As many as one in three people face the invisible but life-altering struggle of chronic pain at any given time. Arthritis is the leading cause, but fibromyalgia features close to the top of the list, too. While an estimated two to seven percent of the world population is affected by fibromyalgia, many remain undiagnosed so the true number may be even higher.
This is a serious problem, not just because you deserve better than to suffer in silence, but also because living with chronic pain, whether caused by osteoarthritis, fibromyalgia, or another condition, can induce brain damage, depression, and social isolation, while decreasing both your physical health and ability to function at work.
What can you do to find relief when you suffer from both fibromyalgia and osteoarthritis?
Fibromyalgia and osteoarthritis: Shared features and differences
Often referred to as "wear and tear arthritis", osteoporosis is a kind of arthritis in which the cartilage between joints is worn out. That in turn causes bone friction, followed by inflammation, stiffness, reduced mobility, often fatigue, and of course — pain. Those who have these symptoms but remain undiagnosed may turn to Google and become convinced they have fibromyalgia. To make things more confusing, they may also have that, because the two can co-occur.
Symptoms common to both conditions include:
- Stiffness after maintaining the same position for prolonged periods of time, commonly after sleeping
- Muscle pain
- A reduced ability to move certain body parts
Co-existing fibromyalgia and osteoarthritis: What are the treatment options?
Conservative, minimally-invasive, treatments options will typically be explored first in people with osteoarthritis — and that means medications aren't the first point of call! You can expect your physician to propose:
- Exercise — low-impact and low-intensity training that helps you build muscle around the joint(s) affected by osteoarthritis reduces your risk of further complications. It is, however, important to consult your doctor about your workout routine, rather than just starting one that may not be suitable for you.
- A brace — for your knee or shoulder, for instance — increases your stability while reducing inflammation and the chance of further injury.
- Anatomic shoe inserts may also help, depending on the site of your osteoarthritis.
- Stay away from positions that put extra pressure on your joint — this will depend on the affected joint or joints, and your doctor will give you instructions.
- Being overweight or obese puts additional pressure on your joints, which will make your symptoms worse, so your doctor will most likely also suggest you lose weight if this is you.
More severe osteoarthritis calls for pharmacological treatment. The following are often used:
- Painkillers to help relieve your discomfort. NSAIDs (non-steroidal anti-inflammatory medications) fight inflammation at the same time. Be aware, however, that this does not mean they do not have a negative impact on your overall health as well; NSAIDs can lead to side effects ranging from heartburn to stomach ulcers, and heart palpitations to organ damage. Tylenol® (acetaminophen), meanwhile, is well-known to have the potential to cause liver damage when used over the long term. Opioids lead to dependence and aren't usually advised.
- Corticosteroids reduce your inflammation. They can be taken orally, but injections are also an option. Be aware that the injections have the potential to increase joint damage over time, so they are used sparingly.
- Glucosamine and chondroitin supplements may reduce the rate at which your cartilage breaks down.
- Hyaluronic acid injections — to supplement a substance that is naturally present in the body and plays an important role in protecting joints.
Fibromyalgia treatment also emphasizes pain relief as the focus of its treatment is on reducing your symptoms to offer you a better quality of life, but some other medication enter the picture too:
- The opioid Tramadol (Ultram®) is often recommended.
- Antidepressants are frequently prescribed not just to combat depression, but also to allow fibromyalgia patients to reduce their pain and fatigue. Common choices include Milnacipran (Savella®), Duloxetine (Cymbalta®), and Amitriptyline (Endep®).
- Medications originally designed for epilepsy have been shown to help fibromyalgia sufferers find relief from fatigue and fibro fog. These include Gabapentin (Neurontin®) and Pregabalin (Lyrica®).
Keep in mind that the first medication you are prescribed will not necessarily help you; some experimentation may be required, and some patients even find that a generic vs brand name medication, or vice versa, will work better for them as there can be subtle differences in composition. Always let your doctor know how you are doing with a medication, and ask for something else if you are not seeing results. Before you begin taking a drug, also tell your doctor about past side effects you have experienced, as well as about medications you use for different conditions (if not prescribed by the same doctor). The partnership between doctor and patient works best when the lines of communication are open!
Lifestyle changes can represent a crucial part of your treatment as well. Many chronic pain patients have benefited and continue to benefit from relaxation techniques. Mindfulness meditation, massage, and gentle exercise may all make a big difference. The idea that meditation can relieve your pain might sound unscientific, but it isn't — research has found that it changes the way in which the brain perceives pain, for both fibromyalgia and osteoarthritis patients.