Aches in the trial tables
The US table keeps only reactions reported by at least 5% of people on Trulicity® and more often than on placebo, so no musculoskeletal entry appears there, and the EU table has none either. [1][3] The Canadian Table 2 lists every event reported by at least 1% in either Trulicity® group during treatment, whether or not the medicine caused it. [4] Its musculoskeletal rows are useful precisely because they include a comparison.
| Event and study pool | Trulicity® 0.75 mg | Trulicity® 1.5 mg | Comparison |
|---|---|---|---|
| Joint pain, placebo-controlled, 26 weeks [4] | 26 of 836 (3.1%) | 22 of 834 (2.6%) | Placebo: 17 of 568 (3.0%) |
| General pain, placebo-controlled [4] | 9 (1.1%) | 6 (0.7%) | Placebo: 5 (0.9%) |
| Joint pain, up to 104 weeks [4] | 67 of 1,671 (4.0%) | 47 of 1,671 (2.8%) | All comparators: 74 of 1,844 (4.0%) |
| Back pain, up to 104 weeks [4] | 78 (4.7%) | 65 (3.9%) | All comparators: 87 (4.7%) |
| Pain in arms or legs, up to 104 weeks [4] | 57 (3.4%) | 50 (3.0%) | All comparators: 55 (3.0%) |
| Influenza, placebo-controlled [4] | 22 (2.6%) | 17 (2.0%) | Placebo: 10 (1.8%) |
Reading these rows
Joint, back and limb pain were common in everyone in these trials, which enrolled adults with type 2 diabetes averaging their mid-fifties. [1][4] On Trulicity® the rates were close to, and at the higher dose often below, those on placebo or other diabetes treatments. [4] Influenza, which brings aches of its own, was slightly more common on Trulicity® than on placebo. [4] The monograph also lists muscle strain and a rise in the muscle enzyme creatine phosphokinase among less common trial events, without rates. [4]
Taken together, the tables do not suggest that dulaglutide causes widespread aching. They also cannot rule it out for an individual, so a clear record of when pain started is still worth keeping.
What research on muscles and joints adds
A 2026 systematic review and meta-analysis pooled 60 studies, mostly randomised trials, covering more than 1.2 million people and several GLP-1 medicines including dulaglutide. It found no effect on bone density, fractures or a standard knee and hip pain score, and a reduction in lean body mass that was mainly driven by liraglutide and semaglutide and appeared largely related to weight loss. The certainty of the evidence was rated low. [6]
A 2026 analysis of US adverse event reports found reporting signals for back pain and muscle pain with GLP-1 medicines as a group, with a median onset within 30 days, but no signal at the broader musculoskeletal level; voluntary reports cannot establish cause. [5] A small 2024 study of older adults with type 2 diabetes and knee osteoarthritis reported less knee pain over six months on dulaglutide, but its abstract describes no comparison group. [7]
Why you might ache on Trulicity®
- Feeling unwell overall: the US fatigue entry includes asthenia and malaise, which people often describe as aching or heaviness. [1]
- Fluid loss: vomiting and diarrhoea can dehydrate you, and MedlinePlus lists muscle cramps among the signs of mild to moderate dehydration. [1][10]
- Low blood sugar: with insulin or a sulfonylurea, weakness and shakiness are listed signs. [2]
- Other medicines: in the REWIND trial, two thirds of participants took a statin and most took an ACE inhibitor or similar blood pressure medicine, and MedlinePlus lists statins and ACE inhibitors among medicines that can cause muscle pain. [1][8]
- Injection site: a sore spot where you inject is a different problem; injection site reactions are uncommon in the EU table and are covered in a separate article. [3]
Other causes of aches and joint pain
MedlinePlus lists the most common causes of muscle pain as injury, overuse and tension or stress, and adds flu and other infections, electrolyte imbalance such as low potassium or calcium, fibromyalgia, polymyalgia rheumatica and, rarely, rhabdomyolysis. [8] For joints it lists osteoarthritis, gout, rheumatoid arthritis, bursitis, tendinitis, viral infections and strains. [9]
Signs that point to joint inflammation rather than a passing ache include swelling, warmth, tenderness, redness and pain on movement. [9]
What the guidance describes
For aches from overuse or injury, MedlinePlus describes rest, acetaminophen or ibuprofen, ice for the first 24 to 72 hours and heat after that, followed by gentle stretching and a gradual return to activity. [8] It also suggests getting enough sleep, reducing stress and drinking plenty of fluids around exercise. [8] For non-arthritic joint pain it mentions warm baths, massage and stretching. [9] Ask a pharmacist which pain reliever suits you, since many people on Trulicity® take several other medicines.
The Medication Guide asks you to drink fluids to lower the chance of dehydration. [2] If aches began when you started or changed another medicine, such as a statin, MedlinePlus advises contacting your provider. [8]
Trulicity® is a registered trademark of Eli Lilly and Company. PepLabo is not affiliated with or endorsed by Eli Lilly and Company.
When to get help
The signs and contact information below come from this article’s sourced guidance.
Emergency
- Severe stomach pain that will not go away, sometimes spreading to the back, with or without vomiting
Contact: Stop Trulicity® and call your provider right away
Medication Guide [2]
- Muscle pain with weakness or inability to move part of the body, trouble breathing or swallowing, much less urine, high fever or a very stiff neck
Contact: Emergency services (911 / 112)
MedlinePlus [8]