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A comprehensive look at Fibromyalgia pain, its symptoms, triggers, and effective strategies to manage and alleviate discomfort.

Have Asthma or COPD? You Could Have a Higher Risk of Rheumatoid Arthritis

Researchers hope that identifying the link between respiratory issues and RA will result in better ways to prevent or screen for rheumatoid arthritis in people with lung disease.

You may have already heard that people with rheumatoid arthritis (RA) are more likely to develop the serious lung disease chronic obstructive pulmonary disease (COPD), which makes it increasingly difficult to breathe. In 2017, Harvard researchers examined data from the huge Nurses’ Health Study and found that women with RA were about 68 percent more likely to develop COPD.

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Now, some of the same research team has combined data on 205,153 participants in two waves of the Nurses’ Health Study and found that the connection also works the other way: After adjusting for age, women with COPD were almost 2.4 times as likely to develop RA and 2.7 times as likely to develop seropositive RA as women without lung disease.

The new study was presented at the 2019 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting in Atlanta.

The group also analyzed the risk after adjusting for smoking (a well-known risk factor for both conditions) and a variety of other lifestyle factors. The risk of RA for women with COPD was still increased by 89 percent and the risk of seropositive RA was still more than double, which suggests that the connection between the two disorders is at least partially independent of common lifestyle factors and needs further explanation.

The association of COPD with seropositive RA was most pronounced in the subgroup of women who were over 55 years old and were current or ex-smokers, who had 2.7 times the risk.

A Link Between Asthma and Rheumatoid Arthritis

While the 2017 study found no increased risk of developing asthma in women who already have RA, the new study (which looked at 196,409 women) did identify a significant (but smaller) increase in the risk of RA among women who already have asthma. Women who reported asthma were 67 percent more likely to develop RA and 51 percent more likely to develop seropositive RA. The percentages were lower but still significant — 53 percent and 42 percent — after adjusting for smoking and other factors.

Just as rheumatologists have been advised to promptly investigate lung symptoms that occur in people with RA, the new study suggests that the possibility of RA should be on the minds of physicians when people with lung disease develop joint pain.

Further study may lead to the identification of overlapping factors that increase the risk of both lung and joint symptoms — perhaps common genes, autoimmune factors, or inflammation itself — and to underlying mechanisms that they may have in common.

In the study abstract, the researchers conclude that “identifying asthma and COPD patients as at-risk populations for RA can help develop prevention and screening strategies as well as provide insight into the role of chronic airway inflammation in RA pathogenesis.”

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03/31/2021
If You’re in Remission on a DMARD for Rheumatoid Arthritis, Should You Taper? Here’s What New Research Says

New data compares what happens when the dosage of DMARDs such as methotrexate is tapered or kept steady.

For most rheumatoid arthritis (RA) patients, sustained remission (inactive disease) is the goal of taking methotrexate or biologic DMARDS to manage their disease. However, what to do after reaching that goal hasn’t been clear. Should RA patients stick with the medication dose that’s working or gradually taper the dose — and thus lessen both the expense of the medication and possible side effects of these powerful RA medications?

Whether or not to taper is usually determined on an individual basis during discussions between individual patients and their doctors, based on shared decision-making around achieving and maintaining remission or low disease activity.

Now, there’s more data to help those discussions. It comes from a trial called ARTIC REWIND (Remission in Rheumatoid Arthritis: Assessing Withrawal of Disease-Modifying Antirheumatic Drugs in a Non-Inferiority Design) that enrolled patients who had been diagnosed with rheumatoid arthritis less than five years earlier and had no swollen joints for at least 12 months while taking a DMARD (about 80 percent on methotrexate). The researchers compared 78 people who were kept on their current DMARD dose with 77 who were moved to a half-dose of the same medication.

The data were presented at the 2019 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting in Atlanta.

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In the main finding, over the next 12 months, 6.4 percent of patients on the stable dose and 24.7 percent of patients moved to a half dose experienced a disease flare, defined as a combination of at least two swollen joints, a change in disease activity score, or both patient and physician agreeing that a clinically significant flare had occurred.

