Celiac disease, a gluten-free diet for difficult to treat joint pain

Marion Hauser Celiac disease and difficult to treat joint painMarion Hauser, MS, RD

We are joint pain specialists, not gastroenterologists. Yet, we see an amazingly large number of patients with symptoms of GI disturbances such as gas, bloating, indigestion, diarrhea, constipation, and other GI related symptoms. These patients are in our office for joint erosion, joint pain, and a realistic alternative to a joint replacement surgery. That there is a connection between between their joint pain and Celiac disease (the abnormal immune system responses to eating gluten, a protein found in wheat, barley, and rye) is obvious and needs to be addressed for the patient to have optimal joint healing.

Celiac disease is also referred to as gluten sensitive enteropathy (GSE), gluten intolerance, or celiac sprue. It is considered to be one of the most under-diagnosed common diseases today, potentially affecting 1 in every 133 people in the USA. It is the result of an immune-mediated response to the ingestion of gluten (from wheat, rye, and barley) that damages the small intestine.

Joint pain improvements on a gluten-free diet, “more than just coincidental.”

In 2011, doctors in Turkey told a story of a 42 year old woman in the prestigious journal Rheumatology international.(1) The title of their small case report was Celiac disease of the joint. Here is what they recorded:

The Turkish doctors emphasized that her joint pain and skin rashes improved when she went on a gluten-free diet, so much so that they stressed in their paper, that these improvements were “more than just coincidental.”

Understanding how devastating Celiac disease can be for your joint pain and your ability to repair joint damage

In the above paper we have a case study significant enough to show the benefits of a gluten-free diet on a patient with joint pain and skin rashes. Doctors in the Czech republic recently presented their research in their paper: “Bone and Joint Involvement in Celiac Disease,” (2) that showed what happened when a patients’s problems with gluten were not addressed.

Here are the bullet points of their research:

“A long-life gluten-free diet in these patients results in the alleviation of metabolic related  joint and muscle problems, in reduced requirements of analgesic and anti-inflammatory drugs as well as in reduced risks of fracture.”

The Czech researchers recommend that the orthopedist or trauma surgeon should be aware of suspected celiac disease in patients who do not respond adequately to the standard treatment of pain related to the musculoskeletal system, in patients with recurrent fractures of the limb bones and in young patients with suspected secondary osteoporosis.

The good news about this research is, as stated above, the recommendation that: A long-life gluten-free diet in these patients results in the alleviation of metabolic-related joint and muscle problems, in reduced requirements of analgesic and anti-inflammatory drugs as well as in reduced risks of fracture.

How Celiac Disease attacks joints

University medical researchers in Italy publishing in the journal Clinical rheumatology write about patients with pain originating from the enthesis attachments of joints.

Not all joint pain is driven by Celiac Disease

As mentioned above, Celiac Disease and gluten intolerance is underdiagnosed in many difficult to treat joint pain patients. However, just as it is under-diagnosed, self-diagnosis and starting a gluten-free diet may not be the answer to all joint pain.

A November 2017 paper in the Annals of medicine entitled: “Gluten-related disorders: certainties, questions and doubts” (4) comes from Italian researchers and gives this warning:

In our many years putting together information on guiding patients to healthier eating, we found that one diet type did not fit all. Some patients are okay with wheat and grain products and in fact, can thrive on them, some cannot. A patient who tolerates and absorbs gluten well can be compromised if they go on a gluten-free diet.

Decisions about going gluten-free should be made with advice from your healthcare provider.

Caring Medical Celiac disease and difficult to treat joint pain

If you have questions about difficult to treat joint pain and treatment options, get help and information from Caring Medical

1 Ozyemisci-Taskiran O, Cengiz M, Atalay F. Celiac disease of the joint. Rheumatology international. 2011 May 1;31(5):573-6. [Google Scholar]

2 Hoffmanová I, Sánchez D, Džupa V. Bone and Joint Involvement in Celiac Disease. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca. 2014 Dec;82(4):308-12. [Google Scholar]

3 Atteno M, Costa L, Cozzolino A, Tortora R, Caso F, Del Puente A, Cantarini L, Scarpa R, Ciacci C. The enthesopathy of celiac patients: effects of gluten-free diet. Clinical rheumatology. 2014 Apr 1;33(4):537-41. [Google Scholar]

4 Valenti S, Corica D, Ricciardi L, Romano C. Gluten-related disorders: certainties, questions and doubts. Annals of Medicine. 2017 May 11:1-3. [Google Scholar]



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