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What’s the Difference Between Rheumatoid Arthritis and Fibromyalgia?

What are rheumatoid arthritis and fibromyalgia?

Rheumatoid arthritis (RA) and fibromyalgia are two different conditions with some similar symptoms. These symptoms include:

  • pain that may feel like a dull ache
  • sleep disturbances
  • fatigue
  • feelings of depression and anxiety

The causes of these conditions are very different. RA is an autoimmune disease that causes the body’s immune system to attack the joints. Fibromyalgia is a disorder accompanied by musculoskeletal pain and symptoms of fatigue, trouble sleeping, and problems with memory and mood.

While the Arthritis Foundation (AF) considers fibromyalgia to be an “arthritis-related condition,” there are distinct differences between the two conditions. RA and fibromyalgia progress very differently. Fibromyalgia usually causes constant pain that may worsen with poor sleep and stress. On the other hand, RA can flare up and grow progressively worse without treatment.

You should always talk to your doctor about your symptoms. Knowing how they are different can help your doctor make a more accurate diagnosis. Learn how these two conditions differ.

How are the symptoms different?

Symptoms

Pain

One of the biggest differences between RA and fibromyalgia is inflammation. In RA, joint inflammation is one of the key symptoms. People with RA often notice that their joint pain appears on both sides of their body. For example, if you have a painful joint in your right wrist, you also may have corresponding pain in your left wrist. A study showed that people with RA and those with fibromyalgia both had more trouble paying attention than those in the control group.

ra fibromyalgia venn diagramra fibromyalgia differences

About 63 percent of people with fibromyalgia report lower back pain, while about 47 percent report:

  • frequent headaches
  • joint pain
  • muscle spams
  • tingling

One study also found that people with RA showed decreased pain after exercise. The results were not significant for people with fibromyalgia.

Sleep disturbances and fatigue

Both conditions can cause sleep disturbances and fatigue. But sleep problems in people with fibromyalgia tend to be more draining. A preliminary study found that women with fibromyalgia reported greater daytime sleepiness and fatigue than women with RA. However, the Multiple Sleep Latency Test (MSLT) showed that women with fibromyalgia had less objective daytime sleepiness compared to women with RA.

With RA, fatigue can also be a result of inflammation and anemia. Anemia, or the lack of red blood cells, affects up to two-thirds of people with RA.

A follow-up study found that reduced sleep affected women with fibromyalgia more than women with RA. They felt more daytime sleepiness and needed a longer recovery time.

Depression and anxiety

Feelings of depression and anxiety are common symptoms of fibromyalgia and RA. These feelings can affect your quality of life. One study found that these feelings were not statistically  different between people with RA and fibromyalgia.

Distinct symptoms

Identification

Distinct symptoms of RA

With RA, your symptoms will flare up, or come and go, periodically. Common RA symptoms include:

  • joint pain, tenderness, and stiffness
  • red, swollen joints, often in your hands or feet
  • a sudden increase in symptoms that intensify for a period of days to months before temporarily subsiding
  • inflammation

Inflammation can affect other parts of your body, such as your:

  • eyes — dryness, sensitivity to light, and impaired vision
  • mouth — dryness, irritation or infection of the gums
  • skin — small lumps around the bones areas
  • lungs — shortness of breath
  • blood vessels — organ, skin, or nerve damage
  • blood — anemia

About 40 percent of the people with RA also experience these signs and symptoms, according to the Mayo Clinic. Without treatment, your joints can shift out of place. 

Distinct symptoms of fibromyalgia

The symptoms of fibromyalgia can appear like symptoms of many other conditions. But the pain in fibromyalgia is widespread and tends to occur on specific tender points.

These points are located in symmetrical pairs on:

  • the back of your head
  • collarbone area
  • upper back
  • elbows
  • bottom
  • knees

You may also have:

  • trouble with memory, often called fibro fog
  • headaches
  • menstrual pain
  • restless leg syndrome
  • sensitivity to temperature, loud noises, or bright lights
  • numbness or tingling
  • irritable bowel syndrome

Fibromyalgia pain can appear in the joints and muscles, but fibromyalgia does not damage your joints the way that arthritis can. It also doesn’t damage your muscles or other soft tissues, although it is known to intensify pain. This can also potentially worsen arthritis pain.

Getting a diagnosis

Diagnosing RA

There’s no single test for RA, so your doctor will conduct several tests to help confirm an RA diagnosis. These tests include:

  • a review of your medical history and that of your family
  • a physical exam to look for joint tenderness, swelling, and pain
  • blood tests to look for inflammation
  • auto-antibody tests — about 80 percent of people with RA have the rheumatoid factor antibody
  • imaging tests, such as ultrasound, to look for joint damage or inflammation

Your doctor will immediately recommend treatment if you have RA. RA requires prompt treatment. If left untreated, RA symptoms can lead to long-term joint damage. Serious cases of RA can even cause damage to major organs, including your heart.

What are the effects of RA on the body? »

Diagnosis

Diagnosing fibromyalgia

A fibromyalgia diagnosis can be difficult to confirm. While there may be clear signs and symptoms, there isn’t one test or examination that can determine if you have fibromyalgia.

One of the best ways for your doctor to help diagnose fibromyalgia is to rule out other conditions.

There is no cure for fibromyalgia, but there are treatment options that can make a difference in your quality of life, including lifestyle changes and medication.

How to manage fibromyalgia pain »

Can RA and fibromyalgia symptoms be a sign of another condition?

Joint pain, fatigue, and muscle pain can also be symptoms of other conditions. Some of these conditions include:

  • lupus, an autoimmune disease that causes damage to any part of the body
  • Sjogren’s disease, an immune system disorder that also has symptoms of dry eyes and mouth
  • hypothyroidism, low levels of thyroid hormone that causes pain allover
  • multiple sclerosis, an immune system disorder that attacks the central nervous system
  • sleep apnea, unrefreshed sleep that causes fatigue

Is it fibromyalgia or multiple sclerosis? »

Talk to your doctor about all your symptoms. Some conditions will have differentiating signs and symptoms that can help your doctor diagnose what’s causing your discomfort.

See a doctor

Next steps

Make an appointment with your doctor if you are experiencing any of the symptoms mentioned above. Even though both conditions share similar symptoms, the treatment and outlook for both conditions are very different. Your doctor can help determine the condition and recommend the right treatment, even if you’re unsure what the cause is. It’s also important to treat RA early as RA lead to serious complications as it progresses.

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