What’s the Difference Between Rheumatoid Arthritis and Fibromyalgia?
When to see a doctor
Rheumatoid arthritis (RA) and fibromyalgia are two different conditions with some similar symptoms. These include:
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 central pain disorder marked by musculoskeletal pain and symptoms of fatigue, trouble sleeping, and problems with memory and mood.
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.
Below, we’ll take a closer look at the differences between RA and fibromyalgia, including how the symptoms of each condition differ and how they’re diagnosed and treated.
How do the symptoms of rheumatoid arthritis and fibromyalgia differ?
While both RA and fibromyalgia have similar symptoms, the causes of each symptom — as well as the way people with each condition experience them — can be different.
Experiencing pain is common in each condition, but the triggers aren’t the same. One of the most significant differences between RA and fibromyalgia is inflammation. Fibromyalgia pain isn’t from 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.
Many people with fibromyalgia initially report pain that’s localized to one place, such as the neck and shoulders or the back. However, pain often spreads to other locations as time passes. It’s also not uncommon for people with fibromyalgia to experience other pain symptoms, such as:
frequent headaches, which can include migraine
numbness and tingling
abdominal cramping or pelvic pain
face and jaw pain
People with RA or fibromyalgia can also have problems with attention and concentration. One of the reasons for this may be that the pain associated with these conditions can make it more difficult to focus your attention or concentrate on things.
This effect appears to be more pronounced in individuals with fibromyalgia. A 2021 studyTrusted Source found that, when compared with those with RA or with individuals without either condition, people with fibromyalgia had longer reaction times and made more errors during an attention test.
Sleep disturbances and fatigue
Both of these conditions can cause sleep disturbances and fatigue. However, sleep problems in people with fibromyalgia tend to be more draining.
A preliminary 2013 study found that women with fibromyalgia reported greater daytime sleepiness and fatigue than women with RA. However, based on the results of a multiple sleep latency test, women with fibromyalgia actually had less objective daytime sleepiness compared with women with RA.
A 2015 study found that reduced sleep affected women with fibromyalgia more than it affected women with RA. Women with fibromyalgia reported feeling more daytime sleepiness and needed a longer recovery time.
With RA, fatigue can also be a result of inflammation and anemia. Anemia, or the lack of red blood cells, affects more than 50 percentTrusted Source of people with RA.
Depression and anxiety
Feelings of depression and anxiety are common symptoms of both fibromyalgia and RA. These feelings can affect your quality of life.
An older 2007 studyTrusted Source found that these feelings weren’t statistically different between people with RA and fibromyalgia. This is supported by a more recent 2018 studyTrusted Source that found that individuals experiencing chronic pain are more likely to have a mental health condition diagnosed, regardless of whether or not they had fibromyalgia.
Still, addressing mental health concerns in RA and fibromyalgia is very important. In fact, a 2020 studyTrusted Source found that people with rheumatic conditions like RA and fibromyalgia are at an increased risk of self-harm compared with the general population.
Distinct symptoms of rheumatoid arthritis
With RA, symptoms will often flare up periodically. Common RA symptoms include:
joint pain and tenderness
joint stiffness, particularly in the morning
red, swollen joints
firm lumps, called nodules, that appear under the skin
low grade fever
loss of appetite
Inflammation from RA can also affect other parts of your body. Approximately 18 to 41 percent Trusted Sourceof people with RA experience these types of symptoms, which can have the following impacts:
eyes: dryness, sensitivity to light, and impaired vision
mouth: dryness, irritation, or infection of the gums
lungs: shortness of breath
heart: cardiovascular disease and stroke
blood vessels: organ, skin, or nerve damage
Distinct symptoms of fibromyalgia
The symptoms of fibromyalgia resemble the 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 in the following areas:
back of the head
You may also have:
trouble with memory, often called “fibro fog“
restless legs syndrome
irritable bowel syndrome (IBS)
temporomandibular disorder (TMJ)
Fibromyalgia pain can appear in the joints and muscles, but fibromyalgia doesn’t damage your joints the way that arthritis can. It also doesn’t damage your muscles or other soft tissues. The pain of fibromyalgia can worsen arthritis pain.
Diagnosing rheumatoid arthritis vs. fibromyalgia
Doctors use different techniques to diagnose RA and fibromyalgia. In each case, you’ll want to give a doctor or other healthcare professional as much information as possible about your medical history and the symptoms you’re experiencing.
Diagnosing rheumatoid arthritis
There’s no single test for RA, so a doctor will first need to take a detailed medical history and a do a complete physical examination. They’ll also conduct several tests to help confirm an RA diagnosis.
These tests may include:
a review of you and your family’s medical history
a physical exam to look for joint tenderness, swelling, and pain
blood tests to look for signs of inflammation in the body, such as tests for C-reactive protein and your erythrocyte sedimentation rate
auto-antibody tests for the rheumatoid factor antibody, which in combination with an anti-cyclic citrullinated peptide (anti-CCP) test increases the chances of an accurate RA diagnosis
imaging tests, such ultrasound or X-ray, to look for joint damage or inflammation
A doctor will immediately initiate treatment if you have RA. This is because, 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.
If your tests are negative for some of the common markers for RA, it’s still possible RA may present. These tests can sometimes come back negative for people who have RA.
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