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Between 10 and 20 percent of people with rheumatoid arthritis develop the functional pain disorder fibromyalgia, compared to only two percent of the general population. What can you do to treat both?

People with inflammatory arthritis have a much higher risk of developing the functional pain disorder fibromyalgia, perhaps in part because chronic pain sensitizes the brain to pain, making stimuli that aren't normally painful at all highly uncomfortable. Even when your arthritis is being treated properly, this hypersensitivity can worsen your arthritis symptoms, and eventually lead to fibromyalgia symptoms like widespread pain and extreme fatigue. 

What Do You Need To Know About The Link Between Rheumatoid Arthritis And Fibromyalgia?

Fibromyalgia is rare in the general population — only two percent of US adults are estimated to be affected. The fact that that number rises to between 10 and 20 percent in people who have rheumatoid arthritis clearly demonstrates that there is a correlation between the two. How does this work, though? 

As an autoimmune disease, rheumatoid arthritis causes your own immune system to attack your joints. Inflammation, pain, and often fatigue follow. Although fibromyalgia isn't an autoimmune disease and its cause remains unclear, there are some striking similarities between the symptoms of fibromyalgia and rheumatoid arthritis; both can cause:

  • Pain — widespread, in multiple parts of the body, and often present on both sides
  • Chronic fatigue
  • Stiffness that gets worse after maintaining the same position for long periods of time
  • Mobility limitations that restrict your daily activities
  • Anxiety and depression

The similarities end there, though. While rheumatoid arthritis leads to joint inflammation and intermittent pain, fibromyalgia appears to be caused by changes in the brain that make patients hypersensitive to pain. The pain people with fibromyalgia experience is ever-present as well as often present everywhere. It's chronic, meaning fibromyalgia can be diagnosed after you have had the symptoms for a minimum of three months, and the tender points associated with fibromyalgia mean that even gentle touch can be seriously painful. 

If this sounds familiar to you, you should know that these are not rheumatoid arthritis symptoms — even though your doctor may quickly say they are when you explain you've been experiencing constant chronic pain. Should you indeed have fibromyalgia in addition to rheumatoid arthritis a proper diagnosis matters, as fibromyalgia is treated differently. 

Medication And Alternative Treatment Options: What Can You Do To Fight Fibromyalgia And Rheumatoid Arthritis?

Medications prescribed for rheumatoid arthritis may include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen (Aleve), which are now both available over the counter, but also prescription-only steroids to help fight the inflammation. Disease-modifying antirheumatic drugs (DMARDs) like methotrexate and leflunomide work by suppressing your immune system and inflammatory response, thus reducing your arthritis symptoms and slowing down damage. A new class of DMARDs called biologic agents may also be part of your treatment regime, and they work by seeking to promote a healthy immune system. They are typically prescribed when other DMARDs do not have the expected effect. 

 

Fibromyalgia medications focus on relieving pain and helping you sleep better, and while some of these drugs are the same ones you may be prescribed for rheumatoid arthritis, different options also enter the arena:

  • Over-the-counter painkillers, like as paracetamol/Tylenol (acetaminophen) and NSAIDs such as naproxen.
  • Antidepressants can help with more than treating depression; they also serve to reduce your pain, fatigue, and sleep quality.
  • Anti-seizure medicines were originally designed for people with epilepsy, but they can help fibromyalgia sufferers become less sensitive to pain stimuli.
Three medications have been FDA-approved specifically to manage fibromyalgia — these are pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella). Because these medications were found to be "moderately effective", essentially meaning that they are likely to reduce your symptoms but not as much as you'd like, fibromyalgia patients may find alternative and non-pharmacological treatments very appealing. 

Methylcobalamin, an active form of vitamin B12, is an example of such a treatment — and in some great news for people who have a dual fibromyalgia/rheumatoid arthritis diagnosis, research has found it an effective way to reduce the pain associated with both conditions. Methylcobalamin likely works because it has the power to restore neuron cells and nerve fibers. 

Lifestyle changes for people suffering from fibromyalgia and rheumatoid arthritis

Lifestyle changes can also be extremely beneficial for people suffering from fibromyalgia and rheumatoid arthritis, and you will want to look into taking the following steps:

Exercise

It may be counter-intuitive because exercising is likely to make your pain worse initially, but research consistently indicates that regular exercise is one of the best ways to manage chronic pain. This doesn't mean you should immediately start hitting the gym hard five days a week, especially if you have been physically inactive for a long time. It does mean that walking, cycling, or swimming for half an hour two times a week will pay off if you keep at it. 

Good-quality sleep

We know it's a tricky cycle — research shows that getting the right amount of good-quality sleep reduces chronic pain, but also, of course, that chronic pain makes it very difficult to achieve the rest you need so much. Those "tired" sleep hygiene tips you've probably read about hundreds of times before may really help, however, so give them a go. Tips that can work include getting into a restful state by beginning a relaxation routine about an hour before you go to bed (get your PJs on, take a nice bath or shower, breaking out that Enya album...), banishing electronics from your bedroom and saving it only for sleep and sex, and establishing regular bed and wake times. 

Relaxation techniques

Relaxation techniques include yoga (which can also count as exercise, by the way), breathing exercises, massage therapy, and even talk therapy — yup, talking to a therapist. Cognitive behavioral therapy (CBT) is a commonly used form of therapy that has been shown to produce results very quickly. 

Physical and occupational therapy for rheumatoid arthritis

A good physical therapist can show you how to improve your posture, strengthen certain muscles, and reduce your stiffness. The ultimate goal of physical therapy is to reduce the amount of pain you have to live with.

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