Does gluten cause inflammation? The surprising link between gluten and joint pain

Going gluten-free isn’t just a fad. Joint pain affects millions of Americans—with causes ranging from injury and overuse to various forms of arthritis —some are asking if what you eat, specifically gluten, might be contributing to inflammation and joint pain.

The truth is that gluten, a protein found in wheat, barley and rye, could be behind persistent joint pain and inflammation in some people.

So, let’s understand how—and what to do if you think gluten is causing your inflammation and joint pain.

Does gluten cause inflammation?

The short answer is yes, gluten can cause inflammation in some people with celiac disease or non-celiac gluten sensitivity. And when it comes to gluten and wheat reactions, there are important distinctions to understand between intolerance and an actual allergy:

• Celiac disease: An autoimmune disorder that damages the small intestine when gluten is consumed.
• Non-celiac gluten sensitivity: Causes similar symptoms without intestinal damage or the genetic and serologic markers. The diagnosis comes typically after ruling out celiac disease.
• Wheat allergy: A true food allergy causing rapid immune reactions including possible anaphylaxis.
• Wheat intolerance: Difficulty digesting wheat without immune system involvement and primarily causes digestive discomfort.

But first, what is gluten? Gluten is a protein that is found in wheat-based products. In people with a genetic predisposition for celiac disease, gluten may result in an inflammatory reaction that primarily affects the small intestine.

The prevalence of this condition is significant—approximately 1 in 100 Americans has celiac disease. Beyond this group, others may experience what's called non-celiac gluten sensitivity, which can produce similar symptoms without the same immune-mediated inflammation. When gluten enters the body of someone with these conditions, it triggers a low-grade inflammatory reaction. As a result, the body's ability to absorb critical nutrients and minerals are inhibited, leading to subtle and sometimes severe organ dysfunction that can cause symptoms throughout the body.

Can gluten cause joint pain?

If you've been experiencing unexplained joint pain, gluten and the resulting inflammation might be the culprit. More doctors are recognizing the connection between this common food protein and joint discomfort.

Here's how it works: when someone with gluten sensitivity eats foods containing wheat, barley or rye, their body can treat gluten as an invader. This triggers inflammation that doesn't just stay in the digestive system—it can travel throughout the body.

People can develop joint pain due to the inflammatory reaction caused by gluten in the system. This inflammation can affect the:

• The joint itself, causing pain and swelling
• Connective tissues where tendons attach to bones
• Soft tissues surrounding joints

For some people, gluten doesn't directly cause joint problems but instead makes existing conditions worse. If you have rheumatoid arthritis or psoriatic arthritis, for example, consuming gluten might intensify your symptoms and make them harder to manage with standard treatments.

Think of it like adding fuel to a fire—gluten can amplify inflammation that's already present, making joint pain more severe and persistent.

Connection between gluten, celiac disease and arthritis

There’s also a deeper connection to explore between celiac disease and arthritis, one of the most common causes of joint pain.

People with celiac disease are at an increased risk of developing arthritis and even refractory arthritis, or arthritis that doesn’t respond to standard treatments. And some people with inflammatory arthritis may have undiagnosed celiac disease contributing to their joint pain symptoms.

This connection isn't coincidental. Recent studies have shown that people with other autoimmune conditions have similar genetics. Therefore, these conditions may be present together and result in symptoms that are difficult to treat if not diagnosed and treated promptly.

This genetic link helps explain why some people with inflammatory arthritis continue to experience symptoms despite conventional treatment—undiagnosed celiac disease, a wheat allergy or gluten sensitivity might be exacerbating their condition.

Gluten-sensitivity symptoms

How can you recognize if your joint pain might be related to gluten sensitivity? Symptoms of gluten-related joint pain include:

• Joint pain
• Redness
• Swelling
• Decreased range of motion
• Early morning stiffness
• Back pain
• Sacroiliitis, a condition that causes pain the lower back and buttocks.

These joint issues typically appear alongside other symptoms of gluten sensitivity, including:

• Abdominal pain and bloating
• Excessive gas
• Constipation or diarrhea
• Fatigue
• Weight loss
• Iron deficiency anemia
• Skin rashes
• Vitamin deficiencies
• Muscle weakness
• Neurological symptoms like ataxia and "brain fog"
• Headaches

Importantly, joint pain can sometimes be the primary symptom, even when digestive issues aren't prominent. While the presence of joint pain does not automatically mean you have celiac disease, you should consider talking to your doctor or a gastroenterologist about getting an evaluation for celiac disease.

Managing gluten and joint pain

For those whose joint pain stems from gluten sensitivity or celiac disease, the primary treatment approach is clear: a strict gluten-free diet. A gluten-free diet dramatically improves symptoms of arthritis in people who have celiac disease or non-celiac gluten intolerance, often in just four to six weeks.

This involves eliminating a wide range of foods containing gluten. This includes grains that contain gluten, such as:

• Wheat
• Spelt
• Farro
• Farina
• Durum
• Emmer
• Einkorn
• Bulgur
• Semolina
• Triticale
• Barley
• Rye
• Kamut

Beyond these obvious sources, be vigilant about hidden gluten in:

• Wheat starch
• Malt (malt vinegar, malt syrup and malted milkshakes)
• Non-certified gluten-free oats
• Gravies, dips and soups
• Beer and some wines
• Croutons
• Certain salad dressings
• Seasonings
• Medication capsules that may contain wheat derivatives

While challenging, this dietary change can make a big difference in how you feel. If you have other forms of arthritis, especially if autoimmune-related, a gluten-free diet may improve your symptoms even when conventional treatments have fallen short.

It’s important to note that not everyone with joint pain should eliminate gluten. This dietary approach is most appropriate for specific groups, so be sure and talk to your doctor before making any significant dietary changes.

Anyone with undiagnosed or refractory arthritis should have an evaluation for celiac disease, especially if other autoimmune conditions are present. Keep in mind that testing for celiac disease requires consuming gluten, so eliminating it before testing can lead to false-negative results.

Working with healthcare providers specializing in gastroenterology, rheumatology and nutrition is the best approach. Your doctor can help connect you with the right experts to help you feel good again.

Finding relief for joint pain

While not all joint pain is related to gluten sensitivity, it could be the missing piece for some people struggling with unexplained inflammation and discomfort. With proper diagnosis and dietary management, many experience significant improvement within weeks of eliminating gluten.

If you're experiencing joint pain alongside other symptoms that might suggest gluten sensitivity, talk to your doctor about whether testing is a good next step for you.

For more information about joint pain, orthopedic conditions or joint replacement options, find a specialist near you.