Joint pain, especially during the harsh winter months, affects millions of people around the world. Experts say it could 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 differentiate.

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

According to Dr. Patil, the experience is real; Threat perception is heightened in these patients, and soothing mechanisms are impaired. “Thus, they are always in a state of “flight or fight.” This leaves patients with chronic fatigue due to sympathetic overexcitation. They also alter the levels of chemicals that transmit signals in the brain, leading to heightened sensitivity of neural networks to non-painful stimuli,” he said.

Why is fibromyalgia misdiagnosed as rheumatoid arthritis?

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

At times, patients are subjected to arthritis-specific tests such as rheumatoid factor, antinuclear antibody, anti-cyclic citrullinated peptide antibody, human leukocyte antigen (HLA-B27), etc. Here, it is important to note that a large part of this may be due to low titer positivity for these antibodies in the general population. “In the general population 4-5% of women are ANA positive, and 3-15% of the population are RF positive. Thus, a person suffering from FM may have a positive RF/ANA or any other test, leading to misdiagnosis and exposure to arthritis medications without actually suffering from it,” said Dr. Patil. .

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

And since RA is an autoimmune condition, it can cause your immune system to damage 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.

Difference Between Fibromyalgia and Other Joint Disorders

Some of the points distinguishing fibromyalgia from inflammatory arthritis are:

• there is no swelling in the joints
• not associated with prolonged fever
• no rashes
• weight loss

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

Medical Treatment for Fibromyalgia

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

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

rest during a flare up

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

Exercise

Some symptoms may cause many people to stay away from exercise. However, gentle, low-impact exercises that focus on stretching and strengthening muscles and joints can reduce symptoms.

anti inflammatory diet

Eating fewer foods that cause inflammation may improve symptoms of both conditions, such as limiting intake of saturated fats, sugars, red meat and alcohol.

hold and cold therapies

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

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