Fibromyalgia is a frequent cause for musculoskeletal pain. It is characterized by aching, stiffness, tender trigger points, and fatigue. Patients often complain of waking up feeling exhausted. They also state that they feel like they've "been beaten up." Patients with fibromyalgia often have other symptoms such as decreased short term memory and hypersensitivity to environmental stimuli such as sounds, smells, and lights. Weather changes seem to aggravate the symptoms.
Fibromyalgia (FM) may either be primary, meaning it occurs by itself with no other underlying disease process being present. Or it may be secondary to or associated with other types of arthritis. For example FM is frequently associated with rheumatoid arthritis, systemic lupus erythematosus, and Lyme disease.
It is difficult to estimate what percentage of RA patients also have FM, since there are features common to both conditions. It is safe to say that during the course of RA, a patient will also have flares of FM. The distinction between a flare of FM versus a flare of RA may be difficult to make.
Rheumatoid arthritis is also characterized by aches and pains as well as fatigue. Weather changes also tend to cause flares or magnify flares.
Features that sometimes help are the presence of obvious synovial inflammation and elevation in laboratory measures such as the erythrocyte sedimentation rate or C-reactive protein. Magnetic resonance imaging and ultrasound may also be helpful in making the distinction between RA flare versus FM flare. Occasionally both conditions flare concurrently making the diagnostic confusion even greater.
Making the distinction between a flare of RA versus a flare of FM is critical. The treatments are very different.
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