Can high blood pressure cause joint and muscle pain

Sometimes PAD has no symptoms, but the most common symptom is pain in the legs when you’re walking or exercising which goes away when you stop, after a short rest. The pain is caused by the lack of oxygen and energy in the muscles, as the blood flow is restricted.

The pain can feel like an aching, cramping or tiredness. It is often in the calves, but, depending on where the affected artery is, it could also be in your thighs or buttocks.

You may notice other signs and symptoms in your legs or feet:

• cold calves and feet compared to the rest of your body
• numbness or weakness
• sores or ulcers that don’t heal
• hair loss
• brittle toenails
• changes in skin colour or shiny skin
• weak or no pulse in the arteries in your feet
• pain which carries on even when you’re not moving about

Speak to your GP if you have any of the symptoms described here. The symptoms often develop slowly as the arteries become narrower. If they appear quickly it could be a sign of something that needs urgent treatment, such as a blood clot.

How is PAD diagnosed?

Your GP will ask you about your symptoms and examine your legs and feet to diagnose PAD.

They will also do a simple test where they measure the blood pressure in your arm and in your ankle. If the blood pressure in your ankle is much lower than the blood pressure in your arm (about 10% lower), it’s likely that the arteries in your legs have become narrower, and you may have PAD.

To find out which blood vessel or vessels are affected, you may also need a scan, such as an ultrasounds scan, but this is usually not needed.  

How is PAD treated?

It’s often possible to stop or slow down the progression of peripheral artery disease (PAD) and improve symptoms through a healthy lifestyle and medications. Surgery is also occasionally used, but only in severe cases. 

Lifestyle changes
The most important changes you can make are:

Walking is a great form of exercise for PAD, and you should walk every day. Walk until the pain becomes too much, rest for a few minutes, then start walking again. Keep going until you’ve walked for at least 30 minutes, or ideally an hour, several times a week. Although this can be tough, if you keep going, you should notice that you’re able to walk for longer without any pain.

Find out more about treating PAD and getting started with exercise from NHS Choices.  

Medicines
You may be given medicines to lower your blood pressure, usually ACE inhibitors or angiotensin receptor blockers. You might also have other medicines such as aspirin to help stop your blood from clotting, statins to lower your cholesterol levels.  If you have diabetes, you will need to keep your blood sugar under control.

These medications are to treat the underlying conditions which affect the blood vessels, so will also help to lower your risk of heart attacks and stroke.

How can I lower my risk of PAD?

By making healthy changes to lifestyle that lower your blood pressure and taking medications if you need to, you can lower your risk of developing PAD. You will also lower your risk of other diseases, such as heart disease and stroke.

Q. I have had high blood pressure for a decade. It has been well controlled with a combination pill that contains two medications. But after I hurt my knee recently, my blood pressure went way up. What should I do?

A. The management of high blood pressure frequently requires adjustment, for a variety of reasons. Blood pressure tends to increase with age. In many people, blood pressure is sensitive to sodium and potassium in their diet. In addition, an injury that causes you to decrease your level of physical activity—like your knee injury did—can certainly lead to an increase in your blood pressure. One of my patients likes to rescue older dogs from shelters. Every time she rescues a dog, her blood pressure goes down from the daily dog walks. When the dog passes away, she becomes more sedentary, and her blood pressure goes right back up. I told her that providing a new home for a shelter dog every time her dog passes away will help her manage her blood pressure.

Fluoroquinolone antibiotics, statins, and aromatase inhibitors are among the medications that most commonly cause joint or muscle pain.

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Joint pain, back aches, and other musculoskeletal complaints are among the most common health issues out there. When it comes to joint pain specifically, arthritis is a common cause. But before you blame your achy joints on arthritis, did you know that everyday medications can cause joint pain too? 

Here are nine common offenders that can cause medication joint pain.

Medications that can cause joint and muscle pain

1. Antibiotic: levofloxacin 

Levofloxacin belongs to a group of antibiotics known as fluoroquinolones and is commonly prescribed for sinus infections and pneumonia. Research shows that muscle and joint aches occur in about 14% of people who take fluoroquinolone antibiotics. This same study found that levofloxacin was more likely than other medications in this class to cause muscle and joint pain. Researchers also noted that adults over 60 had a greater risk of these side effects than younger adults. Experts found that among those reporting muscle or joint aches, symptoms began about 3 days after starting the antibiotic. Other studies have found that, on average, these side effects resolve about 7 days after people discontinue the medication.

