Does Ozempic cause muscle and joint pain?

Ozempic (semaglutide), the type 2 diabetes drug that can be prescribed off-label for weight loss, is known for a range of side effects, from abdominal pain to “Ozempic butt.” But what about muscle and joint pain? While they were not reported as side effects in clinical trials, a quick search on the Ozempic subreddit reveals dozens of posts from people who say they’ve experienced an uptick in muscle or joint pain since starting the prescription medication.

So, what’s the deal? Does Ozempic cause muscle and joint pain or not? The short answer: It’s unlikely. For the longer answer, including what could be behind the anecdotally reported aches and pains and what you can do about it, read on.

Muscle pain, or “myalgia” in medical parlance, is not a common side effect of Ozempic. In clinical trials of the drug, participants taking Ozempic—as well as those taking the placebo, for what it’s worth—did not report significant muscle pain. However, they did note back and joint pain. (Among these, fewer individuals reported joint pain than those on a placebo, and the percentage of people mentioning back pain was almost the same across Ozempic vs. a placebo.)

Ozempic works by mimicking a gut hormone called glucagon-like peptide-1 (GLP-1). In doing so, the medication slows digestion, regulates the release of insulin and glucose, and sends signals to your brain that you’re full—all of which can help keep blood sugar levels in check and lead to weight loss. Given the drug’s mechanisms of action, the majority of Ozempic’s side effects are digestive in nature, with the most common being nausea, vomiting, diarrhea, abdominal pain, and constipation. Other side effects can occur, but they are much rarer. 

While Ozempic is not known to cause muscle pain, that doesn’t mean that you can’t experience it while taking the drug. It just means that it may be more likely that your symptoms are due to another cause rather than directly linked to the medication. Some possible explanations for muscle pain on Ozempic include pain near the injection site, dehydration, and overzealous exercise.

Injection site pain

Ozempic is administered weekly via a subcutaneous (under the skin) injection in the abdomen, thigh, or upper arm. To minimize discomfort and allow the area to heal, it’s recommended to rotate through the injection sites and avoid injecting the medicine in the exact same place repeatedly.

Failing to switch up injection locations could be to blame for muscle pain on Ozempic. However, even with rotation, some people may be more likely to experience pain at the injection site than others. Repeatedly injecting in the same place can cause a lump of fatty tissue to build up in that spot, which can lead to pain and may even affect the absorption of the medication. In clinical trials, between 0.2% and 1.2% of people reported injection site reactions (discomfort or rash).

Dehydration

Some of Ozempic’s side effects—namely, nausea, diarrhea, and vomiting—can cause dehydration. This can also happen due to GLP-1’s potential effect on the body’s ability to sense thirst. Dehydration, in turn, can cause symptoms like darker urine, thirst, headache, and muscle cramps—the latter of which may be to blame for muscle pain on Ozempic. 

If you are experiencing the aforementioned GI side effects (especially vomiting and diarrhea) and not adequately replenishing your fluids, you are increasing your chances of experiencing dehydration and, in turn, muscle cramps and, in turn, muscle pain on Ozempic. The solution here is super simple: Make sure to hydrate. You can do this by upping your intake of water (which, BTW, may further help with weight loss), sucking on ice cubes, and drinking electrolyte-rich beverages. 

Exercise

Whether you are taking Ozempic for type 2 diabetes or off-label for weight loss, the drug is meant to be used in combination with lifestyle changes such as diet and exercise. If you are new to working out or have recently upped the intensity of your routine, you may experience aches and pains that are typically the result of increased physical activity. The good news? The soreness, which is known as delayed onset muscle soreness (DOMS), should subside as the muscles recover and become stronger over time. 

That said, it’s also possible that any muscle pain on Ozempic may be from an injury sustained during exercise. Research suggests that people with higher body weights may be more vulnerable to injury while working out and that obesity can make these injuries feel worse. A personal trainer or physical therapist can help you design a workout routine that includes adequate warm-up and cool-down exercises, as well as a gradual buildup in intensity, so you can reduce your risk of getting injured.

Similar to muscle pain, joint pain is not considered a common side effect of Ozempic. In fact, in one clinical trial, joint pain, technically known as “arthralgia,” was actually less common among the people taking Ozempic than those taking a placebo. Around 4–5% of people taking Ozempic reported “arthralgia,” or joint pain, compared with 6.5% of those taking a placebo. Back pain was reported as a separate side effect, but even that was essentially equal between Ozempic and placebo.

