Systemic lupus erythematosus (SLE) — often just called lupus — is an autoimmune disease that can affect many parts of the body. In lupus, the immune system, which normally protects your body from germs, attacks healthy tissues instead. Lupus symptoms can vary widely from person to person and may include skin rashes, kidney problems, joint pain, and fatigue. Some MyLupusTeam members describe arm pain that feels like they’ve had a flu shot — even though they haven’t.

“My left arm feels like I got a shot in my arm: soreness that turns into severe pain. It radiates down my arm all the way into my hand,” one member shared. “It’s not a constant problem, but when it hits, it can last for a few hours to a few days.”

Many people with lupus wonder if this kind of arm pain is related to their condition. Here are some of the most common reasons why someone with lupus might experience arm pain that radiates (spreads to other areas).

1. Muscle Pain

During a lupus flare (a period of worsening symptoms), people often feel body aches all over. “Flares for me begin with fever, body aches, and severe fatigue,” one member explained.

If you have lupus and experience a worsening of your usual lupus symptoms along with muscle pain in your shoulder or arm, there’s a chance it’s a lupus flare. It can sometimes be accompanied by myositis (muscle inflammation), which might add to the soreness in your arm. In fact, muscle pain is one of the most common symptoms of lupus.

People in the MyLupusTeam community have shared their tips for managing sore muscles during a flare. “I’ve been covering it with lidocaine patches all the way to — and including — my hand,” one member explained. “I then wrap it all for compression.”

You might also find relief by:

• Icing the area
• Gently stretching
• Giving your muscles time to rest

2. Joint Pain

Joint pain is a common symptom of lupus and can come from two main sources: arthritis (joint pain with swelling) or arthralgia (joint pain without swelling). In fact, close to 95 percent of people living with lupus experience some form of joint pain or stiffness. These symptoms can affect the neck, legs, shoulders, and upper arms. Many people describe lupus joint pain as similar to the pain they experience with the flu, with intense aching.

When a joint becomes swollen, it can sometimes affect how your entire arm works. One MyLupusTeam member shared, “I can’t raise my left arm. My arm and hand are pretty useless when this happens.”

Swollen joints can be a frustrating and sometimes unbearable symptom of lupus. There are some steps you can take to protect and improve your joint health when living with lupus. While it might feel difficult, gentle physical activity can help strengthen your joints and make it easier to move over time. For example, your rheumatologist (a specialist in joint and autoimmune disorders) might suggest working with a physical therapist to create a safe and effective exercise plan tailored to your needs.

Always discuss a new exercise routine with your doctor to be sure it is appropriate for your particular condition. Taking small, manageable steps toward staying active can make a big difference in managing joint pain and stiffness.

3. Lupus Skin Symptoms

When most people think of lupus skin symptoms, they picture the malar rash, also known as the “butterfly rash,” which spreads across the bridge of the nose and cheeks. But lupus can cause skin issues on other parts of the body, too. Skin sensitivity and skin rashes can appear almost anywhere, including the arms. Between 70 percent and 80 percent of people living with SLE develop skin lesions (areas of damaged or irritated skin) during the course of their disease.

Because people with lupus are often sensitive to the sun, areas of the body that get more sun exposure — including the arms — may be prone to irritation, rashes, and related joint pain. One member shared, “Today, I ended up getting sunburned even with sunscreen on. After that, I got a mild flare from being out in the sun for like five hours.”

If you notice changes in the color or texture of the skin on your arm, especially if the area feels painful to the touch, your arm pain might be related to lupus skin symptoms. Sun exposure is a common trigger, so protecting your skin by wearing sunscreen and covering up with long sleeves can help reduce irritation.

If skin symptoms or pain last more than a few days or start getting worse, talk to your rheumatologist. They can help identify the cause and recommend treatment options, such as medicated creams or anti-inflammatory medications, to manage the symptoms.

4. Lupus Myelitis

Lupus myelitis is a rare lupus symptom that affects just 1 percent to 2 percent of people with SLE. It occurs when the spinal cord (which carries messages between the brain and the rest of the body) becomes inflamed. When this inflammation happens on both sides of the spinal cord, it’s called transverse myelitis.

Arm pain caused by lupus myelitis can happen when inflammation affects the cervical spine (the upper part of the spine), leading to nerve compression or other neurological (nerve-related) issues. People with lupus myelitis may also experience weakness or even paralysis that starts in one arm or leg and, in serious cases, can progress to paraplegia (paralysis in both legs).

Early symptoms of lupus myelitis might include:

• Muscle spasms
• Numbness or tingling
• Sensitivity to touch
• Pain in the back, legs, abdomen, or arms

One MyLupusTeam member shared some related nerve symptoms of lupus: “I have recently started experiencing neurological issues such as double vision, face drooping, and balance issues.”