2. Cholesterol-lowering medications: statins 

The group of cholesterol drugs known as statins are notorious for causing muscle pain. Statins lower cholesterol levels by blocking the liver from making cholesterol. The dose of statins does not seem to be related to the occurence of muscle pain. But lowering the dose of statins is one way to reduce statin-induced pain. In one study, about 0.03% of people taking 20 mg of simvastatin had muscle pain, and 0.9% of people taking 80 mg of simvastatin had muscle pain. In another study, about 9% of people taking 80 mg of atorvastatin had muscle pain, compared to a little less than 5% for those taking a placebo (a pill with no medication in it).  

3. Osteoporosis medication: bisphosphonates

Bisphosphonates are medications that treat osteoporosis, a condition that causes weak and brittle bones. These medications prevent the minerals in bones from dissolving and leaking back into the bloodstream, but they can also cause joint pain. For example, the labeling for alendronate (Fosamax) warns that severe bone, muscle, or joint pain can occur with bisphosphonates, even though it is a low risk. 

4. Asthma inhalers

Inhaled corticosteroids (“steroids” for short) are common inhalers that treat lung conditions like asthma and chronic obstructive pulmonary disease (COPD). They work by lowering inflammation (swelling) in the lungs and opening the airways. 

Although it’s very rare, these inhaled steroids can cause a severe and painful bone complication called osteonecrosis in a small number of people. Osteonecrosis is when bone cells don’t get enough oxygen and start to die.

Long-term use of oral steroids or steroids that are injected into a joint are much more likely to cause this severe bone side effect than inhaled steroids.

Muscle pain is also possible with inhaled steroids. For example, muscle pain is listed as a possible side effect on the labeling for fluticasone (Flovent). However, it’s relatively uncommon.

5. Breast cancer medications: anastrozole, exemestane, letrozole

Anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) are medications used in the treatment of breast cancer. They belong to a group of medications known as aromatase inhibitors that block the body from making estrogen hormones. People usually take these medications for several years after initial treatment to prevent breast cancer from returning. Some studies have found that as many as 47% of people taking one of these medications may experience joint pain.

6. Acne treatment: isotretinoin

Isotretinoin (Absorica and other brands) can treat severe acne. Between 16% and 51% of people who take this medication experience muscle pain or stiffness. A smaller study reported even greater numbers of pain. That study found that about 70% of people taking isotretinoin had back pain, and 53% had muscle pain. Additionally, 48% of study participants taking isotretinoin had joint pain. 

7. Nerve pain / anti-seizure medication: pregabalin

Pregabalin (Lyrica) can treat certain kinds of nerve pain issues, like those related to fibromyalgia and diabetes. It can also treat seizures. Joint pain can occur as a side effect of this medication. If you experience joint pain with pregabalin, consider talking to your doctor about gabapentin (Neurontin), an alternative medication that is useful for many of the same conditions as pregabalin. It does not cause the joint pain side effect.

8. Estrogen medication: Premarin

Premarin (conjugated estrogens) is a hormone medication that many female people take to treat hot flashes and other symptoms related to menopause or low estrogen. This medication causes joint pain in up to 6% of people who take it.

 9. Blood pressure medication: carvedilol

Carvedilol (Coreg) is a type of medication known as a beta blocker, which relaxes the muscle cells in the heart and blood vessels to lower blood pressure. Carvedilol is used to treat high blood pressure and heart failure. almostUp to 6% of people who take it report joint aches and back pain.

How can you stop joint pain caused by medication?

The main way to stop joint pain caused by a medication is to stop taking the medication that’s causing it. But always check with your healthcare provider before stopping a medication. It’s possible that there could be other explanations for the pain.

There are many over-the-counter (OTC) medications and products that can help with pain relief. Your healthcare provider may recommend using one or more of these products if they expect the pain to be short term or if it is mild.

Your healthcare provider may also recommend applying ice or heat to the affected area, compressing the joint with a wrap or brace, and/or elevating the joint above heart level. An appropriate exercise program that does not worsen damage to your muscles or joints can also be helpful.

The bottom line

Joint pain as a true side effect is rare for most medications. But there are some medications that are more likely than others to cause joint or muscle pain. Fluoroquinolone antibiotics (such as levofloxacin), oral acne medications (such as isotretinoin), and aromatase inhibitors (such as anastrozole) are among those with the most common reports of joint or muscle pain.

If you think that one of the medications you are taking is causing joint or muscle pain, talk to your healthcare provider. They may ask you to stop the medication or help you find an alternative. They may also recommend OTC or non-medication treatments like ice, heat, or compression of the affected area. It’s important that you don’t stop taking any of your prescribed medication without talking to your healthcare provider.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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