Two chronic pain conditions that go hand-in-hand are Rheumatoid arthritis and Fibromyalgia (FMS) and while they are entirely different conditions, their symptoms can appear similar, thus making diagnosis difficult. Both RA and FMS can strike at any age, however, women, in comparison to men, are much more likely to get both conditions.
The Difference Between Fibromyalgia and Rheumatoid Arthritis
To differentiate between the two conditions, a doctor will look at what’s going on in your body, how the conditions are progressing, and how they are treated.
One of the main differences between the two conditions is that RA causes joint damage and deformity whereas FMS is not linked to any joint damage or deterioration. Furthermore, RA is an autoimmune disease, which means your immune system attacks your healthy tissues as if they were foreign invaders, and currently, FMS is not classified as autoimmune. With that said, research has suggested that some cases of FMS may involve autoimmunity.
RA is an unpredictable condition, however, about 10% of people suffering from it will become severely disabled after a number of years and they will start to struggle with even the most basic tasks. That said, if you can receive the proper treatment, ending up in a wheelchair is a lot more rare than you might expect.
The course of FMS is also unpredictable with experts stating that about one-third of the people suffering from the condition will get significantly worse over time. With that in mind, the same experts say that about one-third of the people with it will get significantly better over time, and about one-third will see no changes in the severity of their symptoms.
Unfortunately, there are no known factors to what influences the course of the illness. While there are some cases of RA that have extended remission in which symptoms vanish for years, other cases have flares (symptoms become more severe) and remissions (periods of lighter symptoms). However, the majority of people suffering from RA have a chronic, progressive form of the condition.
FMS also involves remissions and flares, however, there are some cases that involve more or less consistent symptom levels. Though it is rare, long-term remission in FMS is possible.
In terms of pain, RA impacts the small joints of the hands and feets. However, RA can also impact your organs. For FMS pain, it is much more common for the pain to strike along the spine, although in some cases, it is possible for the pain to strike anywhere in the body.
Why Do Fibromyalgia & Rheumatoid Arthritis Go Hand-In-Hand?
Researchers are still unsure of what causes either condition, so it is unclear as to why FMS and RA often go together.
However, research has shown that people with RA are much more likely to develop FMS, while people with FMS are no more likely than anyone else to develop RA. Some believe that chronic pain, from RA or other conditions, can lead to FMS by changing the way our nervous system perceives and processes pain.
If you have both conditions, keep in mind that the pain of RA can triggle FMS flares, which makes controlling your symptoms much harder.
Diagnostic Results
To differentiate RA from other forms of arthritis, a doctor might conduct a specific blood test called the anti-CCP antibody test. Additionally, several other tests might need to be ordered to confirm the diagnosis and to help get a better idea of how the disease will progress.
Along with testing to rule out various other possible causes of your symptoms, FMS is diagnosed by a tender-point exam or scores on a specially designed evaluation.
Symptoms
As the symptoms of RA and FMS can be extremely similar, they both include:
- Joint Pain
- Pain in the same place on both sides (symmetrical pattern)
- Lack of energy and fatigue
- Anxiety and Depression
Symptoms of RA that aren’t associated with FMS include:
- Joint swelling
- Lack of appetite
- Joint deterioration
- Limited motion
Symptoms of FMS that aren’t associated with RA include:
- Cognitive dysfunction
- Light, noise, and smell sensitivity
- Pain that moves to all areas of the body
- Sleep that is unrefreshing
If you have been diagnosed with one of these conditions, but you are showing symptoms that might indicate the other, it is crucial that you mention this to your doctor as soon as possible.
Options for Treatment
Luckily, RA can be treated in various ways. Drugs available for treatment include:
- Pain relievers, such as Tylenol (acetaminophen)
- Ibuprofen and Naproxen (non-steroidal anti-inflammatories)
- COX-2 inhibitors
- Taking Glucocorticoids such as and
- Disease-modifying antirheumatic drugs, such as Imuran and Azulfidine
- TNF blockers, including Enbrel, Remicade and Humira
If you are struggling with severe joint pain, surgery can help to relieve some of the pain.
To treat FMS, a multi-pronged approach is necessary, which may involve:
- Prescription drugs
- Various supplements
- Tailor-made exercise program
- Alternative treatments
Keep in mind that it is important that you talk to your doctor and pharmacist about possible drug interactions if you are taking medication for both conditions. For example, there are some FMS experts that believe that corticosteroids, which is used to treat RA, can make FMS symptoms worse. Working alongside of your doctor allows you to find effective treatments that work for both of your conditions.
Living with Chronic Pain: Rheumatoid Arthritis & Fibromyalgia
Both conditions can make an individual’s life extremely difficult and can limit their functionality. By finding and following an effective treatment plan, you are able to preserve your independence.
Additionally, it is crucal for an individual to have a support system as both conditions can cause them to fall into a isolated or depressive state. If you think that you are becoming depressed, try having an open conversation with your doctor or those you’re closest to.
Featured Image: Depositphotos/lightwavemedia