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Fibromyalgia & Rheumatoid Arthritis

Living With 2 Chronic Pain Conditions

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Updated May 12, 2014

Rheumatoid arthritis and fibromyalgia (FMS) are two pain conditions that commonly go together. While they're very different conditions, their symptoms can be remarkably similar, making diagnosis difficult.

Women are more likely to get both conditions, and both rheumatoid arthritis (RA) and FMS can strike at any age. Unlike FMS, however, RA causes damage and deformity to the joints.

What is Rheumatoid Arthritis?

RA is an autoimmune disease, which means that your immune system mistakenly attacks healthy tissues as if they were foreign substances. FMS is not known to be an autoimmune disease. The course of RA is unpredictable, but after many years about 10% of people with it become severely disabled and have a hard time with even the most basic tasks.

Some cases of RA have prolonged remissions in which symptoms vanish for several years. Others have flares and remissions similar to those of FMS. The majority, however, have a chronic, progressive form of RA.

RA can impact any joint and even your organs, but it most often involves the small joints of the hands and feet.

Why Do Fibromyalgia & Rheumatoid Arthritis Go Together?

Researchers don't know what causes either condition, so we don't yet understand for sure why FMS and RA go together so often. Studies show, however, that people with RA are more likely to develop FMS, but people with FMS are no more likely than anyone else to develop RA. Some scientists believe that chronic pain, from RA or other sources, can lead to FMS by causing changes in the ways our nervous systems perceive and process pain.

Regardless of why you have both conditions, the pain of RA can trigger FMS flares and make your symptoms harder to control.

Diagnosing Rheumatoid Arthritis

A specific blood test called the anti-CCP antibody test can distinguish RA from other forms of arthritis. Your doctor may also order several other tests to confirm the diagnosis and to help determine your prognosis.

Symptoms of Rheumatoid Arthritis & Fibromyalgia

Symptoms of RA and FMS can be extremely similar. They both include:

  • Joint pain
  • Symmetrical pattern (pain in the same joint on both sides)
  • Fatigue and loss of energy
  • Depression

RA also can cause symptoms that aren't associated with FMS, such as:

  • Joint swelling, with warmth around affected joint
  • Loss of appetite
  • Joint deformity
  • Limited range of motion

Treating Rheumatoid Arthritis

A lot of drugs are available for treating RA. They include:

  • Common pain relievers, such as Tylenol (acetaminophen)
  • Non-steroidal anti-inflammatories (NSAIDs), such as Motrin/Advil (ibuprofen) and Aleve (naproxen)
  • COX-2 inhibitors, such as Celebrex (celecoxib)
  • Glucocorticoids, including prednisone and methylprednisolone
  • Disease-modifying antirheumatic drugs (DMARDs), including Trexall/Rheumatrex (methotrexate), Imuran (azathioprine), and Azulfidine (sulfasalazine)
  • TNF blockers, such as Enbrel (etanercept), Remicade (infliximab) and Humira (adalimumab)

Sometimes, surgery can help people with severe joint damage.

Rheumatoid Arthritis Treatment vs. Fibromyalgia Treatment

If you're taking medications for both RA and FMS, be sure to talk to your doctor and pharmacist about possible drug interactions.

Some FMS experts believe that the corticosteroids sometimes used to treat RA can make FMS symptoms worse. By working closely with your doctor, you should be able to find treatments that work for both of your conditions.

For more on how to decide on the best course of treatment for RA and FMS, read Fibromyalgia vs. Rheumatoid Arthritis Pain - What Factors Determine Treatment?, from About.com Guides to Arthritis Carol & Richard Eustice.

Living With Rheumatoid Arthritis & Fibromyalgia

Both RA and FMS can make your life extremely difficult and limit how functional you can be. By finding and following a treatment/management regimen, you may be able to preserve your functionality and independence.

Because both conditions can lead to depression and isolation, it's important for you to have a support system. Keep lines of communication open with your doctor and the people you're close to, and get early help if you think you're becoming depressed. Support groups -- both online and in your community -- may be a big help to you, too.

Resources for Rheumatoid Arthritis

Sources:

American College of Rheumatology. "Rheumatoid Arthritis"

The Johns Hopkins Arthritis Center. "Rheumatoid Arthritis Clinical Presentation"

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