Fibromyalgia vs. Polymyalgia Rheumatica: Understanding the Key Differences
Having trouble telling fibromyalgia apart from polymyalgia rheumatica? There are some key differences. Fibromyalgia can strike individuals of any age and is known for causing chronic, widespread pain, whereas polymyalgia rheumatica typically affects those over 55 years old and concentrates pain in the shoulders and hips.
This article will break down the characteristics of each condition, including their diagnosis and treatment methods so you can be better informed on how to tell the difference between these two conditions.
What is fibromyalgia?
Fibromyalgia is characterized by chronic widespread pain , among other symptoms, that persistently invades the body like an unwanted visitor refusing to leave and it often affects younger to middle-aged individuals.
This pervasive pain throughout the body in people who live with fibromyalgia patients is primarily due to central sensitization – a phenomenon where their nervous system excessively heightens and misinterprets sensory information. This heightened response can result in widespread pain even from normally non-painful stimuli.
What is polymyalgia rheumatica?
Polymyalgia rheumatica is an inflammatory disease that affects your muscles, and it's something you usually see in people over 50 years old1. We're not entirely sure what causes it, but doctors think it might be an autoimmune condition – that's when your immune system gets confused and starts attacking your own body, in this case, the connective tissues2.
This disease doesn't spread pain all over like fibromyalgia. Instead, it shows up as pain and stiffness in certain parts of your body.
How can you tell the difference between the two?
There are certain differences between these two conditions. Polymyalgia rheumatica usually shows up in people over 50 years old and is thought to be an autoimmune disease. Blood tests often find signs of inflammation. On the other hand, fibromyalgia can start at any age and it's not classified as an autoimmune disease.
What are the symptoms of fibromyalgia vs polymyalgia
Fibromyalgia and polymyalgia rheumatica are distinguishable by their unique symptoms. The former is recognized by persistent, all-encompassing pain, with doctors assessing 18 specific tender points on the body to diagnose it.
On the other hand, polymyalgia rheumatica is characterized by sharp pain and stiffness that are confined to particular regions.
Fibromyalgia
In addition to pain throughout the body that lasts for at least three months, fibromyalgia brings along other problems too, such as:
- fatigue and feeling tired all the time
- having a hard time thinking clearly and remembering things, known as “fibro fog”
- not sleeping well and finding it tough to fall asleep
- mood disturbances such as depression or anxiety.
There are many other symptoms that can also show up with fibro.
Polymyalgia
The primary symptoms of polymyalgia are severe stiffness and pain in the muscles of the neck, shoulder and hip areas. Inflammation within the muscles surrounding these areas induces the characteristic muscle pain and stiffness5. and it can significantly restrict movement in these areas, especially after periods of immobility. It is also possible to feel pain or stiffness extending into your wrists, elbows, or knees.
People with this condition also may have flu-like symptoms, including fever, weakness and weight loss. However, unlike fibromyalgia’s persistent nature, this discomfort typically dissipates within an hour.
Approximately 15% develop a potentially dangerous condition called giant cell arteritis – an inflammation of the arteries3. Symptoms such as headaches and blurred vision could mean giant cell arteritis4.
Is polymyalgia rheumatica worse than fibromyalgia?
Neither fibromyalgia or polymyalgia rheumatica is necessarily worse or tougher to deal with. Each one comes with its own set of challenges.
Think of fibromyalgia like a constant, uninvited guest that just won't leave. It can make you feel pain all over, all the time. This might make it seem harder for you to handle as time goes on, because you have to accept that this pain is sticking around for the long haul.
On the other hand, polymyalgia rheumatica can really limit what you can do because of the intense stiffness and pain, although the silver lining is that this condition might go away after some time has passed.
Diagnosing fibromyalgia & polymyalgia rheumatica
Diagnosing fibromyalgia or polymyalgia rheumatica can be like solving a complex puzzle, especially because neither condition has a single test to confirm whether you have it or not.
For both conditions, your physician will look at your medical history and your symptoms and do a physical exam. They will probably also conduct blood tests or other scans.
For polymyalgia rheumatica, the doctor will be looking for signs of inflammation, such as C-reactive protein and the sedimentation rate6. Another clue is how you respond to a specific type of anti-inflammatory medicine called glucocorticoids7. For fibromyalgia, the doctor will be ruling out other conditions that have similar symptoms, and will be particularly keen to understand your experience – where you feel pain, whether it changes or moves around, and any other symptoms that you experience.
Treatment approaches for fibromyalgia & polymyalgia rheumatica
In the management of pain related to both fibromyalgia and polymyalgia rheumatica, a holistic, multidisciplinary strategy is necessary.
Polymyalgia
Treatment for polymyalgia is targeted at relieving inflammation and corticosteroids are commonly used8. These are strong anti-inflammatory drugs that can quickly reduce pain and stiffness. However, finding the right amount to take can be a bit like adjusting a radio dial to get the clearest signal – we need to use just enough to control your symptoms without causing other problems.
Sometimes, another medicine called methotrexate is used together with corticosteroids to help your body deal with the inflammation. Alongside medication, staying active with exercises and working with a physical therapist can help keep your muscles strong and reduce pain.
Polymyalgia rheumatica might not last forever. In fact, it's possible for it to go away after a few years.
Fibromyalgia
Treating fibromyalgia involves a multi-disciplinary approach that targets the broader aspects of the condition itself. It involves a holistic approach to training your body to avoid fibromyalgia triggers and respond to these flare-ups.
Retraining your pain
Chronic pain can be affected by how we think and feel, including whether we're feeling stressed!
Techniques that help us to relax also help our brains to deal with pain better. Tools such as cognitive behavioral therapy and mindfulness meditation can teach us to notice when we're getting stressed and help us relax, so the pain doesn't feel so intense, or as emotionally distressing.
Exercise & physical therapy
Moving when you're in pain might seem counterintuitive, but research shows that exercises to make your muscles stronger can help lessen pain for people with fibromyalgia9. It can also increase mood, boost energy, and help you get better sleep!
When you become more active – and it doesn't have to be formal exercise, any sort of movement or physical activity helps – start slowly and increase the difficulty bit by bit. This way, you won't make your symptoms worse.
If you keep doing these exercises, you might not only feel less pain but also feel better overall and be able to do more things.
Medications
While incorporating medication into your overall pain management strategy is beneficial, it's crucial to view it as one component among many. Medications are tools that support your participation in other effective strategies for managing pain, such as educational resources, lifestyle changes, and psychological support.
A variety of medications are commonly prescribed to alleviate fibromyalgia pain, including:
- non-prescription drugs such as aspirin and ibuprofen
- antidepressants, for example, amitriptyline and duloxetine, which can both alleviate pain and elevate mood
- modulators for pain and inflammation such as Low Dose Naltrexone (LDN)
- medications typically used for epilepsy, like pregabalin and gabapentin, can be effective in managing an overactive nervous system.
Consulting with your healthcare provider is the best way to determine the most appropriate medications for your unique circumstances.
More information
At MoreGoodDays®, we're passionate about helping you handle fibromyalgia better. Our simple guides and tips are made to teach you about fibromyalgia and give you ideas on how to deal with the variety of symptoms you might be feeling, so that you can get back to the life you want to live.
We're here to help you find ways to feel better and have more fun days, even when fibromyalgia is a part of your life.
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