This trend seems to hold true for Wegovy, which contains the same active ingredient as Ozempic (semaglutide) but in higher dosage strengths. In clinical trials of Wegovy, people taking a placebo were more likely to report joint pain than those taking the drug, and the same held true for back pain as well.

Joint pain seems to be less common on Ozempic compared to placebo, at least according to clinical trials. So, if you’re experiencing joint pain on Ozempic, it’s possible it’s due to another reason, such as underlying health conditions or other medications you may be taking.

Underlying health conditions 

Joint pain can be associated with certain health conditions, such as osteoarthritis and autoimmune disease. Osteoarthritis is a type of arthritis that commonly affects the joints in the hands, hips, and knees, resulting in joint pain. It also tends to overlap with both obesity and type 2 diabetes—two conditions for which people may take Ozempic. For example, individuals with type 2 diabetes are about twice as likely to have arthritis. Furthermore, obesity is a risk factor for both type 2 diabetes and arthritis. 

While osteoarthritis is common, it is not the only potential cause of joint pain. Other conditions associated with joint pain include:

• Lupus

• Bursitis

• Gout

• Tendinitis

• Infection

• Injury 

If you are experiencing joint pain on Ozempic, it could be a warning sign of an underlying health issue, and it might be a coincidence that you are noticing it now while taking Ozempic. A healthcare provider is best equipped to determine whether an underlying illness may be to blame for your symptoms and how to best treat it. And on that note, it’s important to remember that it’s always a good idea to consult a healthcare provider if you’re experiencing symptoms you didn’t expect—such as muscle and joint pain—on Ozempic.

Medications 

Certain medications, including other drugs that also treat type 2 diabetes, are known to cause joint pain. For example, some DPP-4 inhibitors, such as Januvia (sitagliptin), have been associated with severe joint pain (as well as muscle pain). Statins, which are typically taken to improve cholesterol, can also cause joint pain or achiness. If you are experiencing joint or muscle pain, tell your healthcare provider; they may need to check blood tests and potentially discontinue culprit medications.

If you are experiencing muscle or joint pain on Ozempic (or both), make an appointment with your healthcare provider. They can help you understand what’s causing your symptoms and recommend a treatment plan—whether that involves treating an underlying condition, adjusting your medications, or continuing to lose weight. 

If you are experiencing muscle or joint pain on Ozempic (or both), make an appointment with your healthcare provider. They can help you understand what’s causing your symptoms and recommend a treatment plan, which typically depends on what’s to blame for your pain. If an underlying condition is causing your pain, treating that condition may offer relief. If you are taking a medication known to cause joint pain, such as a DPP-4 inhibitor, your healthcare provider may want to adjust your dosage or switch you to another medication. 

In some cases, continuing treatment with Ozempic may be the best path forward. Taking Ozempic as directed—which includes keeping up with exercise and following a healthy (often low-calorie) diet—can lead to weight loss and increased muscle strength, both of which can relieve muscle and joint pain. Weight loss can relieve the pressure on the joints, while exercise can help build up the muscles around them, providing further relief. Losing fat mass, in particular, may relieve muscle and joint pain, as body fat is linked with increased joint pain in the back, knee, and foot. 

Studies of people with knee osteoarthritis have found that those who lose at least 10% of their body weight experience significant pain relief and improved functioning. Moreover, research shows that people who lose weight by eating better and moving their bodies more—rather than just focusing on one or the other—experience the greatest pain relief. And you don’t have to wait until you make a lot of progress to experience muscle pain relief. In fact, it can start with earlier weight loss milestones, with those who lose at least 5% of their body weight experiencing pain relief. 

If you’re experiencing joint or muscle pain while taking Ozempic, it’s likely not due to the drug itself. But it’s still worth bringing up to your healthcare provider. They can help you determine what’s actually behind the symptoms and help you navigate a treatment plan to achieve relief. 

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

October 23, 2024

Written by

Amelia Willson

Fact checked by

Beverly Tchang, MD and Raagini Yedidi, MD

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About the medical reviewers

Beverly Tchang, MD

Beverly Tchang, MD, is an Obesity Medicine Advisor for Ro. She is also an assistant professor of Clinical Medicine at Weill Cornell Medicine in New York and triple board-certified in Internal Medicine, Endocrinology, and Obesity Medicine.

Raagini Yedidi, MD

Raagini Yedidi, MD, is an internal medicine resident and medical reviewer for Ro.