Accutane joint and back pain after stopping

Joint, back and muscle pain are very common on isotretinoin (Accutane, sold in the UK as Roaccutane), and the UK leaflet says side effects generally go once treatment stops. For some people the pain has carried on. It’s one of the problems described by people with post-Accutane syndrome, or PAS.

PAS is the name widely used for problems that last after isotretinoin, and they aren’t only sexual. In 2022, doctors and researchers proposed a checklist to recognise lasting sexual problems after the drug. They also list things that can come with those problems, or on their own: “joint changes”, depression, skin and bowel changes, and problems with concentration and memory.

The NHS page on isotretinoin lists muscle and joint pain but doesn’t say it can last. That can make it hard to be believed when your knees or back still hurt months after your last capsule.

Miriam took two courses of isotretinoin for mild acne. Halfway through the second, she says, she started having “lots of back pain”. In her last month her knee hurt so much she could barely walk. When she finished, it got better.

It didn’t stay that way. In this short clip she lists what she lives with now: eye pain, struggling to concentrate, joint and back pain, and cartilage loss in both knees.

Play video: Miriam on what she lives with after isotretinoin

How common is joint pain on Accutane?

Very common. The UK leaflet lists “back pain; muscle pain; joint pain particularly in children and teenagers” among side effects that may affect more than 1 in 10 people.

The UK leaflet says side effects are generally reversible once treatment stops. That’s what happened to Miriam’s knee at first.

Can Accutane joint pain last after stopping?

For some people, it has. The same leaflet also says “some may continue after treatment has stopped”. It doesn’t say which ones.

The US information for doctors asks them to check the muscles and joints of anyone with this kind of pain “during or after a course”.

The clearest figure comes from rheumatologists, the doctors who treat inflamed joints. A study published on 23 October 2026 looked back at 100 adults whose back pain came from inflammation and began on isotretinoin. Most got better. Nearly 1 in 4 still had it more than three months after stopping.

Because everyone in it had this inflamed kind of back pain, it can’t tell you how often everyday aches last. We found no study that has counted that, as of October 2026. For some people it has lasted years. Nobody knows yet who will be affected, or whether it will ease.

Elliot took Accutane at 17. When he came off it he still had back pain, and expected it to “get better over the years”. Thirteen years on, his shoulders are “so achy all the time”, he says, and he has lower back pain.

Play video: Elliot on the physical symptoms he lives with

Why does my lower back hurt more when I lie down?

Back pain that’s worse when you rest and better when you move can be a sign of inflammation. One kind is sacroiliitis, where the joints between your spine and pelvis become inflamed.

The UK leaflet calls it “a type of inflammatory back pain causing pain in your buttocks or lower back”. While you’re on the medicine, it asks you to tell your doctor about “persistent pain in your lower back or buttocks”. You may need a scan, such as an MRI.

The NHS page on a related back condition describes how this pain feels. It’s worse in the morning and at night, and can wake you up. Exercise helps. Rest doesn’t.

The UK information for doctors says the reported cases got better once people stopped isotretinoin and were treated. But sacroiliitis can be missed. Doctors in Turkey described a woman whose sacroiliitis wasn’t diagnosed for three years after her course. They couldn’t be sure isotretinoin caused it, and urged other doctors to ask about isotretinoin when someone has lower back pain.

What can I do if the pain hasn’t gone?

Tell your GP, and give them the details that help separate one kind of pain from another.

Isotretinoin helps many people. If you have side effects, what to do is a decision for you and your prescriber.

1

Your course

“Isotretinoin 40 mg a day from March 2025, last capsule September 2025.”

2

Where it hurts

“Lower back and buttocks, and both knees.”

3

When it started

Before the course, during it, or after your last capsule.

4

What changes it

“Stiff in the morning, wakes me at night, easier once I'm moving.”

5

What to ask

“Could this be sacroiliitis, and do I need a scan or a rheumatologist?”

You could start with: “This pain began on isotretinoin, and it hasn’t gone since my last capsule.”

Miriam says she found herself “arguing with so many doctors” who “wouldn’t believe that Accutane was the cause”. Bring the leaflet line: “some may continue after treatment has stopped”. You can report it without a doctor agreeing.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. PAS has no reporting term yet, so name each symptom, such as joint pain or lower back pain, and say it continued after stopping.

Our reporting guide walks you through it

What else do people ask?

Is it just the medicine still in my body? Not after the first month. The UK information for doctors says it’s “completely eliminated” from your body within a month of the last dose. Pain that’s still there months later isn’t leftover medicine. More in how long Accutane stays in your system.

