Heavy lifting, poor sleep or a particularly tough workout can lead to aching joints, generalized body pain and fatigue. But these common symptoms may actually reflect a medical condition when they are severe and persist. There are many potential causes of these symptoms, such as autoimmune disorders, Lyme disease, fibromyalgia and polymyalgia rheumatica. It can be difficult to pinpoint the cause of fatigue and body aches based on symptoms alone. Additional testing is often necessary.
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Autoimmune disorders -- such as lupus, rheumatoid arthritis and ankylosing spondylitis -- can result in stiff, achy joints, body pain and significant fatigue. These conditions may affect up to 9 percent of the population, based on estimates reported in a November 2009 article in the "Journal of Autoimmunity." When an autoimmune disorder prompts the immune system to attack a person's own tissue, symptoms including joint pain and fatigue frequently develop. Skin rashes, mouth sores and eye problems are also common. In most cases, blood tests can clarify which disorder is to blame. Medications that curb immune system activity and offset chronic inflammation can restore joint mobility and gradually improve fatigue.
Lyme disease is caused by a bacterium called Borrelia burgdorferi, which is spread to humans by a tick bite. The Centers for Disease Control and Prevention reports that the overwhelming majority of Lyme disease cases in the United States are diagnosed in a dozen states, including Connecticut, Pennsylvania, Maine, Maryland, Minnesota and Wisconsin. Initially, fever and skin rash are common symptoms of Lyme disease. Without treatment, however, muscle and joint pain and persistent fatigue often occur. Blood tests to check for antibodies against the Borrelia bacterium are sometimes inconclusive, but may help confirm the diagnosis. Wearing long sleeves and pants during outdoor activities and using an insect repellent that is effective against ticks can help prevent this potentially debilitating disease.
Fibromyalgia is a chronic condition associated with pain in multiple joints and muscle tenderness throughout the body. The disorder affects about 5 million people in the United States, according to a January 2008 article published in "Arthritis and Rheumatism." Additionally, according to the Arthritis Foundation, about 80 percent of people with fibromyalgia report chronic fatigue. Other possible symptoms include headaches, morning stiffness, and slow or foggy thinking. Women are more prone to the disorder than men are. There are no specific tests currently available to diagnose fibromyalgia, but testing to exclude other conditions can be useful. Gentle exercise is often recommended to ease symptoms. Prescription medicines, such as pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella), might also be prescribed to help control symptoms.
Polymyalgia rheumatica (PMR) causes neck, shoulder and hip pain in adults older than 50. The intensity of the pain often interrupts sleep and leads to fatigue. Over the course of a lifetime, roughly 2 percent of people in the United States will develop PMR, according to a March 2011 report published in "Arthritis and Rheumatism." Researchers are unsure about the exact cause of PMR, but a problem with the immune system may be involved. Laboratory tests are typically not helpful in diagnosing PMR. The symptoms tend to improve dramatically with low doses of steroids, however, which confirms that polymyalgia rheumatica is the cause.
Fatigue and body aches can occur with a number of other conditions. Some examples include: -- an underactive thyroid gland -- adrenal gland disorders -- leukemia and lymphoma -- severe depression -- a low phosphate level -- medication side effect from certain antiviral, antibacterial and cholesterol lowering drugs, among others
Accompanying signs and symptoms, their course and severity, and provoking or alleviating factors can help your doctor shorten the list of possible causes of extreme fatigue and body pain.
Reviewed by: Tina M. St. John, M.D.
REFERENCES & RESOURCES
- Journal of Clinical Pathology: Autoantibodies and Overlap Syndromes in Autoimmune Rheumatic Disease
- The New England Journal of Medicine: Differentiation of Reinfection from Relapse in Recurrent Lyme Disease
- Centers for Disease Control and Prevention: Fibromyalgia
- Journal of Autoimmunity: Recent Insights in the Epidemiology of Autoimmune Diseases: Improved Prevalence Estimates and Understanding of Clustering of Diseases
- Arthritis and Rheumatism: Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States, Part II
- Arthritis and Rheumatism: The Lifetime Risk of Adult-Onset Rheumatoid Arthritis and Other Inflammatory Autoimmune Rheumatic Diseases
- Centers for Disease Control and Prevention: Tickborne Diseases of the United States
- Centers for Disease Control and Prevention: Lyme Disease
- American College of Rheumatology: Polymyalgia Rheumatica