Joint problems

Crohn’s and Colitis do not just cause gut symptoms. Many people also have symptoms that affect other parts of their body. Joint problems, including joint pain and arthritis, are one of the most common symptoms outside of the gut.

Arthritis is when one or more of your joints become inflamed. This causes pain and swelling in the affected joints. There can be a direct link with the gut inflammation that you get in Crohn’s or Colitis. This is sometimes known as the gut-joint axis.

It’s difficult to know exactly how many people with Crohn’s or Colitis have joint problems. But some studies suggest that nearly half of all people with Crohn’s or Colitis may get them.

About joints

A joint is where 2 or more bones meet. These include:

• Large joints, such as your knees, hips and shoulders
• Small joints, like in your hands, wrists and feet

Below, we show a diagram of a typical joint.

A joint is made up of:

• Cartilage. This covers the surfaces of the bones in your joint. It allows the bones to move freely and cushions the joint.
• Muscles. These control the movement of your joint.
• Tendons. These connect your muscles to the bones.
• Ligaments. These connect the bones in a joint together.
• Entheses. These are areas of connective tissue where a tendon or ligament attaches to the bone.

Sometimes, your whole joint can become inflamed. But you can also just have inflammation that affects a tendon or enthesis. This is not always in a joint. An example is the Achilles tendon at the back of your heel.

Impact of joint problems

Having joint problems can have a big impact on your life. It can make it harder to get around, cause pain and fatigue, and affect your mental health. This can make it difficult to:

• Work
• Exercise
• Look after others
• Do your usual activities

For some people, these symptoms can be just as bad, or even worse, than the gut symptoms associated with Crohn’s and Colitis.

Without effective treatment, arthritis can cause permanent damage to your joints. But there are lots of treatment options available. Some are the same as medicines for Crohn’s or Colitis. There are also lots of things you can do to help manage your symptoms.

Let your IBD team know about any symptoms affecting your joints. They can help you to get the right treatment as soon as possible. This may make it easier to manage symptoms and prevent permanent damage.

Types of spondyloarthritis

• Enteropathic arthritis or IBD-associated arthritis. Spondyloarthritis associated with gut conditions, like Crohn’s and Ulcerative Colitis.
• Axial spondyloarthritis. When you mostly have symptoms affecting your back and spine.
• Peripheral spondyloarthritis, When you mostly have symptoms affecting joints and tendons outside of your spine.
• Psoriatic arthritis. A type of spondyloarthritis where you also have a skin condition called psoriasis. See Crohn's, Colitis and other immune-related conditions for more information.
• Reactive arthritis. When the arthritis starts after an infection.

You can get any of these types of spondyloarthritis if you have Crohn’s or Colitis. The type your doctor diagnoses you with can depend on which most closely fits your main symptoms. But there can be overlap between the different types. You may have features of more than one. Your symptoms and diagnosis may also change over time.

Ankylosing spondylitis is an older term for a more severe form of axial spondyloarthritis. It causes more permanent, structural changes to the joints of your lower back. These changes can be seen on an X-ray.

Most people with Crohn’s or Colitis who get arthritis develop symptoms after their diagnosis of Crohn’s or Colitis. But for some people, joint problems can happen before a Crohn’s or Colitis diagnosis.

If you have arthritis associated with your Crohn’s or Colitis, you may get some of the following symptoms.

• Pain and stiffness in your back. This can affect any part of your back. It’s due to inflammation in or around the joints of your spine. These are known as your axial joints. Back pain tends to be worse in the morning and gets better with movement. Pain around your lower back and bottom can be due to inflammation in the joints in your pelvis. This is called sacroiliitis.
• Painful, swollen joints in other parts of your body. These are known as your peripheral joints. You might find the pain and swelling comes and goes, or switches between different joints. They may include your:
  • Knees
  • Ankles
  • Shoulders
  • Elbows
  • Wrists
  • Fingers
• Inflammation of the entheses. This causes pain and tenderness in areas where tendons or ligaments attach to the bone. The medical term for this is enthesitis. The areas most commonly affected include:
  • The back of your heel, known as Achilles tendinitis
  • Underneath your heel,  known as plantar fasciitis
• Swollen and painful fingers and toes. They are sometimes described as looking “sausage-like”. The medical term for this is dactylitis.

These diagrams show the location of the axial and peripheral joints, and the entheses around your heel.

If your peripheral joints are affected, there can be different patterns to your symptoms:

• You may have a small number of large joints affected, such as your knees or hips. These might flare up at the same time as gut symptoms, and then get better within a few weeks.
• Or you may have several joints affected at once, on both sides of your body. This will often be the small joints in your hands. This can last for months or years, and might not be related to your gut symptoms.

This pattern can change over time.

There can be lots of other reasons for joint problems in Crohn’s and Colitis. Some of these may be related to your Crohn’s or Colitis, and some not. They can include injury, infection, side effects of medicines, and other types of arthritis.

Joint pain without arthritis

You may get joint pain without any signs of arthritis or inflammation in your joint. This is known as arthralgia. Anyone can get arthralgia. But it is more common in people with Crohn’s or Colitis. For some people with Crohn’s or Colitis, having joint pain may mean you’re more likely to go on to develop arthritis. But this is not the same for everyone. Tell your doctor or IBD team if you regularly have joint pain.