In other measures, 79.5 percent of patients continuing the stable DMARD dose had no progression of joint damage on imaging during the year, compared with 62.7 percent in the half-dose arm. Using Disease Activity Scores to define who was still in remission after a year, remission continued in 91.8 percent of patients on a stable dose and 85.1 percent of those moved to a half-dose.

More people (75) who continued on their prior dose experienced a drug side effect during the year, compared with 53 people who were moved to a half-dose. However, serious adverse events were more common in the tapered arm (four patients, including two serious infections) than in the stable-dose arm (two patients).

The researchers, primarily from Norway, concluded that continued DMARD therapy with stable doses led to significantly fewer disease activity flares and less frequent joint damage progression on imaging than tapered DMARD treatment.

The hard data should provide a helpful starting place for patients and rheumatologists to make decisions about tapering, which still need to take into account more subjective factors such as patients’ fears of RA disease progression and patients’ experiences with medication side effects.

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03/31/2021
If Rheumatoid Arthritis Inflammation Is Improving, Be Patient: Less Pain and Fatigue May Be Coming

Knowing there could be a lag between objective measures of improvement and patient–reported outcomes could help prevent over-treatment.

When a rheumatologist measures disease activity in a patient with rheumatoid arthritis (RA), objective clinical measures like C-reactive protein levels in the blood and swollen joint count are essential to factor in, but so are patient-reported measures including pain and fatigue. While both are certainly important, there may be some benefit to evaluating clinical factors and patient-reported measures independently rather than combining both into a composite disease activity score.

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(You can use our ArthritisPower app to track your symptoms and disease activity and share your results with your doctor.)

According to a new study, presented at the 2019 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting in Atlanta, there may be some lag time between when objective tests show that patients are getting better and when patients actually start to feel better.

The researchers, led by Janet Pope, MD, MPH, at Western University in Ontario, analyzed data on 986 patients. They found that the time it took for to reach remission or low disease activity varied widely depending on whether or not patient-reported factors were used as the goalpost.

When the Clinical Disease Activity Index (CDAI), which relies on solely clinical measures, was used, it took patients an average of 12.4 months to reach low disease activity. Yet it took the same group of patients getting the same exact treatment nearly 19 months to reach low disease activity when it was defined by patient global assessment of disease activity (PtGA).

Knowing that this lag time of several months exists is important, because it suggests that health care providers shouldn’t necessarily rush to change up a patient’s treatment regimen if clinical scores are good; waiting it out a few months to see if pain and inflammation improve might be a better option.

“Careful interpretation of [patient-reported outcomes] and composite scores could impact management, including prevention of overtreatment and unnecessary switching of DMARDs,” the authors concluded.

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03/31/2021
Here’s More Data That Suggests We Shouldn’t Use Opioids to Treat Osteoarthritis Pain

Surprisingly, stronger opioids were the worst at relieving pain in a new multi-study analysis.

Despite concerns about safety and addiction, lots of people with osteoarthritis (OA) take opioids to address their chronic pain. A recent study in Sweden, for example, revealed that one in four patients with OA had been prescribed an opioid in the previous year — despite the fact that the drugs aren’t on the list of recommended treatments except in extreme circumstances or after surgery.

Opioid medications work by attaching to opioid receptors in the brain and spinal cord and reducing the pain messages that are sent to the brain.

With lots of people with many different kinds of chronic pain, including various forms of arthritis, taking the powerful drugs, researchers at Tufts Medical Center in Boston stepped back to ask whether opioids actually work to relieve pain and improve life for people with OA.

Their results, based on an analysis of 11,402 participants across 23 randomized controlled trials, were presented at the 2019 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting in Atlanta.

In all of the studies included in the analysis, opioids were compared against a placebo. Here’s what the authors found:

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Did opioids relieve pain and improve function? In assessments at two, four, eight, and 12 weeks, there were small but statistically significant improvements.

Did opioids help with depression or improve quality of life? Not at all.

Did people taking opioids sleep better? Yes.

Were stronger opioids more effective than weaker opioids? Surprisingly, stronger opioids demonstrated consistently worse pain relief, the researchers reported.

“’Strong opioids’ underperformance was the study’s most interesting finding, and likely due to the relationship between pain relief and tolerability of opioids based on dose,” study lead author Raveendhara R. Bannuru, MD, PhD, told the American College of Rheumatology in a press release.

