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Fibromyalgia and RA

Fibromyalgia is a chronic condition involving pain and tenderness at points throughout the body. The term fibromyalgia comes from the Latin word “fibro” meaning “fibrous tissue” and the Greek words “myo” meaning “muscle” and “algia” meaning “pain.”

About 4 million people, or 2 percent of the U.S. population, has fibromyalgia.1 It sometimes occurs with rheumatic diseases including rheumatoid arthritis.

Symptoms of fibromyalgia

In addition to widespread body pain and tenderness, fibromyalgia comes with a range of other symptoms, including fatigue, memory or concentration problems, headaches, sleep problems, depression and anxiety, tingling or numbness in the hands and feet, and digestive problems.1 Unlike RA, fibromyalgia is not considered a type of arthritis and is not associated with joint inflammation and damage. However, like RA, fibromyalgia is considered a rheumatic condition, causing chronic pain that affects the joints and soft tissues.

Women are 10 times more likely to have fibromyalgia than men. The disorder is most often diagnosed in middle age, but it can affect young adults and children, as well. The cause or causes of fibromyalgia are not known. However, it is suspected that genetic and environmental factors may play a role in making a person more susceptible to the disorder.2

Fibromyalgia can occur commonly with RA

It is not uncommon for someone with RA to also have fibromyalgia, with one study finding 14 percent to 19 percent had both conditions. People who have both conditions tend to have more severe symptoms spanning both conditions, including greater pain, joint tenderness, and more severe depression.3

Who is at risk for fibromyalgia?

Studies have shown that heredity plays a role in susceptibility for fibromyalgia. In other words, fibromyalgia is more common in people who have family members who have or have had the disease. However, similar to rheumatoid arthritis, genetics is not the whole picture when it comes to risk for fibromyalgia. Environmental and psychological factors are also thought to play a role in increasing risk for the disorder.4

How is fibromyalgia diagnosed?

Because the pain and symptoms associated with fibromyalgia may be similar to those seen in many other diseases, it can be particularly difficult to diagnose the disorder. However, it can be useful to determine the exact location and pattern of pain.

People with fibromyalgia tend to feel pain, especially at points at the neck, shoulders, elbows, knees, hips, and lower back, for periods of longer than three months. Your doctor will ask you about other common symptoms such as fatigue, sleep problems, headaches, depression, anxiety, irritable bowel syndrome, jaw pain, and problems thinking or remembering. After a physical exam, your doctor may order x-rays and blood tests to rule out other conditions.5

What are treatment options for fibromyalgia?

Fibromyalgia is best treated with a combination of approaches, including medication and non-pharmacologic approaches, including exercise, cognitive-behavioral therapy, massage, and patient education. In fact, the American Pain Society Fibromyalgia Panel recommends a varied approach to the disorder.6

Medication for fibromyalgia may include an antidepressant to help decrease pain, improve overall well-being, and help with sleep problems. Tricyclic antidepressants (such as amitriptyline) can provide these benefits but are generally used short-term due to side effects. Muscle relaxants may help with pain and improve sleep but generally do not help with fatigue. Selective serotonin reuptake inhibitors (SSRIs) tend to help with the depression and fatigue common to fibromyalgia but do less to manage pain and improve sleep.7

Written by: Jonathan Simmons | Last reviewed: September 2019.
  1. Centers for Disease Control and Prevention. Fibromyalgia. Available at: https://www.cdc.gov/arthritis/basics/fibromyalgia.htm. Accessed on 9/20/19.
  2. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008;58:26-35.
  3. Wolfe F, Cathey MA, Kleinheksel SM. Fibrositis (Fibromyalgia) in rheumatoid arthritis. J Rheumatol 1984;11:814-8.
  4. Naranjo A, Ojeda S, Francisco F, et al. Fibromyalgia in patients with rheumatoid arthritis is associated with higher scores of disability. Ann Rheum Dis 2002;61:660-661.
  5. MedlinePlus. U.S. National Library of Medicine. Available at: https://medlineplus.gov/fibromyalgia.html. Accessed on 9/21/19.
  6. Chakrabarty S, Zoorob R. Fibromyalgia. Am Fam Physician 2007;76:247-54.
  7. Hawkins RA. Fibromyalgia: A Clinical Update. J Am Osteopath Assoc 2013;113(9):680–689. doi: 10.7556/jaoa.2013.034.