Headlines everywhere these days proclaim the benefits of a gluten-free diet, and many people do find that eliminating gluten eases digestive problems – or even joint pain. But while eliminating gluten is essential for people with celiac disease, an autoimmune condition, not everyone who goes gluten-free will find joint pain relief, and some might not benefit at all.

In those who have celiac disease, ingesting gluten sets off an inflammatory response in the small intestine that damages its ability to absorb nutrients. Over time, poor absorption of essential vitamins and mineral, such as calcium, can lead to fatigue, skin rash and even osteoporosis. Joint pain is another symptom, though experts aren’t yet sure why.

“The most accredited theory is that gut inflammation triggered by gluten causes activation of T lymphocytes that can eventually migrate to joints, causing local inflammation and, therefore, joint pain,” says Alessio Fasano, MD, director of the mucosal biology research center at the University of Maryland School of Medicine in Baltimore. “This theory is in line with the fact that celiac disease is now defined as a systemic disease that can affect any organ or tissue, including joints.”

The mechanisms behind gluten sensitivity are still being studied. But some of the reactions to gluten, including diarrhea, bloating – and in some cases, joint pain – are the same as in celiac disease. And sometimes, joint pain is reported, too.

“Joint pain can occur in both celiac disease and gluten sensitivity,” says registered dietitian Shelly Case, a celiac/gluten-free diet expert on the medical advisory boards of the Celiac Disease Foundation and Gluten Intolerance Group.

Peter Green, MD, director of the Celiac Disease Center at Columbia University in New York City. “Only five 5 percent of the one 1 percent with celiac disease are diagnosed.”

Wondering if gluten is causing or worsening your aches? Talk to your doctor about having a blood test to help detect whether you have the disease, and about an elimination diet for gluten.