In the studies, twice as many people taking strong opioids (such as morphine, oxycodone, fentanyl, and high doses of tramadol) dropped out because of side effects than those who took weak opioids (such as codeine, dihydrocodeine, and lower doses of tramadol).

“In light of this evidence, clinicians and policymakers should reconsider the utility of strong opioids in the management of OA,” says Dr. Bannuru.

The less-than-impressive results are consistent with the latest guidelines from the Osteoarthritis Research Society International (OSRI), which strongly recommends against using opioids in OA involving the knees, hips, or multiple joints.

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03/31/2021
This Is Important for RA Patients to Know: Taming Inflammation Doesn’t Always Alleviate Pain

“This may have implications for management decisions beyond treating to disease activity targets alone.”

Pain and inflammation often go hand in hand, especially for people with inflammatory conditions like rheumatoid arthritis (RA). So it logically follows that when inflammatory markers decrease, less pain would follow. But according to a new study that isn’t always the case.

The study, which was presented at the 2019 2019 American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting in Atlanta, used data from three earlier trials. The authors, led by Mart A.F.J. van de Laar, MD, PhD, from Arthritis Center Twente in the Netherlands, aimed to separate patient reports of pain from objective measures of inflammation (including swollen joint counts and C-reactive protein).

In each of the three trials, a sizeable portion of RA patients being treated with baricitinib (Olumiant) achieved inflammation control by week 24, yet not everyone who had less inflammation reported corresponding improvements in pain. Not surprisingly, patients who said they had less pain in addition to low inflammation as indicated by swollen joint count and C-reactive protein level were more likely to report better physical functioning, less fatigue, and overall better quality of life compared to those whose inflammation (but not pain) was brought under control.

“Despite apparently well-controlled inflammation [swollen joint count ≤1 and CRP ≤1 mg/dL], residual pain may persist,” the authors concluded. “This may have implications for management decisions beyond treating to disease activity targets alone.”

Baricitinib is a JAK inhibitor, an oral medication that is not a first-line treatment for RA. Whether a similar number of patients taking difference types of RA medications, such as TNF inhibitors, experience improvements in inflammation but not pain is unclear as it was not part of this research.

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03/31/2021
Medical Marijuana for Arthritis: Does Legal Status Affect Whether Patients Use It — or Talk to Their Doctor About It?
No matter who you talk to in the chronic pain, arthritis, and musculoskeletal disease community — patients, clinicians, researchers, public health experts — medical marijuana is controversial. Is it safe? Is it effective for treating pain and inflammation? Should it be legal?

While more clinical trials are sorely needed to understand the benefits and side effects of using medical marijuana to treat conditions like arthritis, it’s important to understand how patients think about and use marijuana to manage their conditions. The United States has a complicated quilt of state laws about the legal use of marijuana. Presently, 33 U.S. states have laws that allow for the legal use of marijuana for medical reasons, according to the National Conference of State Legislatures. (When you add recreational marijuana use and the legality of cannabidiol or CBD to the mix, things get even more confusing.) We have to recognize that its legal status may, in fact, influence whether patients use marijuana — or feel comfortable talking to their doctor about it. So researchers, including those from our non-profit organization, the Global Healthy Living Foundation (GHLF), set out to study this.

In research presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting in Atlanta, researchers surveyed 1,059 patients through the Chronicwoman patient community and the Chronicwoman research registry. Of those, 37 percent of people reported using marijuana for medical purposes, either presently or in the past. Of those, the majority said they did so to manage a specific health condition, such as:
- Rheumatoid arthritis: 51 percent
- Osteoarthritis: 46 percent
- Fibromyalgia: 35 percent
Nearly two-third of people currently using medical marijuana reported doing so at least once a day.

