Can Immunotherapy Cause Joint Pain?

Yes, immunotherapy can cause joint pain (arthralgia) and muscle aches (myalgia), usually due to immune-related inflammation affecting joints and surrounding tissues. ^[1] Joint symptoms can include new or worsening pain, stiffness, and swelling in the joints or limbs. ^[1] Joint inflammation–related pain is recognized among common side effects of immune checkpoint inhibitors. ^[2]

Why It Happens

Immune checkpoint inhibitors activate the immune system to attack cancer, but sometimes this activation also targets normal tissues like joints, causing inflammation and pain. ^[2] Most side effects can often be managed safely if recognized and treated early. ^[2]

Common Symptoms to Watch For

• New, different, or increasing joint or muscle pain. ^[1]
• Joint stiffness that makes movement harder. ^[1]
• Swelling in joints or limbs. ^[1]

If you notice any of the above, it’s important to report them promptly so they can be managed early and safely. ^[1]

How Often Does It Occur?

Musculoskeletal complaints (like arthralgia or muscle pain) are commonly reported with checkpoint inhibitors in clinical experience and product safety information, though exact rates vary by drug and cancer setting. ^[3] Safety listings for checkpoint inhibitors include arthralgia and musculoskeletal pain among adverse reactions. ^[3]

When to Seek Medical Help

• Pain that limits daily activities or is worsening. ^[1]
• New swelling, redness, or warmth in joints. ^[1]
• Any new breathing issues, severe fatigue, rash, diarrhea, or other organ-related symptoms along with joint pain, since these can indicate broader immune-related side effects that need timely care. ^[2]

Evaluation Your Team May Consider

Your care team may assess symptoms and, if needed, check inflammatory and autoimmune blood markers (such as ESR, CRP, ANA, RF, anti-CCP), and tailor tests based on the pattern (e.g., HLA‑B27 if spine involvement is suspected). ^[4] These tests help differentiate simple joint pain from an inflammatory arthritis triggered by immunotherapy. ^[5]

Coping and Treatment Options

Self-care and Mild Symptoms

• Use simple pain relievers like acetaminophen if appropriate for you. ^[6]
• Consider non-steroidal anti-inflammatory drugs (NSAIDs) if you have no contraindications (stomach, kidney, heart risks, or blood thinners). ^[6]
• Apply warmth to painful joints to relax muscles and reduce stiffness. ^[7]
• Gentle, regular movement and low-impact exercise can help maintain range of motion and reduce stiffness. ^[7]
• Weight management and physical therapy can support joint function and reduce pain. ^[7]

Moderate to Severe Symptoms

• Your team may recommend scheduled NSAIDs at effective doses and then taper as pain improves, often combined with acetaminophen. ^[8]
• If pain is significant or not responding, short courses of corticosteroids may be considered to calm inflammation. ^[6]
• For severe pain or NSAID contraindications, short-term opioid analgesics may be considered under close supervision. ^[8]
• Referral to a rheumatologist is often advised for persistent or complex cases to fine-tune diagnosis and treatment. ^[6]

Treatment Adjustments

Sometimes, holding immunotherapy temporarily (“drug holiday”) is considered while symptoms are evaluated and controlled, with the goal of safely resuming treatment when possible. ^[7] Early recognition and management increase the chances you can stay on therapy safely. ^[2]

Practical Tips for Daily Comfort

• Keep a symptom diary noting which joints hurt, morning stiffness duration, and what helps or worsens it; share this with your team for more precise adjustments. ^[9]
• Use warm showers in the morning and brief stretching sessions to ease stiffness. ^[7]
• Pace activities and use joint-friendly tools (e.g., jar openers, supportive footwear) to reduce strain. ^[7]
• Stay hydrated and maintain balanced nutrition to support recovery and overall resilience. ^[7]

Key Takeaways

• Joint pain and stiffness can be a side effect of immunotherapy due to immune-driven inflammation, and it’s usually manageable with timely care. ^{[2] [1]}
• Report new or worsening joint symptoms promptly; early action often prevents progression and helps you continue treatment safely. ^{[2] [1]}
• Management ranges from acetaminophen and NSAIDs to corticosteroids and specialist input, tailored to symptom severity and your health profile. ^{[6] [8] [6]}