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The Musculoskeletal System: Scleroderma and Joint Complications

Scleroderma can affect tendons, joints, muscles, nerves, and other tissues that help the body move. The increased production of collagen associated with scleroderma can cause thickening and tightening of the skin and connective tissues, while blood vessel changes and inflammation can contribute to pain, swelling, and stiffness.

Scleroderma and Joint Symptoms

Joint symptoms are common in scleroderma and may affect both small and large joints. These complications can make everyday activities—such as dressing, writing, cooking, or walking—more difficult over time.

Scleroderma-related joint pain can also develop as hand stiffness caused by inflammation, swelling (edema), or tightening of the skin around the joints.

Scleroderma can cause several different joint and movement-related complications, including the following:

Joint contractures

The development of fibrotic tissue can limit movement. Scarring and skin thickening can cause the fingers, wrists, elbows, knees, or other joints to become “stuck” in a bent or flexed position. Contractures can make it difficult to fully open the hands or straighten the limbs.

Muscle weakness (myopathy or myositis)

Some people with scleroderma experience muscle inflammation or muscle damage, which can lead to weakness, fatigue, and reduced strength. This may affect the arms, legs, or core muscles.

Carpal tunnel syndrome

Swelling and tissue changes in the wrist can put pressure on the median nerve, leading to numbness, tingling, burning, or weakness in the hands and fingers. This can affect grip strength and hand function.

Tendon friction rubs

Tendons may become inflamed and feel like a rubbing or crackling sensation when moving a joint. Tendon friction rubs are highly specific to systemic sclerosis and may signal deeper tissue involvement.

Inflammatory arthritis

Some people with scleroderma may develop arthritis, which can cause warmth, tenderness, swelling, and pain in the joints. This may feel similar to rheumatoid arthritis in some cases.

Treatments for Joint Pain in Scleroderma

Treatment depends on the cause of the joint symptoms. Aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce pain, swelling, and stiffness.

Other ways to help manage joint complications include:

  • Stretching and range-of-motion exercises to maintain flexibility
  • Hand and face exercises to reduce stiffness and preserve movement
  • Gentle cardiovascular exercise to support circulation and mobility
  • Physical or occupational therapy to improve strength and function
  • Splints or supportive devices for contractures or carpal tunnel symptoms

Early treatment and regular movement can help prevent worsening stiffness and improve quality of life. Your doctor may recommend additional therapies if symptoms become severe or begin to affect daily activities.