Aching joints, especially in the cold winter months, affect millions of people around the world. Experts say it can be due to fibromyalgia because the primary symptom of this disorder is widespread musculoskeletal pain, including joint pain, which mimics other conditions like arthritis, making it difficult to distinguish.

There is no single definitive test for fibromyalgia and its symptoms can overlap with other conditions. “It is not uncommon to see these patients being told, “It’s all in your head,” Dr. Abhishek Patil, HOD and Consultant, Rheumatology, Manipal Hospital, told Times Now.

According to Dr. Patil, the experience is real; the threat perception is higher in these patients, and soothing mechanisms are impaired. “Thus, they tend to be always in a “flight or fight” state. This leaves the patients with chronic fatigue due to sympathetic overdrive. They also have altered levels of chemicals that transmit signals in the brain, which leads to excess sensitivity of the neural network to non-painful stimuli,” he added.

Doctors say fibromyalgia and rheumatoid arthritis differ in their symptoms and causes. Fibromyalgia typically causes pain and tenderness throughout the body, while RA tends to cause pain, inflammation, and tenderness in certain joints. The physical inflammation of joints as a cause of pain is a key difference between fibromyalgia and RA. “Various associated features include fatigue, brain fog, sleep disturbance, abdominal pain, etc. Typically, extensive laboratory evaluation in these patients yields normal results,” said Dr. Patil.

Many times, the patients are subjected to arthritis-specific tests like rheumatoid factor, antinuclear antibodies, anti-cyclic citrullinated peptide antibodies, human leukocyte antigen (HLA-B27), etc. Here, it is important to note that a considerable proportion of the normal population can have low titer positivity for these antibodies. “ANA is positive in 4-5 per cent of normal females, and RF is positive in 3-15% of the population. Thus, a person suffering from FM may get a positive RF/ANA or any other tests, which can lead to misdiagnosis and exposure to arthritis medications without actually suffering from one,” Dr. Patil added.

Fibromyalgia also changes the way your brain and nervous system process and interpret pain. Those who have the condition often feel pain and tenderness throughout their body and amplified pain when they experience everyday injuries.

And since RA is an autoimmune condition, it can lead your immune system to harm the synovial tissues lining the joints, causing inflammation and pain. Over time, RA can cause permanent damage to the bones and connective tissues in the joints.

There are a few differentiating points in fibromyalgia from inflammatory arthritis:

• No swelling in joints
• Not associated with prolonged fever
• No rashes
• Weight loss

Normal results on routine lab parameters such as hemogram, liver, and kidney functions with normal inflammatory markers (such as ESR/CRP). However, the most important part of diagnosis is a careful clinical evaluation by a specialist to look for and rule out inflammatory rheumatic diseases.

While medications for RA and fibromyalgia both aim to reduce pain, their mechanisms are different. According to experts, there is no singular medication that can treat or cure fibromyalgia. However, pain management medications can reduce symptoms.

For RA, it is important to treat it early to mitigate the symptoms that can help reduce inflammation and slow the condition’s progression. To treat the symptoms of both RA and fibromyalgia, you must take the following steps:

When your symptoms get worse, it is often helpful to rest the affected areas.

Exercise

A few symptoms can cause many people to avoid exercise. However, gentle, low-impact exercises that focus on stretching and strengthening muscles and joints can ease the signs.

Eating fewer foods that cause inflammation can improve symptoms of both conditions, like limiting the intake of saturated fats, sugars, red meats, and alcohol.

You can ease the symptoms by taking long, warm baths and using heating pads and ice packs.

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