Viral arthritis is a type of arthritis caused by a viral infection. The disease comes on quickly, causing intense swelling and pain in the joints.
Viral arthritis often goes away after several weeks, but it can sometimes persist for months.
Understanding Viral Arthritis
The onset of viral arthritis is acute, meaning that it tends to come on quickly. It can be intense and very painful.
Viral arthritis usually causes inflammation of the small joints in the hands, wrists, ankles and elbows. This type of arthritis can “jump” from joint to joint. It usually affects joints on both sides of the body.
In people with viral arthritis, inflammation causes the joints to become swollen, stiff, and painful. The affected joints can feel like they’re “on fire.”
The viral infection that triggers the arthritis may cause people to feel generally unwell, achy, tired, and feverish. They may have a loss of appetite. This can feel a lot like having the flu.
In some cases, a widespread rash appears on the skin, which may be caused by the virus.
Viral arthritis can be difficult to diagnose because the symptoms are similar to many other forms of arthritis. It is best diagnosed by a rheumatologist, a type of specialist who is very familiar with arthritic diseases.
A careful and complete history will be taken followed by a thorough physical examination.
You should tell your doctor if you’ve recently had a viral infection or if you have been in contact with others who are ill.
Blood tests can be done to look for inflammation and help diagnose viral arthritis. However, blood tests alone are not enough to diagnose the disease.
If there is evidence of acute viral illness, tests to confirm the infection may be performed. Several other tests that can help make a diagnosis include:
- Complete Blood Count (CBC) – some viruses can alter levels of red and white blood cells
- Erythrocyte Sedimentation Rate (ESR) to look for systemic inflammation
- C-Reactive Protein (CRP) to look for systemic inflammation
- Aspartate Aminotransferace and Alanine Aminotransferace – Liver enzymes – (to look for signs of infection with hepatitis B or C)
- Creatinine – A test of renal function as some viruses can affect the kidneys
- Urinalysis – To look for protein or blood in the urine
- Chest x-ray – if there are respiratory symptoms
- Testing for specific viruses can also be done such as EBV, Parvo B19, Hepatitis B & C, and HIV.
- Testing to rule out other causes of inflammatory arthritis such as a Rheumatoid Factor, Anti-Nuclear Antibodies, etc.
Viral arthritis typically appears during the early stages of the viral infection that triggers it.
The onset of viral arthritis is usually dramatic: it comes on quickly and intensely. You could go to bed and be fine, and then wake up in the morning with very swollen, painful and stiff joints.
It’s not fully understood why some people get viral arthritis and others do not. One theory is that people may be genetically predisposed to viral arthritis.
There are many infections that can cause viral arthritis. Some common examples are the Epstein-Barr virus that causes mononucleosis (“mono”), parvovirus B19 that causes fifths disease, and the hepatitis B and hepatitis C viruses. Arthritis can also be associated with HIV.
Viral arthritis can affect anyone, but it is more common in women and younger adults.
People who come into contact with viruses more often, such as those in contact with children, are more likely to get viral arthritis.
Viral arthritis is usually self-limiting, meaning that it will go away on its own. Treatment is often targeted to controlling the symptoms and making patients feel more comfortable.
Improvement is usually seen within 2 weeks, though it can take a few months to feel normal again.
Medications for Viral Arthritis
A combination of medications is often required to treat the symptoms of viral arthritis.
During the acute attacks, corticosteroids can be very effective to control inflammation. These can be taken orally as pills (prednisone) or sometimes as cortisone injections directly into a joint. This type of treatment provides the quickest relief of the pain and swelling in joints affected by viral arthritis.
Non-Steroidal Anti-Inflammatory Drugs or NSAIDs are sometimes used to reduce joint inflammation caused by viral arthritis. They can also help to reduce pain. They may take a little longer to work than corticosteroids.
Analgesics (Pain Relievers)
Simple analgesics (pain relievers) such as acetaminophen or paracetamol may be sufficient for managing the pain caused by viral arthritis.
When non-prescription analgesics and NSAIDs are not enough to control the pain, stronger medicines called opioids may be used. These should be discussed with your doctor. While opioids can be very effective at controlling pain, they should be used with caution. These drugs can cause dependence and have been associated with drug abuse. Examples of opioids include codeine, morphine, and oxycodone.
Coping with Viral Arthritis
The sudden onset of viral arthritis symptoms can cause a lot of anxiety. It is important to not panic and take a deep breath.
We recommend that you:
- Learn as much as you can about this disease
- Attend your doctor and/or rheumatologist appointments regularly
- Take it easy
- Learn about the medications used to treat viral arthritis.
If you have viral arthritis or think you may have it, your family doctor should refer you to a rheumatologist. A rheumatologist is a specialist who is an expert in treating arthritic diseases. This type of doctor is in the best position to help you manage your condition.