Woman sitting on edge of bed holding her lower back
Stiffness, in particular in the morning, is a symptom of both fibromyalgia and arthritis.

Arthritis and Fibromyalgia

Arthritis and fibromyalgia are two conditions that cause chronic pain among other symptoms. Although the causes of arthritis and fibromyalgia are quite different, there can be some overlap between the two conditions and this can make diagnosis more complex.

In this article, we explore the link between arthritis and fibromyalgia, along with some treatment options for these two conditions.

Is Arthritis Common in Fibromyalgia Patients?

There is some overlap between arthritis and fibromyalgia. Patients with arthritis are thought to be more likely to develop fibromyalgia, although patients with fibromyalgia appear to have the same risk of developing arthritis as the general population.

Additionally, a 2015 survey shows that the diagnosis of fibromyalgia and arthritis can often be confused. It found that of the patients who met the diagnostic criteria for fibromyalgia, only 27% had been diagnosed with this condition while 15.3% had been diagnosed with rheumatoid arthritis, 3.3% with gout, 1.4% with lupus and 21.7% with lower back pain.

Of course, it is possible that the patients in the study were suffering from arthritis and fibromyalgia at the same time. Research shows that as many as 41.9% of rheumatoid arthritis patients are also affected by fibromyalgia. These patients experience more symptoms, use more medication and have a lower quality of life than those with arthritis alone. Another study found that 53.33% of patients with psoriatic arthritis also suffer from fibromyalgia. In comparison, fibromyalgia only affected 4.54% of healthy control subjects.

The exact link between arthritis and fibromyalgia is unclear but one theory is that arthritis patients may undergo changes in the way their nervous systems process pain signals. This idea is supported by research on osteoarthritis and fibromyalgia that shows that the brains of patients with both conditions react to pain in a similar way.

Symptoms of Fibromyalgia and Arthritis

There are many similarities in the symptoms of fibromyalgia and arthritis, especially rheumatoid arthritis. Both conditions can cause the following issues:

  • Pain
  • Stiffness, which may be worse on waking
  • Sleep disturbances
  • Fatigue
  • Increased risk of anxiety or depression

However, there are also some key differences between the symptoms. Firstly, arthritis is an inflammatory condition. It causes swelling and tenderness of the joints that may become damaged and deformed over time.

Fibromyalgia, on the other hand, is not considered an inflammatory disease. It is thought to be caused by an imbalance in neurotransmitters which increases sensitivity to pain. However, people with fibromyalgia may still suffer from inflammation from other co-existing conditions.

Secondly, arthritis only affects the joints while fibromyalgia causes pain throughout the whole body. The pain from arthritis can come and go but with fibromyalgia it is usually present all the time.

Finally, people with fibromyalgia may also suffer from problems with concentration and memory, a phenomenon sometimes known as "fibro fog." Although people with arthritis can often have trouble sleeping or feel tired during the day, they do not usually experience these symptoms.

If a person is suffering from both conditions, they could have a combination of symptoms. This can make it difficult to get an accurate diagnosis and receive the right treatment. Fortunately, there are several treatments that can help with both symptoms at the same time.

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Treatment for Fibromyalgia and Arthritis

There are many similarities and also some differences when it comes to treatment. Let’s take a closer look.

Medication

Both conditions cause pain, and so medication such as painkillers and anti-inflammatory drugs may help. However, arthritis may respond better to anti-inflammatory medication such as non-steroidal anti-inflammatory drugs (NSAIDs) and steroids, whereas fibromyalgia might be better treated with analgesics such as acetaminophen.

Other drugs for arthritis include disease modifying anti-rheumatic drugs (DMARDs) and biologic agents. These medications suppress the immune system and can benefit patients with autoimmune disorders such as rheumatoid and psoriatic arthritis. Patients with fibromyalgia will not experience relief from these drugs, but may be helped by antidepressants or antiseizure medications that have an effect on the central nervous system.

Exercise

Both conditions have symptoms can be improved with exercise. A combination of aerobic activities to raise the heart rate and muscle strengthening exercises is best. The ideal amount of physical activity for all adults is around 30 minutes each day. If this is too much to handle in one go, it can be broken up into smaller chunks, for example three 10-minute sessions a day.

Whatever exercise you choose to do, start off slowly and increase the intensity over time to avoid injuries. Your physical therapist can advise you on the best exercises to help manage your symptoms as well as checking that you know the correct techniques.

Stress Management

Stress can make pain symptoms seem worse, and so learning to manage it can be helpful for people with both conditions. There are many different options for keeping your stress levels under control. These include yoga, meditation and breathing exercises. You could also try a therapy, such as acupuncture or massage to help you relax and manage pain.

Cognitive behavioral therapy (CBT) is another useful therapy for people suffering from chronic pain. It can teach you coping strategies and ways to manage symptoms such as anxiety and depression.

Sleep

Both conditions can cause sleep problems. Improve your chances of getting a good night’s rest by going to bed and getting up at the same time each day, making your bedroom as comfortable as possible and doing something relaxing before bed. You should also avoid drinking alcohol or caffeine and looking at electronic screens in the evening. All of these activities can interfere with your sleep and contribute to tiredness the following day.

The way that you manage your fibromyalgia and arthritis is very individual and what works well for one person may not do anything for the next. Discuss your symptoms with your health care provider to find a regime that is effective for you.