Are Rheumatoid Arthritis and Fibromyalgia Related: what’s the link?

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Both conditions cause pain and sleep disturbances, and they can occur together, adding insult to misery. But rheumatoid arthritis and fibromyalgia are distinct entities with different physiological origins. Even so, people who have rheumatoid arthritis (RA) have a greater risk of having fibromyalgia — up to 30 percent of people with RA will also develop fibromyalgia, according to the Arthritis Foundation, — though no one knows exactly why.

The Basics: Rheumatoid arthritis is an autoimmune disease in which the person’s immune system erroneously attacks the joints, causing inflammation inside and around the joints, leading to pain, swelling, and stiffness and compromising the joints’ ability to move normally. Approximately 1.5 million people in the United States have rheumatoid arthritis (RA).By contrast, fibromyalgia is not an autoimmune disorder but rather a syndrome of unknown origins that causes widespread pain, mostly in the muscles, as well as fatigue, and mood changes.

With both conditions, pain is the common denominator, though it tends to occur in different locations. There aren’t specific diagnostic tests for either RA or fibromyalgia. When it comes to RA, doctors look for certain criteria during a medical exam and while taking a medical history, including persistent joint pain, tenderness, swelling or stiffness; morning stiffness that lasts at least 30 minutes; and symmetrical symptoms (both ankles or hands are affected, for example). “With RA, there are visible signs — the joints are red, hot, and swollen, especially in the wrists, ankles, fingers, and knees,”

Fibromyalgia is also diagnosed during a physical exam, accompanied by a health history assessment. The hallmark of fibromyalgia is “longstanding diffuse pain in tender points throughout the body,” Kaplan explains. “It’s often hard for people to tell where the pain is coming from — they just know that they hurt.” To make the diagnosis, a physician will assess pain in 19 areas of the body (tender points) as well as other symptoms such as fatigue, waking up from sleep feeling unrefreshed, and cognitive (thinking and memory) problems.

Double Trouble: When the two conditions occur together (a phenomenon called “comorbidity”), “usually rheumatoid arthritis is first then the person develops secondary fibromyalgia,” Kaplan says. “But they may or may not be diagnosed in that order.”One of the key differences between the conditions is “that RA is associated with inflammation of the lining of the joints, which can lead to damage and deformities,” Dr. Gota says. Fibromyalgia doesn’t cause “any damage to joints,

Treatment For RA and Fibromyalgia: Unfortunately, there isn’t a cure for either condition, and each needs to be treated individually. With RA, the primary goals are to stop the inflammation, slow damage to the joints, and decrease the disease’s rate of progression, which can be achieved with the newer disease-modifying anti-rheumatic drugs (DMARDs, for short) and biologic therapies, Kaplan explains.

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