How Do You Know If You Have Fibromyalgia, RA, or Lupus

Tea timeThere is no easy (or any) test that definitively proves if someone has fibromyalgia. Quite frequently fibromyalgia, rheumatoid arthritis, and lupus get diagnosed in place of one another. The similarities in the symptoms which these diseases share often makes achieving an accurate diagnosis quite challenging.

The differences between the symptoms of these chronic conditions were the subject of a recent research study. The participants were asked to complete the Symptom Impact Questionnaire (SIQ) and the Revised Fibromyalgia Impact Questionnaire (FIQR). The goal was to determine the specific features of each condition.

Both questionnaires revealed the key differences between these conditions involved discomfort upon sitting for a 45-minute length of time, trouble cleaning floors, and in having tenderness to the touch. There were other smaller differences involving neck pain, arm pain, hand pain, and mid and outer lower back pain.

Those who conducted the survey concluded that a new questionnaire should be developed based on their findings. The hope being that the differences between these diseases will aid in their diagnosis.

Fibromyalgia

Primarily, fibromyalgia causes muscle pain and tenderness throughout the whole body as well as fatigue. Some of the additional symptoms are tingling in the hands and feet, fibro fog, difficulty sleeping, painful menstruation, and stiffness in the morning.

It is possible that irritable bowel syndrome, CFS, and other painful conditions coincide with fibromyalgia. The cause is still widely debated, but leading theories are that it is stress induced, caused by repetitive injury, illness, environmental pollutants, or that it is a direct result of diet or genetics.

The key for me diagnosing fibromyalgia is that the patient will not only have chronic pain, but will also have issues with poor sleep. True fibromyalgia patients will always have and problem either falling or staying asleep. Low serotonin (a brain chemical) is the chief identifier of fibromyalgia. Low serotonin leads to poor sleep, chronic pain, low moods, anxiety, IBS, and brain for.

Fibromyalgia vs. Rheumatoid arthritis

iStock_000010461940XSmallThe symptoms of RA and fibromyalgia may be similar, but they are quite different. The Arthritis Foundation suspects fibromyalgia to be a condition which is arthritis-like while recognizing that there are distinct differences.

The first difference comes in the form of inflammation. Fibromyalgia pain is not caused by inflammation. Although the big pharmaceutical companies are spending vast amounts of money trying to brainwash doctors and their patients into believing that inflammation and drugs to reduce inflammation are key to fibromyalgia. However, while yes patients with fibro do have inflammation as some have demonstrated on blood work (elevated CRP, SED rate, etc), most have normal blood work markers. “Your blood work likes good” is routine and disheartening to most fibro patients….surely there is something wrong with me?

Those with autoimmune disease will most likely have positive blood work markers.

There is also no joint damage from the inflammation. Both of these are strong indicators that your condition is RA.

While the symptoms of RA get progressively worse, this is not seen with fibro patients. Over time, your condition may get worse if you suffer from RA. This is caused by the continuing joint damage. Fibro symptoms are more akin to episodes, one day you may have few symptoms, the next you might have many.

Another important difference between these two conditions is the symmetry of pain. If you have RA you may notice that your left knee hurts, then soon after the right one will hurt too. With fibromyalgia, pain is usually experienced all over your body. The pain with RA is caused by inflammation, which as we know is not what causes fibro pain.

Fibromyalgia vs. lupus

iStock_000001770966XSmallOnce again, we see similar symptoms with two very different conditions. But, commonly fibromyalgia sufferers get a diagnosis of lupus, particularly when antinuclear antibodies are found in their bloodwork. If a lupus rash or lupus kidney disease are present, this is the quickest way to achieve an accurate diagnosis.

Lupus is basically when your immune system starts to attack healthy cells along with the unhealthy ones. Your immune system creates actual autoantibodies that destroy healthy tissue. It is these autoantibodies that cause the pain and inflammation in lupus sufferers. In fibromyalgia, we know that lack of sleep, fibro fog, and fatigue all contribute to the pain.

Since both of these conditions have different treatments, a misdiagnosis means taking pills that not only don’t work but, aren’t designed to treat your condition. These are not the only conditions that get confused with fibromyalgia either.

