For certain people, eating wheat and wheat products can lead to joint pain.1Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014;12:85.,2Slot O, Locht H. Arthritis as presenting symptom in silent adult coeliac disease. Two cases and review of the literature. Scand J Rheumatol. 2000;29(4):260-3.,3Zopf Y, Dieterich W. [Non-celiac disease non-wheat allergy wheat sensitivity]. Dtsch Med Wochenschr. 2015;140(22):1683-7.,4Murry JA, Editor. Mayo Clinic Going Gluten Free, p. 44-45. 2014. Time Home Entertainment Inc. New York, NY.,5Rath, L. The Connection Between Gluten and Arthritis. The Arthritis Foundation. Accessed August 20, 2015. These people have an inflammatory reaction to the gluten proteins found in wheat.

Researchers have long known that people with autoimmune forms of arthritis, such as rheumatoid arthritis and psoriatic arthritis, are at higher risk for celiac disease 5Rath, L. The Connection Between Gluten and Arthritis. The Arthritis Foundation. Accessed August 20, 2015.,6Barton SH, Murray JA. Celiac disease and autoimmunity in the gut and elsewhere. Gastroenterol Clin North Am. 2008;37(2):411-28, vii. an autoimmune disorder triggered by gluten.

See Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or Another Autoimmune Disorder?

More recently, medical experts have begun to acknowledge the possible connection between gluten and non-pathologic joint pain—joint pain that is not explained by disease. A growing body of research supports this idea.1Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014;12:85.,2Slot O, Locht H. Arthritis as presenting symptom in silent adult coeliac disease. Two cases and review of the literature. Scand J Rheumatol. 2000;29(4):260-3.,3Zopf Y, Dieterich W. [Non-celiac disease non-wheat allergy wheat sensitivity]. Dtsch Med Wochenschr. 2015;140(22):1683-7.,4Murry JA, Editor. Mayo Clinic Going Gluten Free, p. 44-45. 2014. Time Home Entertainment Inc. New York, NY.

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Gluten and Joint Inflammation

When a person with celiac disease or a gluten sensitivity eats gluten (gliadin and glutenin proteins) the immune system jumps into action, causing inflammation. This inflammation can affect the body’s organs and soft tissue.4Murry JA, Editor. Mayo Clinic Going Gluten Free, p. 44-45. 2014. Time Home Entertainment Inc. New York, NY.,5Rath, L. The Connection Between Gluten and Arthritis. The Arthritis Foundation. Accessed August 20, 2015. A person may not notice external signs of inflammation, such as redness and swelling, but feel other symptoms, such as joint pain.

See Ingredients That May Trigger Fibromyalgia Symptoms

The joint pain may be constant and chronic or it may be intermittent.

Celiac Disease vs. Gluten Sensitivity

In people with celiac disease, gluten can cause damage to the lining of the small intestine. While gluten sensitivity can generate symptoms similar to celiac disease, it seems to cause little or no damage to the small intestine.1Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014;12:85.

See Conditions Related to Inflammatory Arthritis

A blood test and biopsy of the small intestine may be used to diagnose celiac disease. There is no medical test to confirm gluten sensitivity.

See Celiac Disease and Low Thyroid vs. Fibromyalgia

Treating Joint Pain With a Gluten-Free Diet

People experiencing painful joint inflammation may consider eliminating gluten and other pro-inflammatory foods, such as sugary sodas. They may try it on a temporary basis—for example, eat gluten-free for 30 days—to see if joint pain is relieved or not.

Below are several tips for people who want to try a gluten-free diet to reduce joint pain.

  1. Consult a medical professional. A doctor or registered dietician may be able to recommend certain foods, helping ensure you get enough nutrients and fiber in your gluten-free diet.

    See Arthritis Treatment Specialists

  2. Choose unprocessed foods. Many pre-packaged, processed foods that are labeled gluten free contain sugar, saturated fats, and chemical preservatives. Whole foods such as fruits, vegetables, brown rice and quinoa are healthier choices.

    See Conditions Related to Inflammatory Arthritis

  3. Exercise. Maintain joint health as well as balance, cardiovascular health, physical strength through exercise.

    See Ways to Get Exercise When You Have Arthritis

Diagnostic screening for celiac disease measures the body’s reaction to gluten proteins; therefore, people who want to be screened for celiac disease are advised to be screened before starting a gluten-free diet.

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Other Signs of Celiac Disease or a Gluten Sensitivity

Many people who have celiac disease or a gluten sensitivity have more than one symptom. This can interfere with the absorption of nutrients from food, cause a host of symptoms, and lead to other problems like osteoporosis, infertility, nerve damage, and seizures.

If gluten is causing joint pain, it might also cause other symptoms, such as:

  • Digestive issues, such as stomach aches, heartburn, bloating, and diarrhea
  • Skin and hair problems, such as rashes
  • Oral and dental problems, such as canker sores
  • Brain and nervous system disorders, such as headaches and numbness and tingling in the feet, legs or hands
  • Fatigue and mood disorders, such as depression and anxiety
  • Hormone irregularities that can cause abnormal periods and infertility
  • Other musculoskeletal issues

These symptoms may be severe or just annoying—or not even noticeable. For example, people with celiac disease do not absorb calcium well, resulting in weak bones. About 2/3 of people with celiac disease have either osteopenia or osteoporosis,7Murry JA, Editor. Mayo Clinic Going Gluten Free, p. 44-45. 2014. Time Home Entertainment Inc. New York, NY. but changes in bone composition are not immediately seen or felt.

  • 1 Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014;12:85.
  • 2 Slot O, Locht H. Arthritis as presenting symptom in silent adult coeliac disease. Two cases and review of the literature. Scand J Rheumatol. 2000;29(4):260-3.
  • 3 Zopf Y, Dieterich W. [Non-celiac disease non-wheat allergy wheat sensitivity]. Dtsch Med Wochenschr. 2015;140(22):1683-7.
  • 4 Murry JA, Editor. Mayo Clinic Going Gluten Free, p. 44-45. 2014. Time Home Entertainment Inc. New York, NY.
  • 5 Rath, L. The Connection Between Gluten and Arthritis. The Arthritis Foundation. Accessed August 20, 2015.
  • 6 Barton SH, Murray JA. Celiac disease and autoimmunity in the gut and elsewhere. Gastroenterol Clin North Am. 2008;37(2):411-28, vii.
  • 7 Murry JA, Editor. Mayo Clinic Going Gluten Free, p. 44-45. 2014. Time Home Entertainment Inc. New York, NY.

Dr. Christopher Pomeroy is an orthopedic surgeon who specializes in hip and knee replacement surgery at OrthoIndy.

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