Medicines

Some medicines may occasionally cause joint pain as a side effect. You can find out about side effects from your medicine in the patient information leaflet that comes in the box. Many medicines for Crohn’s and Colitis help with joint pain.  

Stopping steroids too quickly can also cause joint pain. This is part of a serious condition that people may get when stopping steroids, called adrenal insufficiency. It’s important to lower the amount of steroids you take gradually. You can find out more in our steroids information. High doses of steroids can also sometimes be associated with a rare complication called osteonecrosis. This causes damage to your joints and joint pain, usually in your hip.

Talk to your doctor, IBD team or pharmacist if you have any concerns about medicines you are taking.

Other types of arthritis

You may get other types of arthritis if you have Crohn’s or Colitis. They include:

• Osteoarthritis. This is the most common type of arthritis in the UK. It usually starts in people aged 45 or older. It’s caused by damage to your joint over time. It most commonly affects the knees, hips, hands and back. Find out more about osteoarthritis from Arthritis UK.
• Rheumatoid arthritis. This is a form of arthritis caused by your immune system attacking your joints. It often starts in the joints of the hands and feet first, and gets worse over time. There is some evidence that people with Crohn’s or Colitis may be more likely to have rheumatoid arthritis. But scientists are not sure why yet. Find out more about rheumatoid arthritis from Arthritis UK.
• Gout. This causes sudden, severe joint pain and swelling, often in the big toe. You might get it in other joints in your body too. It’s caused by too much of a chemical called urate in your body. It’s more common in men, women after menopause and people with kidney disease. Find out more about gout from Arthritis UK.

Infection

Inflammation of a joint can be caused by bacterial infection. This is known as septic arthritis. It is rare but is a medical emergency.

Germs can enter a wound on your body and travel through your bloodstream to infect a joint. Your joint can also get infected directly, through an injury or during surgery.

You are at greater risk of infections if your joints are already damaged or you are taking immunosuppressant medicine to treat your Crohn’s or Colitis. We have more information about immunosuppressant precautions.

Usually, a single joint is affected. Symptoms may include:

• Sudden pain
• The joint swelling or changing colour
• A high temperature

Get medical help immediately if you think you might have septic arthritis.

Find out more about septic arthritis from Arthritis UK.

Your IBD team may not always ask about joint problems. But it’s important to tell them if you are experiencing pain or swelling in any of your joints, or any back pain. Getting a diagnosis of arthritis when you have Crohn’s or Colitis can often take a very long time. This means that effective treatment may be delayed.

Some medicines for your Crohn’s or Colitis may be better at treating joint symptoms than others. Letting your IBD team know early on about joint symptoms can help you to get the right diagnosis and treatment as soon as possible. This may help to prevent damage to your joints.

If you find it hard to get in contact with your IBD team, you can also book an appointment with your GP. Ask your GP or IBD team if they can refer you to a rheumatologist. A rheumatologist is a doctor who can diagnose and treat arthritis and related conditions.

Tests and checks for joint problems

When investigating joint problems, your doctor may:

• Ask about your symptoms, including which joint or joints are affected, and how bad any pain and stiffness are
• Ask about any other conditions that affect you or your immediate family
• Look at your joints to check for swelling, and to see how well you can move them
• Carry out blood tests to rule out other conditions and look for signs of inflammation
• Ask you to have a blood test for a gene called HLA-B27, which can be linked with spondyloarthritis
• Refer you for an X-ray, MRI or ultrasound scan on the affected joint

Living with joint problems when you have Crohn’s or Colitis can be really difficult. But sometimes, small changes can help to make things more manageable. Here, we list things you can try that might help with symptoms or daily life.

Keeping active

Doing any form of movement or exercise might feel impossible when you’re dealing with joint pain and stiffness. But doing what you can, when you can, may make a difference. Staying as active as you can may help with your joint symptoms in the long term. It may also help to boost your energy and mood.

If possible, try to build more activity into your daily life. For example, you might walk to the shops rather than drive. Other types of gentle exercise you could try include:

• Swimming
• Cycling
• Tai chi, Pilates and yoga
• Walking or jogging
• Gym-based exercises, like using exercise bikes or treadmills

It may take some time to find a type of exercise that works for you. Read more about exercising with arthritis from Arthritis UK. We also have more information on being active with Crohn's or Colitis.

Lifestyle changes

Making small, healthy lifestyle changes when you can may have a positive effect on your joint problems. As well as keeping active, this may include:

• Eating a healthy, balanced diet. There is no specific diet for arthritis. The most important thing is to aim for a balanced diet. We have more information on food for people with Crohn’s or Colitis.
• Aiming to keep to a healthy weight. This will ease any strain on your joints. It may help to ease inflammation too. The NHS have more information about healthy weight.
• Stopping smoking, if you smoke. Smoking may worsen symptoms of axial spondyloarthritis and lead to more damage to your joints. We have more information about smoking and Crohn’s and Colitis, including getting help to stop.

