Understanding the two conditions

You’re feeling muscle pain, stiffness, and fatigue. You suspect you may have one of two specific conditions. Only your doctor can provide a diagnosis. But it can help to understand the differences between these two health conditions that have similar symptoms.

Educating yourself about polymyalgia rheumatica (PMR) and fibromyalgia will better prepare you to talk to your doctor about what you’re experiencing.

Polymyalgia rheumatica and fibromyalgia are musculoskeletal conditions with symptoms that may be hard to tell apart. When you have polymyalgia rheumatica you feel pain and stiffness in the muscles in your shoulders and upper arms (shoulder girdle) and hips (pelvic girdle). This feeling often comes after you’ve spent time resting, and is most severe upon wakening from sleep.

Fibromyalgia can also cause muscle pain in the same parts of the body. But it’s more wide-spread and the pain is more severe. People with fibromyalgia tend to experience other symptoms as well, including:

  • tiredness
  • trouble sleeping
  • memory problems
  • bowel and bladder problems

It’s not always easy to tell who has a greater chance of developing either condition. However, certain risk factors provide some clues. According to the Mayo Clinic, older adults, usually over age 65, are more likely to be diagnosed with polymyalgia rheumatica. It’s rare in people under age 50.

On the other hand, anyone can get fibromyalgia. But it tends to be more common in women than in men and can occur at any age.

Polymyalgia rheumatica is diagnosed more frequently in certain seasons. This suggests that something in the environment, such as a virus, may play a role.

Some illnesses such as rheumatoid arthritis (RA) and other autoimmune disorders are associated with higher incidence of fibromyalgia. Post-traumatic stress disorder and other emotional or physical traumas have also been linked to fibromyalgia.

How can you tell the difference between these two painful disorders? Your doctor may want to conduct a number of tests to make a diagnosis of polymyalgia rheumatica, including:

  • blood tests that look for an inflammation marker
  • imaging tests such as X-rays or ultrasound
  • biopsy to check for a condition called giant cell arteritis

However, a diagnosis of fibromyalgia can be more difficult to achieve. No lab or diagnostic test exists that can accurately confirm a diagnosis. Your doctor may try to first rule out conditions with similar symptoms through blood tests.

Polymyalgia rheumatica is primarily diagnosed by symptoms that include pain and stiffness of both shoulders and hips and with an elevated inflammatory blood test (ESR). First-line treatment usually involves corticosteroids such as prednisone to quickly relieve symptoms.

Fibromyalgia treatments take a combination approach to fighting fatigue as well as pain. Your doctor may recommend over-the-counter options like Tylenol or ibuprofen. They may also suggest antidepressant medications to manage pain and to help with sleep problems. Other medications that are available specifically for fibromyalgia include:

  • Cymbalta
  • Lyrica
  • Savella

However, research has shown that exercise is the most beneficial.

Medicines may be one option that your doctor suggests to combat the discomfort of polymyalgia rheumatica and fibromyalgia, but they’re not the only thing that can help. An anti-inflammatory diet, regular exercise, and good sleep can make a big difference in managing symptoms.

If you have polymyalgia rheumatica you can also take steps to make your daily tasks go more smoothly. For example, use rolling suitcases when you travel and avoid wearing high heels to prevent falls. People with fibromyalgia can feel better by practicing good sleep habits and pacing their activities to avoid overdoing it.

Experiencing the symptoms of either polymyalgia rheumatica or fibromyalgia can be challenging and frustrating. People with polymyalgia rheumatica usually have to take with daily medication to reduce their pain and stiffness.

In addition to dealing with pain and fatigue, people with fibromyalgia may also sometimes feel misunderstood by others who don’t have the condition — even those in the healthcare community.

Use what you know about your condition to seek support from family, friends, co-workers, and your doctor. Taking steps to manage your symptoms can bring a feeling of control as well as relief.