Statins and Joint Pain: Why It Happens and How to Manage It
Key takeaways:
Statins are widely used to lower cholesterol levels. They also lower the risk of heart attack and stroke.
Although statins are usually well tolerated, they can cause side effects including joint pain in the hands and knees.
If you experience joint pain from statins, changes to your activities or your medications can help you avoid or manage this side effect.
Statins are a popular and useful group of medications. In fact, they’re among the most widely prescribed medications in the U.S. They’re generally well tolerated by people who take them.
But sometimes statins may come with unwanted side effects. For example, muscle pain is a statin side effect you may have heard about. Joint pain is another one. Although joint pain from statins isn’t common, it can cause a lot of discomfort for people who experience it.
Let’s talk more about statins and joint pain, including what to do if you develop painful joints while taking them.
What are statins?
Statins are in a class of medications called hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors. They work by blocking an enzyme (protein) in the liver that helps make cholesterol.
Statins are first-choice medications for managing high cholesterol levels. What’s more, they lower the risk of heart attack and stroke for people who need them. More than a quarter of all U.S. adults over 40 years old take one.
Common statins include:
Simvastatin (Zocor, FloLipid)
Rosuvastatin (Crestor)
Atorvastatin (Lipitor)
Fluvastatin (Lescol XL)
Pitavastatin (Livalo)
Lovastatin (Altoprev)
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Why do some people feel joint pain with statins?
Muscle aches and pains are well-known side effects of statins. But there’s not a lot of information about why people sometimes experience joint pain with statins.
A few recent studies have looked at this question. Often, joint pain from statins seems to be associated with arthritis. Arthritis can cause joint pain in places like the hand, hip, and knee.
It’s also believed that this type of statin-related joint pain happens more often in older adults and people who take high doses of statins.
Can all statins cause joint pain?
Yes. Although joint pain from statins is uncommon, it’s possible for all statins to cause it. Some statins appear to be more likely to cause it than others. But the reason why isn’t clear.
According to one report, the statins most reported to cause joint pain include:
Simvastatin
Atorvastatin
Rosuvastatin
Pravastatin
These are among the most commonly prescribed statins, so there may be more reports of joint pain with them simply because more people are taking them than other statins. Also, arthritis and joint pain are common health conditions in older adults. And older adults are more likely to be taking a statin, too. So it’s hard to know for sure if these symptoms are actually being caused or worsened by the statin.
What does joint pain from statins feel like?
From the information available, joint pain from statins feels a lot like the pain caused by a common type of arthritis called osteoarthritis (OA). Symptoms of OA include pain and swelling of the joints. You may also notice the affected joint(s) feel less flexible and are harder to move.
For some people, it may feel like the statin makes any existing joint pain worse.
How can you manage joint pain from statins?
If you experience joint pain while taking a statin, don’t panic. There are multiple causes of joint pain, so it may not be related to your statin. Sometimes, the pain will go away on its own. Other times, you’ll need to take other steps to manage it.
Give it some time
Sometimes, joint pain will go away on its own. This is especially true if an injury is the cause. In this case, over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be your best bet, as long as your healthcare provider OKs them.
If your joint pain is still bothersome or affecting your quality of life, you may need to take other steps to manage it.
Talk to your pharmacist about possible drug interactions
A number of drug interactions may change the levels of statins or how they work in your body. Higher statin levels may be more likely to cause side effects, such as joint pain. Your pharmacist can help you discover if any of your other medications have this risk. This is one reason why it’s a good idea for you to keep an updated medication list and make sure your healthcare team has access to it.
Examples of medications and foods that may interact with statins include:
Gemfibrozil (Lopid)
Amlodipine (Norvasc)
Tacrolimus (Prograf, Envarsus XR, Astagraf XL)
Make changes to your lifestyle
If you’re having joint pain, some changes to your lifestyle may help improve your symptoms.
Some high-impact exercises, such as running, can place a lot of stress on your bones and joints, which can cause or worsen joint pain.
Low-impact exercise is a great way to make sure you’re getting the activity you need without placing extra stress on your joints. Some joint-friendly exercises to consider include brisk walks, swimming, and cycling.
It’s also a good idea to eat less sugar or other foods that can cause inflammation, when possible. Less inflammation may make a difference if you have swollen, painful joints.
Talk to your provider about changing your medication
If you’re having joint pain and you think it’s related to your statin, you shouldn’t stop taking it until you talk to your healthcare provider. They’ll want to take a closer look to figure out exactly what’s causing your pain and how best to manage it.
Sometimes, a lower dose of your statin or taking it less often may be all that’s needed. Other times, your provider may have you try a different statin to see if that lessens your pain. But it could be true that statins are just not the right medication for you. In that case, your healthcare provider may recommend a statin alternative instead.
Will joint pain from statins go away?
It’s not known for sure.
For many people, joint pain will go away over time or after medication changes. But for others, symptoms may continue — which could be a sign that your joint pain is caused by something else.
Until how and why statins cause joint pain is fully understood, it’s hard to know for sure if it’s temporary or permanent. But letting your healthcare provider know about it is the best way to make sure it’s managed properly.
The bottom line
Statins, such as simvastatin, are useful medications that help lower cholesterol and protect against heart attack and stroke. But sometimes statins can cause joint pain. The reason why this happens isn’t fully clear.
If you experience joint pain while taking a statin, it may go away on its own in a couple of weeks. But if it doesn’t, speak with your healthcare provider. Together, you can take steps to manage your symptoms, such as lowering your dose or switching to a different medication.
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References
American Sports & Fitness Association. (n.d.). High-impact vs. low-impact exercises.
Campion, J., et al. (2008). Statins and joint pain. British Journal of Clinical Pharmacology.
Centers for Disease Control and Prevention. (2021). Physical activity for arthritis.
Fitchett, D. H., et al. (2015). Statin intolerance. Circulation.
Salami, J. A., et al. (2017). National trends in statin use and expenditures in the US adult population from 2002 to 2013: Insights from the medical expenditure panel survey. JAMA cardiology.
U.S. Preventive Services Task Force. (2022). Statin use for the primary prevention of cardiovascular disease in adults. Journal of the American Medical Association.
Ward, N. C., et al. (2019). Statin toxicity. Circulation research.
Zhang, Z., et al. (2022). The association between statin use and osteoarthritis-related outcomes: An updated systematic review and meta-analysis. Frontiers in pharmacology.
