In an article by Wendy Henderson on sclerodermanews.com, joint stiffness, arthritis, joint contractures, tendon pain, and nerve pain are the most common causes of pain for people living with scleroderma.
The Johns Hopkins Scleroderma Center reports that pain is the most common symptom. That pain usually comes from these five sources.
People living with scleroderma have joint stiffness. This is due to excess fluid build-up around the joints which causes swelling in the hands. This pain tends to be worse upon waking up. Once a person is up and moving, the swelling decreases and the pain is less severe. The joint stiffness and swelling may last for weeks, months, or even years. Joint swelling can happen in any place in the body.
Arthritis is another common pain source. Both osteoarthritis and inflammation arthritis are seen in scleroderma patients. Arthritis pain is worse upon waking up and after inactivity. Osteoarthritis pain usually lasts a short amount of time, but inflammation arthritis lasts longer and is more painful. Steroids may be used to treat arthritis, but may not always help.
Skin thickening can also occur.
Joint contractures are the result of skin thickening. People living with scleroderma are unable to straighten out their joints such as knees, fingers or elbows. This causes a decrease in range of motion which causes pain and joint stiffness in the affected area. Physical therapy may help.
Tendonitis is another source of scleroderma pain. Tendons attach muscles to bones. In scleroderma, tendons lose the fluid that lubricates them, so the tendon rubs causing friction. This usually affects the elbows, ankles, and knees and can cause mobility and movement issues. Anti-inflammatory medications and heat can help manage pain.
Nerve pain, such as Carpal Tunnel Syndrome and trigeminal neuralgia, are common in scleroderma patients. Swelling can trap nerves causing numbness and pain in those areas. This is usually worse at night and can cause sleep issues. Carpal Tunnel can be treated with injections of cortisone, splints, and possible surgery. For neuralgia, treatment involves medication and, if severe, surgery may be needed.