Pain and fatigue are common symptoms of many diseases, some chronic, others not. Sometimes a treatment for one condition will temporarily help with fibro symptoms, thus both patients and doctors will think that a correct diagnosis was made. At least until the symptoms return. Diagnosing fibromyalgia basically comes down to a process of elimination. Doctors really only have what each patient says about their own symptoms.

The last thing that makes diagnosing fibromyalgia so difficult is that many patients have multiple maladies. If you are having symptoms of lupus and fibromyalgia, figuring out your symptoms and their causes will take longer than if you just have one. My advice to all patients is to practice patience and to rely less on medications. Altering your diet may help with symptoms of all of these diseases.

Those who specialize in fibromyalgia, like I do, can usually know within minutes of reviewing a new patient questionnaire if a patient has fibromyalgia, rheumatoid, lupus or all three. Blood test can accurately pinpoint who has and who doesn’t have an autoimmune disease like rheumatoid and or lupus.

 


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4 replies
  1. Trisha
    Trisha says:

    Hi Dr. Murphree, interesting article on the similarities between fibromyalgia, rheumatoid arthritis, and lupus…of which fibromyalgia does not have a diagnostic blood test, and RA and lupus do (Rheumatoid Factor and ANA respectively)

    It would be helpful to see an article from you on the similarities between FM and Lyme disease (infection with Borrelia burgdorferi bacteria) as the symptoms are also very similar…widespread pain, fatigue, and neurocognitive problems (depression, anxiety, “fibro fog” like issues).

    I think your knowledge and opinion on this topic would greatly benefit the fibromyalgia community! Thank you.

    Reply
  2. Marla Ash
    Marla Ash says:

    Hi!! I really enjoy the testiomonies of your patients…I was such an active mom.. I’m so glad my kids are raised & on there own..I got an overdose in 2005.. I was told by the dr. it was a real bad overdose…A nurse came & just shot 2 mg of staydol in my foot..It hit my leg, heart, head & was jerking & couldn’t speak..She never even looked…I ouldn’t look for contoller jerking so Praise God the controller was close to me & just started pushing buttons as I pulled it to my side..She came in & saw me & started yelling!! I’m so sorry please forgive me..I’ll never do it again I’m so sorry…They heard her & came running in & got her out of there & didn’t see her again..I could hear everything..She has one rainbow of a chance…It was awful..My friends had left & I was doing so good from surgery & going home the next day..Nurses were so careful with me & one my friend..Had never had her..Not one word to me..They had IV in my foot..They couldn’t find one anywhere else..They don’t do Iv’s in feet because of me..It changed my life…Tried to go back to work but my blood pressure would shoot up…Everything just went down hill…I had been told I had Fibermylogia & Chronic Fatigue but people said always Drs. were quacks who believed that..No such thing..I can’t sleep good but so exhausted..Thinking & focusing & memory is worse..I ache all over..Foods bother me..medicines bother me..I can’t drive…I have always been so independant & enjoyed life, work, fishing, hunting, landscaping, gardening, crafts..boating…bowling, Just love all sports…Was an active mom & grandma..Church is so important to me & struggling to read or pray!!! Havjng trouble with my eyes..Just can’t function but try so hard…The ladt four years has been awful they gave me bllodpressure medications that just kept me awake..I can’t take naps…I love a posative attitude but I’m real tired..I lost my little dog I loved, my step mom & then my dad & two real good friends on top of things & much more…I just want to feel good but so tired…I tried natural but some of them things bother me…You sound like you care & know a lot..Decided to try this & see what happens…I don’t trust anymore except for God..I want to but it just doesn’t let me anymore…Have a blessed day…Marla

    Reply
  3. Suzy
    Suzy says:

    For almost 40 years I was diagnosed with fibrocitis, then fibromyalgia. 3 different rheumatologists told me I definitely did not have RA or Lupus. Finally, after becoming bedridden for 3 weeks, I tried another rheumatology group. Using MRI and X-rays, RA was finally confirmed, as I have no blood marker for RA, known as “0 Factor RA.” I still think that I have a Fibro/RA combo, however. Good to know that you feel it is possible!

    Reply
  4. Gladys N Mumba
    Gladys N Mumba says:

    Thank you very much for the information.

    Sometimes your news letters come as junk but I donot consider them to be that way. They are very important to me because they make me understand my condition better… I know what I should do and what I should not do.

    Thank you once again.

    Reply

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