Can Accutane affect your bones? The US information for doctors says it may lower bone density (how thick and strong your bones are) in some people. In one trial, teenagers whose bone density fell hadn’t recovered on scans two to three months later. Thinning bones and fractures have also been reported after stopping. Miriam says she has been diagnosed with advanced osteopenia, which means thinner bones than normal.

Does Accutane cause arthritis? Very rarely, says the UK leaflet. It lists arthritis, sore tendons and changes to bone density among side effects that may affect up to 1 in 10,000 people. Miriam talks about her knees and bones in a longer clip in what PAS feels like.

When Miriam’s back first hurt, she didn’t think an acne medicine could be strong enough to cause it. If your pain began on isotretinoin and is still there, write down your dates and report it. Our post-Accutane syndrome page covers the other symptoms people describe.

Sources

1. Roaccutane 10 mg soft capsules, patient leaflet, Electronic Medicines Compendium (EMC 100633), last revised April 2026. Section 2: “persistent pain in your lower back or buttocks” may be signs of sacroiliitis; imaging “such as MRI” may be needed. Section 4: side effects “generally reversible after changing the dose or stopping treatment, however some may continue after treatment has stopped”. Very common (may affect more than 1 in 10 people): “Back pain; muscle pain; joint pain particularly in children and teenagers”. Very rare (up to 1 in 10,000): arthritis, bone disorders including changes to bone density, sore tendons. Unknown frequency: sacroiliitis.
2. Roaccutane 10 mg soft capsules, summary of product characteristics, EMC 100633, revised 27 April 2026. Section 4.4: “In cases reported post-marketing, sacroiliitis improved after discontinuation of Roaccutane and appropriate treatment”; isotretinoin is “completely eliminated” within one month of the end of treatment.
3. Absorica and Absorica LD (isotretinoin), US prescribing information, revised August 2026, DailyMed, US National Library of Medicine. Section 5.12: “Evaluate the musculoskeletal system of patients who present with these symptoms during or after a course”. Bone density fell in 27 of 306 people aged 12 and over in a 20-week trial; repeat scans 2 to 3 months later “showed no recovery”. Spontaneous reports of osteoporosis, osteopenia and fractures “following cessation of treatment”. The label does not say musculoskeletal symptoms persist after stopping.
4. NHS, Isotretinoin (Roaccutane), page last reviewed 26 June 2026. Lists “muscle and joint pain”; doesn’t say any side effect can continue after stopping.
5. NHS, Ankylosing spondylitis: symptoms, page last reviewed 5 January 2023. Describes inflammatory back pain in that condition; used only to describe how this kind of pain feels.
6. Albayrak F, Zengin O, Baran R and colleagues. Clinical characteristics of persistent isotretinoin-associated inflammatory back pain: a retrospective cohort study. Clin Rheumatol, published online 23 October 2026. Authors from rheumatology departments in Turkey. 100 consecutive adults with new inflammatory back pain during isotretinoin, meeting ASAS criteria; 23 still had it more than three months after stopping. Read from the PubMed abstract only.
7. Mülkoğlu C, Nacır B. A patient with chronic sacroiliitis undiagnosed for three years after isotretinoin use. BMC Musculoskelet Disord 2020;21(1):300. One case report; the authors write that “it is difficult to state that sacroiliitis definitely developed due to ISO treatment”.
8. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Section 6: effects that “can occur independently of any sexual difficulties but may also accompany sexual problems” include “joint changes”, cognitive impairment, skin and bowel changes and depression. Proposed criteria, not an official diagnosis.
9. Moral Medicine, From Mild Acne to Severe Dry Eyes, Hair Loss and Infertility: Miriam’s Nightmare After Isotretinoin, interview with Miriam, October 2025 (the title is the channel’s). Back pain in the middle of the second course at 11:54; knee pain and “as soon as I finished the medication … it got better” at 12:20 to 12:32; not thinking the drug was strong enough at 12:42; joint and back pain and cartilage loss at 20:12 to 20:23; advanced osteopenia at 20:49; arguing with doctors at 35:40 to 35:51. Quotes from YouTube’s automatic captions. Her story on our site: Miriam’s story.
10. Moral Medicine, He Took Accutane at 17. His Life Never Returned to Normal., interview with Elliot, January 2025 (the title is the channel’s). Back pain after the course and expecting it to “get better over the years” at 1:04:52; 13 years at 1:11:22; aching shoulders and lower back pain at 1:17:12. Quotes from YouTube’s automatic captions.

Sources checked on 27 October 2026. AI-assisted writing and review, not clinical review.