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It can be very difficult to differentiate between fibromyalgia and arthritis. The two conditions have much in common in terms of pain. Even doctors may have difficulty telling the difference between the two.

What is fibromyalgia?

There are, however, some major differences between these two painful and debilitating conditions. It is helpful to have a good understanding of both conditions before the differences between the conditions can be fully understood.

Fibromyalgia is a condition in which the main symptom is pain. Pain can be felt anywhere on the body and is typically experienced in more than one area, although there may be one area that is most painful. Most people with fibromyalgia also complain of fatigue. This fatigue is not the normal fatigue that many people experience- the fatigue of fibromyalgia is all-consuming and may make it difficult for a person to go about their daily routine. There are many other symptoms that a person with fibromyalgia may suffer from, such as migraines and headaches, gastrointestinal symptoms, sleep disturbances, numbness and tingling in the extremities, skin problems, dry eyes, mouth and throat, cognitive dysfunction and TMJ pain. Many people with fibromyalgia also suffer from depression and anxiety due to the disabling symptoms they often experience.

There are no tests that can definitively diagnose fibromyalgia. People with fibromyalgia are often subjected to a battery of tests when their physician tries to discover the source of their pain and fatigue. These tests are often done to rule out other conditions that share common symptoms with fibromyalgia. However, these tests are usually negative and fibromyalgia is diagnosed when another cause for symptoms is ruled out. Fibromyalgia may be confused with thyroid or blood disorders, cancer, lupus, ankylosing spondylitis and, of course, arthritis.

The American College of Rheumatology has set forth criteria for the diagnosis of fibromyalgia which includes pain/tenderness lasting longer than 3 month consistently, pain on both sides of the body and both above and below the waist and the presence of 11 out of 18 identified “tender points”, or areas that are tender when a prescribed amount of pressure is applied. The diagnosis of fibromyalgia is made only if there is no other identified or recognized cause for pain. This is why tests are required: to rule out other conditions, not to rule in fibromyalgia.

Fibromyalgia symptoms may wax and wane. In other words, symptoms may come and go. Symptoms may even disappear for weeks and months, providing a “remission” from the pain and fatigue that accompany fibromyalgia. When symptoms are present, they are treated with a variety of lifestyle modifications and medications that target pain and fatigue. Related symptoms, such as gastrointestinal complaints, may be treated based on symptoms.

Fibromyalgia does not cause damage to body tissues and is not fatal. People with fibromyalgia live as long as people without the debilitating disorder.

What is arthritis?

People are more familiar with arthritis, as it is also a common condition. Arthritis is actually an umbrella term for more than 100 conditions. When people talk about arthritis, they are often referring to one of two types of arthritis, osteoarthritis and rheumatoid arthritis.

Rheumatoid arthritis is the more serious form of the two. In rheumatoid arthritis, swelling and pain of the joints is the most common symptom. Sufferers may also experience fatigue, weight loss, fever and loss of appetite. People with rheumatoid arthritis often feel stiff and sore for a period of time upon awakening. Sometimes other organs are involved, such as the eyes, heart and skin. Some people are affected mildly, while others experience a severe form of the disease. The disease is more common in women. Rheumatoid arthritis often affects the small joints of the fingers and toes, as well as the knees and wrists. However, any joint can be affected. Rheumatoid arthritis affects the lining of the joints, eventually destroying bone and cartilage. Blood tests may often reveal elevated inflammatory markers in the blood. These inflammatory markers can be used to gauge response to treatment. Treatment is aimed at halting the progression of the disease and minimizing joint destruction. Steroids and antiinflammatories are often used for this purpose. Surgery is sometimes needed to replace joints that have been severely affected by rheumatoid arthritis.

Osteoarthritis (also known as degenerative joint disease) is one of the oldest recognized diseases in humans. Osteoarthritis causes joint tissue to break down, resulting in joint pain and stiffness. It commonly affects knees, spine, hips and feet. Many older people suffer from this form of arthritis. This type of arthritis is progressive and may lead to crippling symptoms if left untreated.

What are the main differences between fibromyalgia and arthritis?

  • Fibromyalgia does not result in the destruction of joints
  • Fibromyalgia is not associated with inflammation
  • Fibromyalgia never requires surgery as a form of treatment
  • Medications to treat fibromyalgia and arthritis are often different
  • There are no blood tests for fibromyalgia
  • X-rays and other imaging tests will be normal in fibromyalgia (unless the person has another health problem)
  • Overwhelming fatigue is common in fibromyalgia
  • Pain in fibromyalgia is related to the muscles, whereas pain in arthritis is related to the joints
  • Other organs, such as the heart, are not affected by inflammation in fibromyalgia
  • Depression occurs more commonly in fibromyalgia
  • There is no obvious joint swelling in fibromyalgia, although some people with fibromyalgia experience tissue swelling (i.e. hands and feet)
  • Paresthesias (tingling, numbness and other abnormal sensations) occur commonly in fibromyalgia
  • Headaches are more common in fibromyalgia
  • Fibromyalgia can be more difficult to diagnose than arthritis
  • Hypothyroidism and hypoglycemia have been implicated in fibromyalgia, but not in arthritis

Although fibromyalgia and arthritis share some common symptoms, such as pain, they are more different than they are similar. The diagnosis of fibromyalgia is often made after arthritis has been ruled out as a potential cause for pain. While both conditions can be debilitating, arthritis leaves identifiable damage to joints in its wake, while fibromyalgia does not result in joint damage. Understanding the two conditions makes it easier to see the differences between the two conditions.