sugar cravings are through the roof since i stopped the gluten. why?

    1. Hi. I had similar issues and in addition to cut gluten, test your B12 and other vitamins and mineral levels. Cutting gluten and getting the vitamins my body was lacking helped me to cure me.

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