New research shows a significant overlap between fibromyalgia tender points and inflammatory sites associated with back pain in spondyloarthropathies (SpA), which are joint diseases of the spinal column.
In SpA, the inflammatory sites are called enthesitis. They're right where your tendons and ligaments attach to bone.
Of the 60 SpA patients examined,18 fit the tender-point diagnostic criteria for fibromyalgia. Many of the others reported symptoms consistent with fibromyalgia that aren't specifically linked to their arthritis, including:
- Symptom onset after 40 (76.6%)
- Morning stiffness (91.5%)
- Less pain with appropriate exercise (60%)
- Stress as a symptom trigger (40.4%)
The locations of tender points also correlated with painful enthesis sites.
Researchers concluded that there's a significant overlap between the two conditions when inflammatory back pain was involved.
I find several things about this interesting. First, recognizing this overlap could help people get proper diagnoses and treatment, rather than doctors attributing all symptoms to one condition or the other and not looking any farther. The treatment paths are very different, so it's well worth diagnosing BOTH problems when they're present.
Second, it's one more association between autoimmune disease and fibromyalgia, which currently isn't believed to be autoimmune but significantly overlaps with a lot of autoimmunities.
Finally, my rheumatologist recently told me she's fairly certain I have a form of SpA, based on the worsening joint pain I'm having in spite of my fibromyalgia being in remission. SpAs are difficult to diagnose and I'm not good a candidate for the standard treatment, so we haven't explored it further.
Treating SpAs often involves immune suppression, to keep the immune system from destroying the tissues. I'm already on an immune modulator for Hashimoto's autoimmune thyroiditis, and I'm prone to treatment-resistant infections. Immune suppressants can also be pretty harsh drugs, and (like most fibromites), I don't tolerate meds well.
SpAs can include problems with the spine, eyes, gastrointestinal tract and skin. If you suspect you have an SpA on top of fibromyalgia, you should talk to your doctor about it.
More information on SpAs, from About.com Arthritis Guide Carol Eustice:
Do you suspect something like this is going on, in addition to your fibromyalgia? What symptoms make you think so? Are you diagnosed with an SpA? Leave your comments below!
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