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How Medical Marijuana’s Legal Status Affects Patients’ Usage

In this study, 77 percent of current or past marijuana users live in a state where it is legal for medical reasons. Just 40 percent of current or past users said they used a medical marijuana card to purchase it. Among the 60 percent of study participants who did not use a medical marijuana card, the top reasons included:
- Not being legal where the patient lives: 42 percent
- Cost of marijuana is more expensive through a dispensary: 19 percent
- Difficulty getting a card: 18 percent
Of the approximately two-thirds of patients surveyed who said they had never used marijuana for medical purposes, illegality played a big role: 40 percent cited that as a reason they haven’t used it. Other reasons for not using marijuana included:
- Potential impairment: 24 percent
- Not knowing where to obtain it: 21 percent
- Not knowing how to obtain it: 20 percent
How Medical Marijuana’s Legal Status Affects the Doctor-Patient Relationship

Our research found that there was a link between whether medical marijuana was legal where patients lived and whether patients spoke with their doctor about their usage. Among patients who live in states where marijuana is medically legal, 68 percent said they told their doctor about using it, while only 54 percent of patients in states where medical marijuana was not legal talked with their doctor about it.

“It’s alarming that not everyone is telling their doctor about their marijuana use, regardless of its legal status,” says study co-author W. Benjamin Nowell, PhD, director of Patient-Centered Research at the Global Healthy Living Foundation. “It is important that your rheumatologist and other providers are aware of what you might be using in addition to prescribed medication.”

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A Lack of Research and Mixed Messages About Effectiveness

If you’re a patient who uses medical marijuana (or CBD, for that matter) to help treat your arthritis symptoms, your health care providers should know about it. Ideally, providers would make patients aware of potential side effects and interactions with other medications they use, advise on dosages, and help patients monitor and evaluate whether these treatments are helping. But our research, and that of others, indicates this isn’t always the case.

Earlier findings from the same survey, for example, noted that only 42 percent of patients perceived that their health care provider integrated their medical marijuana usage into their overall care (for example, made note of it and discussed how it fits in with other medications they take).

In a separate, unrelated study presented at the 2019 ACR meeting, when researchers at the University of Vermont Medical Center surveyed rheumatology clinicians about their patients’ usage of medical marijuana and CBD, they found that 45 percent of more than 100 doctors disagreed that marijuana or CBD should be recommended as medical therapy for people with rheumatologic conditions.

Here, legality may play a role too: More doctors who practiced in states where marijuana was legal for medical and recreational use said they were comfortable addressing questions about usage than in states where it was not legal. The authors concluded that “surrounding laws likely impact clinician perception and comfort with medical use.”

Part of this challenge is a dearth of solid research that rheumatologists and other doctors need to feel comfortable making recommendations to patients. In fact, in a recent paper published in the journal Expert Review of Clinical Immunology, researchers reviewed animal and human clinical studies on the use of cannabis for treating rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, systemic sclerosis, and fibromyalgia. “Despite the presence of studies supporting the benefits of cannabis, the researchers were unable to definitively conclude that cannabis or cannabis-related products are safe and effective for treatment of rheumatic diseases,” reported Clinical Pain Advisor. “They noted a gap between animal and clinical studies, as well as the paucity of studies examining long-term adverse effects. Large-scale clinical trials are necessary to examine the safety and efficacy of cannabis before it can be recommended for the management of rheumatoid arthritis, osteoarthritis, and fibromyalgia.”

“Indeed, our [Chronicillness.co and Chronicwoman.com] research shows that despite a lack of quality evidence to guide the usage of medical marijuana and regardless of its legal status, many patients with arthritis are using it — and need more support,” says study co-author Kelly Gavigan, MPH, manager of research and data science at the Global Healthy Living Foundation (GHLF). “We need high-quality randomized controlled clinical trials to better understand whether and how medical marijuana might be used to help patients manage these diseases, in conjunction with their recommended medication.”

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03/31/2021
Fibromyalgia Symptoms: 10 Clues You Might Be Ignoring

If you’ve had a nagging sore throat, your doctor may take a swab to check for strep. If you’re suffering from a high fever and bad cough, your doctor may order a chest X-ray to look for pneumonia. But not all diagnoses are that straightforward.

Case in point: Fibromyalgia, a condition that causes widespread chronic pain — as well as fatigue, sleep disturbances, and cognitive difficulties — is often challenging for a physician to pinpoint.

“Fibromyalgia can be difficult to diagnose because there’s no gold standard test like an X-ray or blood work,” says Lenore Brancato, MD, a board-certified rheumatologist at NYU Langone Ambulatory Care in New Hyde Park, New York. “It’s a diagnosis of exclusion, which means you first have to rule out other diseases that may be causing symptoms. It’s not a cookie-cutter condition.”