While lupus myelitis is an uncommon cause of upper arm pain, it’s good to be aware of this rare lupus complication. If you’re concerned that you may be experiencing symptoms of lupus myelitis, speak to your health care provider. They can recommend blood tests and other evaluations to check for lupus myelitis and rule out other conditions.

5. Medication Side Effects

Sometimes the symptoms of lupus aren’t caused by the disease itself but by the medications used to treat it. Common lupus treatments include corticosteroids, immunosuppressants, biologics, and antimalarial drugs.

Corticosteroids, such as prednisone, are known to cause problems when used long-term or in high doses. One potential side effect is muscle weakness in the arms and legs. Long-term steroid use can also lead to osteoporosis (bone loss), which may result in bone pain or an increased risk of fractures (breaks). If you’ve been on steroids for more than a few weeks and notice these or other symptoms, talk to your doctor about your concerns.

Rituximab (Rituxan) is a biologic therapy often given as an infusion (through an IV) in a doctor’s office or clinic. While it’s not officially approved by the U.S. Food and Drug Administration (FDA) for lupus, doctors sometimes use it off-label (outside of its FDA-approved purpose) to treat the condition — usually when other treatments haven’t worked.

Biologic drugs like rituximab are lab-made antibodies designed to block specific inflammatory proteins in the immune system, helping to reduce lupus-related inflammation.

Common side effects of rituximab include body pain and aching joints during or shortly after an infusion. These symptoms are usually mild and go away on their own within a short time. However, if you experience severe or long-lasting side effects, contact your doctor right away.

Another biologic drug used in the treatment of active lupus, belimumab (Benlysta), can cause pain in the extremities (arms and legs) as a side effect.

If you think your medication is causing new or worsening symptoms, reach out to your doctor. They can adjust your treatment plan or recommend ways to manage side effects. Never stop taking a medication without consulting your health care provider first.

6. Heart Conditions

If you have lupus and are experiencing left-sided arm or shoulder pain, one urgent condition to rule out is a heart attack. Having lupus increases your risk for coronary artery disease, a condition in which the arteries that supply blood to your heart become narrowed or blocked. It also raises your risk for other heart conditions, such as blood clots. These conditions can raise your risk of a heart attack over time.

Your heart attack risk may be higher if you have lupus and any of the following additional risk factors:

• Preexisting cardiovascular disease
• High blood pressure
• Age over 45
• A family history of heart attacks

Symptoms of a heart attack can vary among individuals, but it’s important to know if arm pain might be serious. Sometimes chest pain can radiate to the neck, jaw, and left shoulder. Arm or shoulder pain on the left side may last for minutes to hours. This pain is often accompanied by:

• Fatigue (feeling very tired)
• Shortness of breath
• Sweating
• A feeling of “impending doom” (a sense that something very bad is about to happen)

If you have any of these symptoms — especially new or unusual arm pain combined with shortness of breath or chest discomfort — seek emergency care immediately. These symptoms could be life-threatening.

If you’re living with lupus, it’s essential to prioritize your heart health. Make sure to have regular checkups with your primary care doctor to monitor your blood pressure and overall heart function. If needed, your doctor can refer you to a cardiologist (heart specialist) for further evaluation or treatment.

7. Other Health Conditions

Not all arm pain is related to lupus — it could be caused by another condition or injury. Common injuries, like tendonitis (swelling of a tendon), can affect anyone, regardless of whether they have lupus. Lupus also often occurs alongside other autoimmune diseases, such as rheumatoid arthritis, which can lead to joint pain that mimics lupus symptoms.

Sometimes, arm pain is simply due to everyday activities. For example, you may have slept in an awkward position, lifted something heavy, or worked out harder than usual. If your arm pain goes away and doesn’t come back, it’s usually nothing to worry about. You can manage minor arm pain at home by icing the area or resting your arm.

However, if you have lupus, it’s important to be cautious about certain pain relievers. Lupus nephritis (kidney disease caused by lupus) can make it risky to take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, on a regular basis. For safer pain relief, acetaminophen (such as Tylenol) is often a good option, especially for people with kidney involvement. Always check with your doctor to make sure any over-the-counter medication is safe for you.

Consult Your Doctor

If your arm pain feels severe, unusual, or is accompanied by other concerning symptoms, it’s important to share these details with your rheumatology team. As someone living with lupus, you know your body best and can often sense when something isn’t quite right. Trust that instinct.

Your doctor can determine the cause of your arm pain by reviewing your medical history, conducting a physical exam, and ordering tests like X-rays or other imaging scans. These steps can help pinpoint whether your arm pain is related to lupus, a medication side effect, or another condition entirely.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 232,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you experienced arm pain while living with lupus? How do you deal with joint or muscle pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.