Research Brief
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.
My Perspective
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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O Adrienne, ANOTHER OVERLAPPER, lol. I should have a medical degree after all the research I do cause the doctors don’t seem to have time or whatever. I’m still mulling over Pots from last week lol. I don’t have insurance or money for any more tests etc so onward I go searching. Took 15 years but last month got my Fibro diagnoses. Read through your whole post today and I am a woman of later years, worked in mental health all my life and did alot of self work before the symptoms got really bad. And thats a good thing or I’d think I’ve lost it with all these triggers, stress, anxiety nowadays. I KNOW it’s not me, it’s my body and that helps alot but jeez I feel like a real pill trying to control my environment to keep distractions down. All the bells and whistles of contemporary life are unbearable. Yes, I can stop, calm myself down after the fact but not while the triggers are going off…..the sweats have started, the frustration, etc etc. Thanks for all you do, you are the Best on the Web, my source of sanity, fibrofran
Your comment “I don’t tolerate meds well.”
seems to be my life
I wonder how prevalent this is among us
I definitely have back pain. A sclerosed SI joint, mild lumbar scoliosis, bulging lumbar disks and vertebral joint pain in the thoracic spine.
I’m allergic to morphine and vicodin so there isn’t a lot in the way of good pain meds that I can take. Between this and pretty much weekly migraines sometimes the fibro is the least of my problems. No one seems to have any answers.
It is all frustrating and sometimes it gets me down. Between various sources of pain and the migraines, it is hard to concentrate for long on any one thing. I make a lot of mistakes.
It is what it is I guess.
I’ve just spent a week in the hospital because of the 20 prescription medications I take. I’ve been blacking out, having slurred speech, of course fibro fog, with the adherent not being able to say the simplest word but being able to describe what I’m talking about in detail. It’s scary when the doctors you count on don’t care if your meds interact or if you live or die because of them.
I have been recently diganoised with osteo arthritis. Great! The arthrtis is all over my back, and neck. Along with the Fibromyalga, Fog, which recently is the worse I have experienced. I think I have lost my memory, as I cannot remember what I thought a few moments eailer. There has been so family stress lately too. I cannot tolerate most drugs too. I also have COPD, and this last winter, I suffered with trying to take a antibiotic. Finally, my Rhumatologist said I should not take antibiotics of any kind. Fine, this winter and next spring, I must find other methods to keep from getting a restpatory infection. I feel the same way that Sandy does, and tonight I am glad to read that some one other than poor me has the same symtoms. Since my spelling is poor tonight, I will close, with hope for a better day tomorrow.
I have HMO and need a referral to see a Rhumatologist, my Doctor said it is very very very hard to get a referral for Rhuma if the symptons look like Fibro. Now what? I have had this for 23 years, and it is getting worse and worse.