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Around a quarter of fibromyalgia patients additionally suffer from lupus, a very different condition that nonetheless has some similar symptoms. What do you need to know about diagnosis and treatment?

Because fibromyalgia and lupus can manifest in similar ways — with pain and fatigue being primary symptoms — and because some people have both, it’s tough to reach a correct diagnosis. The patient has to go through lab tests, a detailed physical exam, and a discussion about your symptoms and medical history. This can be a lengthy and frustrating process.

You might not know that:

  • The majority of both fibromyalgia and lupus patients are women.
  • The symptoms of fibromyalgia can interfere with a lupus diagnosis.
  • If you are a fibromyalgia patient who also suffers from lupus, which describes about a quarter of people with fibromyalgia, your symptoms will probably be worse and strike more often, leaving you with significant disability and making it hard to do everyday things such as personal hygiene and household chores.

Differences between lupus and fibromyalgia

Most fibromyalgia patients initially tell their doctors that they feel:

  • Exhausted
  • Muscle aches and pains that become more severe when they haven’t slept well

Lupus patients, meanwhile, experience fatigue and muscle pain as well, but their first symptoms can be very different:

  • A skin rash on their nose and cheeks that is very sensitive to sunlight
  • Trouble breathing
  • Kidney issues
  • Heart attack
  • Stroke
  • Blood clot
People with fibromyalgia have natural joint movement and no inflammation, but experience painful tender areas over their muscles, while lupus patients can feel stiff, suffer from swelling and joint pain, and may be limited in their movements. As you can see, fibromyalgia and lupus share some common characteristics, but are ultimately radically different in nature.

A physical examination and a knowledge of a patient’s medical history and symptoms will usually help point a doctor in the direction of the correct diagnosis. Lab tests, such as the antinuclear antibody (ANA) test, can help confirm what the doctor already suspects. Lupus patients tend to test positive for the ANA test (though this is not a one-stop diagnostic test as other inflammatory conditions also respond to it), while people with fibromyalgia do not show any abnormalities in their blood work.

Relief for fibromyalgia pain

A cure hasn't yet been discovered for fibromyalgia, but the condition can be managed. The following medications have been shown to be beneficial in offering you pain relief:

  • Lyrica is an anticonvulsant that has been shown to be helpful in treating people with fibromyalgia
  • Muscle relaxers
  • Cymbalta is an antidepressant but it can’t just help lift your mood it might also reduce pain.
  • Insomnia therapies

Treating fibromyalgia pain with home remedies

There are a lot of home remedies and lifestyle changes that can make a huge difference to your fibromyalgia pain, for instance:

  • Acupuncture
  • Massage therapy
  • Relaxing before you go to sleep; try putting on some gentle music, taking a bath or shower, or reading a book (Stay off the computer!).
  • Workouts like yoga, tai chi, and pilates have all been shown to be helpful to fibromyalgia and chronic pain patients.

Just remember that not all these remedies will work for you, so you may have to try a few before you find something that helps you.

Prescription drugs to treat lupus pain

Your doctor may recommend one of these medications:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen combat inflammation while also offering pain relief.
  • Immunosuppressants which may include azathioprine (Imuran, Azasan), methotrexate (TrexallImuran), and mycophenolate mofetil (CellCept).
  • Corticosteroids and steroids like Prednisone and methylprednisolone (A-Methapred, Medrol) help fight inflammation and have been shown beneficial for lupus patients in preventing organ damage.
  • Rituximab (Rituxan ) may be an option for people with resistant lupus.
  • Antimalarial medications like hydroxychloroquine (Plaquenil) alter the functioning of your immune system and can help prevent lupus flare-ups.
  • Biologics, for instance belimumab (Benlysta), are injected and might also control your lupus.
Note that all these medications have potential side effects, some of them very serious. Have a detailed discussion with your doctor about the risks and benefits of taking any of these drugs. Even over the counter drugs can induce side effects. Never take more than you are supposed to, and let your doctor know that you are using them.

Complementary approaches to lupus management

Dehydroepiandrosterone (DHEA) supplements might hold some promise when it comes to reducing muscle pain and boosting your energy. Omega-3 fatty acids, in fish oil for instance, could also lessen your lupus symptoms. Further research needs to be conducted before it’s really clear if this helps, but these supplements certainly won't be bad for you. Just like acupuncture helps some people with fibromyalgia, it reduces lupus-related muscle aches for certain patients as well, so this is another option patients can consider.

Lupus and fibromyalgia: What if you have both?

Because the treatment recommendations for fibromyalgia and lupus are so different, you may worry that one will interfere with the other. Fibromyalgia treatment centers on pain medication, antidepressants, and muscle relaxers, while autoimmune drugs and biologics are generally chosen for lupus.

Patients will be relieved to here that the medications you might be prescribed for lupus do not usually interact with fibromyalgia treatment, or worsen your fibromyalgia symptoms. Steroids are a potential exception; some doctors and patients suggest that they can aggravate fibromyalgia symptoms. If you have different doctors for fibromyalgia and lupus, make sure they are in touch so that they can discuss your treatment plan.

In double fibromyalgia/lupus patients, a treatment plan is likely to include:

  • Corticosteroids or disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate for lupus.
  • Antidepressants, psychotherapy, and physical therapy, for fibromyalgia.

Although you’ll be prescribed different medications to deal with your two conditions, the good news is that the lifestyle changes doctors recommend for fibromyalgia and lupus are virtually identical. The steps you take should help you feel a lot better.

When a person has both fibromyalgia and lupus, corticosteroids or disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, should be prescribed to prevent lupus-related damage to the internal organs. Physical therapy, counseling and antidepressant medications can help improve muscle aches, sleep and mood changes associated with fibromyalgia.

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