Multiple sclerosis (MS) and fibromyalgia are very different conditions. However, they sometimes share similar symptoms and signs.
Both conditions require a variety of medical tests for a diagnosis. Before you begin any tests, you may be able to distinguish your symptoms and decide if they’re signs of one of these conditions. Your doctor can help, too.
Fibromyalgia is characterized by musculoskeletal pain that affects the entire body. In addition to chronic pain, fibromyalgia causes increased drowsiness and fatigue, as well as mood and memory issues.
Medical researchers and doctors don’t fully understand what causes fibromyalgia. However, it’s believed the condition amplifies the natural pain sensations. In other words, people with fibromyalgia appear to experience normal pain in an overly painful way.
Multiple sclerosis (MS) is an autoimmune neurological condition that destroys the protective coating (myelin) that surrounds the nerves. MS causes the body to mistake the healthy myelin that surrounds the nerves as foreign.
MS destroys the myelin and eventually causes the nerves to no longer be able to function as they should. Over time, MS can completely destroy the myelin. It may then begin attacking and destroying the nerves themselves.
While these two conditions share some symptoms, they also have distinct symptoms of their own.
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Pain associated with fibromyalgia is chronic and widespread. It’s described as a dull, aching pain. To be classified as fibromyalgia, a person must experience the chronic pain for at least 3 months. Also, the pain must occur on both sides of the body, above and below the waist.
Other symptoms of fibromyalgia include:
- Memory issues. “Fibro fog” is a term applied to the confusion, difficulty focusing and concentrating, and changes in memory that people with fibromyalgia often experience.
- Mood changes. Depression is not uncommon in people with fibromyalgia. Also, people with fibromyalgia sometimes experience mood swings.
- Chronic fatigue. Fibromyalgia causes a great deal of fatigue. People with fibromyalgia are prone to long periods of sleep and rest. However, many people with fibromyalgia also have sleep disorders, such as sleep apnea and restless leg syndrome.
MS destroys the protective coating around your nerves and eventually the nerves themselves. Once damaged, the nerves may not be able to feel or experience sensations as well as healthy nerves.
The symptoms associated with MS vary depending on the amount of nerve damage and which nerves are affected. It’s common for people who have MS to have significant chronic pain, eventually experiencing numbness and weakness in affected areas. Tingling and mild pain can occur, too.
Other symptoms of MS include:
- Difficulty walking. You may develop an unsteady gait and have trouble walking. Coordination and balance are also challenged.
- Slurred speech. As the myelin is worn away, communication from the brain may slow down. This can make speech seem more difficult, and you may have a harder time speaking clearly.
- Vision problems. Vision disturbances like double vision and complete or total vision loss can occur. Eye pain is common, too.
Diagnosing either condition can be difficult for doctors. In many cases, a doctor will come to one or the other condition after they’ve ruled out other possible causes for your symptoms.
Fibromyalgia is diagnosed if your doctor can’t find any other explanation for your whole-body pain. The pain will also need to have occurred for at least 3 months.
There’s no specific test that can be used to diagnose fibromyalgia. Instead, a doctor will make a diagnosis off a group of symptoms, one of which is widespread pain.
Doctors often also use “tender points” to diagnosis fibromyalgia. What this means is that people with fibromyalgia feel additional pain when a doctor applies firm pressure to these sensitive points on the body.
MS isn’t diagnosed with a single test or procedure. If other conditions are ruled out, an MRI can detect lesions on your brain and spinal cord. Additionally, your doctor may conduct a spinal tap.
During this procedure, your doctor will remove a small sample of spinal fluid and test it for antibodies that are associated with MS.
Once a diagnosis has been made for either fibromyalgia or MS, your doctor will suggest different treatments to help treat symptoms and improve your quality of life. Just as the two conditions are different, treatment options for the two conditions differ.
There are a variety of different types of treatment options for fibromyalgia, including over-the-counter (OTC) drugs, prescription medications, and alternative treatments.
OTC solutions include:
Prescription medications include:
- antidepressants, such as duloxetine (Cymbalta)
- antiseizure medications, such as pregabalin (Lyrica)
Alternative treatments include:
- massage therapy
- tai chi
Lifestyle changes include:
- getting enough sleep
- exercising regularly
- limiting caffeine intake
- reducing stress
- adjusting diet
- physical therapy
As with fibromyalgia, there are a variety of treatments available for those with MS. These prescription treatments can reduce the inflammation and slow or change the course of disease progression.
Other treatments can help with symptom management and improve a person’s quality of life. These include OTC medications, alternative remedies, and lifestyle changes.
OTC medications, which are used to help relieve musculoskeletal pain, include:
- acetaminophen (Tylenol)
- ibuprofen (Advil, Motrin)
Prescription medications and interventions include:
- injectable medications, such as Avonex or Extavia
- oral medications, such as Aubagio and Tecfidera
- infused medications, such as Lemtrada
- high doses of Solu-Medrol (a steroid) for relapse management
- physical therapy for rehabilitation
- speech language pathology
Alternative treatments include:
- stress management
- cognitive behavioral therapy
Lifestyle changes include:
- eating a nutrient-dense, well-balanced diet that includes omega-3 fatty acids and is high in fiber and low in saturated fat
- exercising regularly, including stretching
No matter what method of treatment you’re currently on, discuss any new changes in your treatments with your doctor before you start them, even if they’re considered “natural” or “safe.” These could interfere with treatments or medications you’re currently taking.
Both MS and fibromyalgia are currently chronic, incurable conditions. Though treatments can alleviate symptoms and improve your overall quality of life, there are no cures available for either condition, and both tend to advance with time.
Fibromyalgia is not fatal. Because medications are limited, lifestyle and alternative remedies are an important part of treatment management.
In general, people with fibromyalgia who adapt to necessary lifestyle changes coupled with the help of medications can experience significant improvement in their symptoms.
Most people with MS will have an equivalent or almost equivalent life expectancy to that of the average person without MS. However, this isn’t generally the outlook for rare cases of severe MS.
People with MS may develop cancer or heart disease just like people without MS.
Symptoms in people with MS can be unpredictable, though most will see some amount of disease progression as time goes on. People with MS who experience more time between symptom attacks and relapses tend to do better and experience less severe symptoms.
Though they sometimes share similar symptoms, MS and fibromyalgia are two very different conditions. Understanding the differences can help you and your doctor start testing for the right condition earlier.
If you have unexplained symptoms that resemble one or both of these conditions, make an appointment with your doctor. They can begin investigating your symptoms to diagnose the cause and get you the treatment you need.
Both of these conditions are likely to be life-changing. As is true with many other conditions, getting treatment as soon as possible can help increase your comfort and quality of life. It can also potentially slow down the onset or advancement of symptoms.