Managing fatigue

Fatigue is very common in Crohn’s and Colitis. But it can also be an effect of joint problems, especially spondyloarthritis. Fatigue is very different from being tired. You may feel extreme mental and physical exhaustion that does not go away after rest or sleep. It can affect people differently. 

There are several things you can do to manage fatigue. Find out more in: 

• Our information on fatigue
• Managing fatigue, from Arthritis UK

Taking care of your mental health

Coping with a long-term condition like Crohn’s or Colitis can have a big impact on your mental health. Joint problems can add to this, especially if they are causing you pain and limiting what you can do. 

Taking some small steps to look after your mental health can make all the difference. It’s also important to know when, and how, to get help. You can find out more on this in: 

• Our information on mental health and wellbeing
• Mental health and arthritis, from Arthritis UK

Support and benefits

You may be able to claim certain benefits if joint problems are having an impact on:

• Your everyday tasks
• Your ability to get around
• Your ability to work

Other Crohn’s or Colitis symptoms may also mean you can claim benefits. But joint problems can often be a major factor in this.

Certain disability benefits may also make you eligible for a Blue Badge. This allows people with severe problems in getting around to park closer to their destinations.

We have lots of helpful information on getting benefits and support, including:

• Disability and sickness benefits
• Claiming Personal Independence Payment (PIP)
• Getting a blue badge in our information on travelling with Crohn's or Colitis

Getting the help you need at work

Living with joint problems, as well as other Crohn’s or Colitis symptoms, may mean you need more support at work. For some people, it can mean being unable to work at all. Under UK law, employers have a duty to make reasonable adjustments for employees that are considered to have a disability. Depending on exactly how they affect you, joint problems may count as a disability.

Examples of reasonable adjustments may include:

• Starting later in the day if your joint problems are worse in the morning
• Supports or aids that may make desk-based work more comfortable, such as a back rest, wrist rest or foot support
• Specialist equipment to support with tasks
• Working from home when possible, if travel is difficult

Find out more in our guides for employees and employers.

We follow strict processes to make sure our information is based on up-to-date evidence and easy to understand. We produce it with patients, medical advisers and other professionals. It is not intended to replace advice from your own healthcare professional.

Key references

Below, you can find some of the key references we have used to create this information. If you would like a full list of references, you can contact us using the details below.

• G Rogler, A Singh, A Kavanaugh, and others. Extraintestinal manifestations of inflammatory bowel disease: current concepts, treatment, and implications for disease management. Gastroenterology. 2021; edition 161, volume 4, pages 1118-1132. doi:10.1053/J.GASTRO.2021.07.042
• H Gordon, J Burisch, P Ellul, and others. ECCO guidelines on extraintestinal manifestations in inflammatory bowel disease. Journal of Crohn's and Colitis. 2024; edition 18, volume 1, pages 1-37. doi:10.1093/ECCO-JCC/JJAD108
• Arthritis: symptoms, causes, types and treatment. Arthritis UK. arthritis-uk.org. Accessed 1 July 2026.
• Spondyloarthritis and psoriatic arthropathy. National Institute for Health and Care Excellence Clinical Knowledge Summaries. cks.nice.org.uk. Accessed 1 July 2026.
• Enteropathic arthritis. StatPearls, NCBI Bookshelf. ncbi.nlm.nih.gov/books. Accessed 1 July 2026.
•  Spondyloarthritis in over 16s: diagnosis and management. National Institute for Health and Care Excellence (NICE). nice.org.uk. Accessed 20 July 2026.
• CA Lamb, NA Kennedy, T Raine, and others. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019; edition 68, Supplement 3, pages S1-S106. doi:10.1136/GUTJNL-2019-318484
• M Fatica, E Çela, M Ferraioli, and others. The effects of smoking, alcohol, and dietary habits on the progression and management of spondyloarthritis. Journal of Personalized Medicine. 2024; edition 14, volume 12, article 1114. doi:10.3390/JPM14121114
• GE Fragoulis, C Liava, D Daoussis, and others. Inflammatory bowel diseases and spondyloarthropathies: from pathogenesis to treatment. World Journal of Gastroenterology. 2019; edition 25, volume 18, pages 2162-2176. doi:10.3748/WJG.V25.I18.2162
• GW Moran, M Gordon, V Sinopolou, and others. British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025. Gut. 2025; edition 74, Supplement 2, pages S1-S101. doi:10.1136/GUTJNL-2024-334395

Contacting us

We hope that you’ve found this information helpful.

Please email us at evidence@crohnsandcolitis.org.uk if:

• You have any comments or suggestions for improvements
• You would like more information about the evidence we use
• You would like details of any conflicts of interest

You can also write to us at Crohn’s & Colitis UK, 1 Bishop Square, Hatfield, AL10 9NE. Or you can contact us through our Helpline by calling 0300 222 5700.

We do not endorse any products mentioned in our information.

Author and reviewer details

At the last full review, this information was:

• Written by Pippa Coulter, BSc (Hons) who is a Health Information Senior Officer
• Approved by Professor Rachel Cooney, DPhil, MBChB, FRCP who is a Consultant Gastroenterologist.