Rheumatoid Arthritis vs Fibromyalgia: What’s the Difference?

Pain comes in many shapes and sizes – not just big, small, burning, or aching, but chronic, progressive, acute, waning, episodic, and constant. Pain can differ from person to person and from condition to condition. But that makes it difficult to tell what kind of pain a person is experiencing – and why. Understanding where your pain comes from is often the first step to addressing it. In the case of chronic health conditions like arthritis or fibromyalgia, it is often the other non-pain symptoms that help provide the most significant clues. Both rheumatoid arthritis and fibromyalgia share major symptoms, such as chronic joint pain, inflammation, and fatigue. But there are key differences in diagnosis, as well as treatment.

Understanding and Living With Rheumatoid Arthritis

Rheumatoid arthritis (RA) is one of over a hundred different categorizations of arthritic pain, and it is one of the most common types of arthritis. Arthritis generally describes any health condition with a primary characteristic of joint swelling and inflammation; rheumatoid arthritis is an autoimmune disorder caused by an attack on the tissue between your bones by your body’s cells. Unlike osteoarthritis, also known as wear-and-tear arthritis, the damage comes from within.

Rheumatoid arthritis is named such because it primarily affects soft tissue and connective tissue. Unlike other types of arthritis that are mainly limited to joint pain, RA often spreads to other parts of the body – including the lungs, heart, eyes, skin, bone marrow, and nerve tissue. The result of severe RA is systemic pain, fatigue, and disability. Like other forms of arthritis, symptoms can come and go in flares accompanied by swelling.

Understanding and Living With Fibromyalgia

Fibromyalgia is an oft-misunderstood and still understudied chronic pain condition. Sometimes conflated or mistaken for other chronic pain conditions (such as RA and myalgic encephalomyelitis/chronic fatigue syndrome), fibromyalgia is its diagnosis characterized by chronic exhaustion, systemic pain, musculoskeletal pain and inflammation, poor sleep or insomnia, and cognitive problems – especially memory loss and inability to focus. Fibromyalgia is often diagnosed alongside at least one other chronic pain condition. Usually, these conditions include:

• Migraines or other forms of chronic headaches;
• Irritable bowel syndrome (IBS);
• Interstitial cystitis (painful bladder syndrome);
• Temporomandibular joint (TMJ) disorder;
• Mental health issues, especially anxiety disorders and depression.

Rheumatoid Arthritis vs Fibromyalgia Symptoms

While RA and fibromyalgia symptoms are similar, the causes of each symptom — as well as the way people with each condition experience them — can be entirely unique. On the surface, both disorders are characterized by chronic widespread pain and fatigue. And although RA and fibromyalgia share many symptoms in common, each condition also has its own unique set of symptoms.

Rheumatoid Arthritis Symptoms

• Chronic fatigue, or “RA fatigue,” that’s often described as deep tiredness or slowing down, akin to the feeling while recovering from the flu.
• Can attack the skin, lungs, and other organs but primarily affects the lining of your joints, especially extremities like fingers, wrists, feet, and elbows.
• Causes swollen, red joints.
• Shows clear signs of inflammation, including swollen lymph nodes, increased tenderness, and a long-lasting low-grade fever.
• Can cause symptoms in your organs, including dry eyes, shortness of breath, sensitivity to light, skin discoloration, and anemia.
• Blood tests can help physicians identify markers of inflammation and a potential autoimmune disorder.

Fibromyalgia Symptoms

• Pain is widespread but often affects the muscles first. It must also occur in multiple locations – not just one side of the body or above the waist, but above and below, on both the left and the right.
• Is harder to identify physically. A person with fibromyalgia might not experience any swelling or clear indications of inflammation but can still feel chronic, draining pain.
• Has a unique form of mental fatigue called “fibro fog.” Patients frequently struggle with concentration, memory, and mood swings. These symptoms must occur separately from the distraction that the pain itself creates.
• Fibromyalgia fatigue is omnipresent, meaning you can wake up from a long rest and feel tired like you haven’t slept.
• Patients with fibromyalgia are more likely to suffer from symmetric pains on specific points of their body, including the knees, elbows, collarbone, and back of the head. Furthermore, they are more likely to experience symptoms of co-occurring physical conditions such as IBS, TMJ, and migraine.
• Most diagnostic tests include ruling out other causes rather than finding any physical signs of fibromyalgia. This is because there are few good tests to explain or single out fibromyalgia pain, and is only considered if the pain has remained consistent for at least three months.

Rheumatoid Arthritis vs Fibromyalgia Treatments

While rheumatoid arthritis (RA) vs fibromyalgia symptoms are similar, the causes greatly differ. As such, the causes of these conditions are generally the influencing factors for determining treatment.

Rheumatoid Arthritis Treatment

Rheumatoid arthritis is often treated with specific medication, such as disease-modifying antirheumatic drugs (DMARDs) and biological medicines. DMARDs focus on slowing and reducing the rate at which rheumatic inflammation spreads. They work differently from over-the-counter anti-inflammatories like ibuprofen, which can reduce swelling temporarily but do not slow down rheumatic arthritis. In the meantime, biological drugs block specific immune functions to reduce the body’s autoimmune response. Pain management is another treatment element that both fibromyalgia and rheumatoid arthritis share.

Fibromyalgia Treatment

In cases of fibromyalgia, a tailored and comprehensive pain management plan is often the only practical course of treatment. This includes physical therapies and mental health treatment to address mood changes and higher rates of anxiety and depression – both of which can lead to lower pain thresholds and hyperalgesia. Treatments may be trial and error at first. There are a variety of antirheumatic drugs, as well as conventional painkillers.

The Final Takeaway

Finding a treatment approach that works best for you can take time, which is why working with pain specialists is essential. A dedicated pain clinic can help you find the proper modalities for your condition and live a better life.