Fibromyalgia is also a diagnosis that’s been subject to change. Back in 1990, when the first diagnostic criteria were set by the American College of Rheumatology (ACR), a doctor had to find the following elements in order to say their patient had fibromyalgia: pain in at least 11 of 18 designated “tender points” throughout the body, plus a history of widespread pain lasting more than three months.

In 2010, however, those diagnostic criteria for fibromyalgia were updated to eliminate the tender point requirement and instead focus on findings that a patient has widespread pain, as well as sleep disruptions, fatigue, and cognitive difficulties.

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Whereas the validity of fibromyalgia as a diagnosis was once questioned in the medical community — leading to a stigma it’s still overcoming — ongoing research has led to a number of possible explanations for physical causes of fibromyalgia (ranging from genetics to physical triggers) and mechanisms (involving the central nervous system).

What we know for sure is that fibromyalgia affects approximately 2 percent of adults in the United States, and your risk of developing the condition increases if you are middle-aged or older and have been diagnosed with lupus or rheumatoid arthritis, says the Centers for Disease Control and Prevention (CDC). You may also be at a higher risk if you are female (most fibromyalgia patient are women), have suffered a trauma or repetitive injury, or if you are obese.

But statistics and risk factors can’t describe how fibromyalgia actually feels to the person living with it. What follows are the descriptions doctors hear patients use when they talk about both usual and less common symptoms of fibromyalgia.

Widespread pain

While every fibromyalgia patient is different, their descriptions of overwhelming, debilitating pain throughout the entire body are very common. “My patients report feeling sore and stiff with an achy pain that goes from the top of their head to their toenails,” says Christopher Morris, MD, a board-certified rheumatologist with Arthritis Associates in Kingsport, Tennessee, and a fellow of the American College of Rheumatology. “They tell me the pain is in the muscles and soft tissues rather than joints.” Dr. Brancato hears similar concerns, with some of her patients saying the pain is lacerating, “like being cut by knives.”

Sensitivity to touch

Fibromyalgia could also make you overly sensitive to touch and temperature. “If you’re a patient with fibromyalgia, and someone brushes up against you in a crowded room it can be very painful,” says Dr. Brancato. “I’ll hear that my female patients can’t tolerate a massage.” Even though the stimulus is taken away, like removing your hand from a hot stove, the pain can continue, she explains.

Sleep issues

If you have fibromyalgia, you may have trouble falling asleep or staying asleep. “My patients say they toss and turn, or their mind wanders,” Dr. Brancato says. “I’ll hear that my patients wake up throughout the night and end up feeling as tired as when they went to bed,” Dr. Morris adds.

Daytime fatigue

One of the most common issues for fibromyalgia patients is fatigue. “It’s exhausting for them,” says Dr. Brancato. “If you ask a patient how they feel in the morning, you’ll hear they felt awful, they never feel ready to go, they feel like they can’t get their head above water.”

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Cognitive problems

“My patients describe having a ‘fibro fog,’” says Dr. Morris. “They have a hard time concentrating.” For her part, Dr. Brancato sees a lot of memory problems. “If you tell a fibromyalgia patient three things during an office visit, then ask them to recall them later during the same visit, they have difficulty,” she explains. “With fibromyalgia, short-term recall can be very poor.”

Depression and anxiety

For many patients, fibromyalgia may also bring feelings of sadness and other negative moods. Some researchers suspect a connection between fibromyalgia and certain types of chronic anxiety and depression.

Headaches

Though less common, headaches can occur among fibromyalgia symptoms. “Stress- and tension-type headaches tend to travel with fibromyalgia,” Dr. Brancato reports, adding that they can be triggered differently than in patients without fibromyalgia. “These headaches can be induced by regular sounds, background music, or even odors like perfumes.”

Digestive issues

Fibromyalgia can sometimes occur alongside digestive problems, such as bloating, constipation, abdominal pain, and irritable bowel syndrome (IBS), says the CDC.

Pelvic floor dysfunction

Some patients with fibromyalgia might also have an increased incidence of interstitial cystitis, says Dr. Brancato. This condition can cause chronic pain or pressure in the bladder and pelvis.

Jaw and facial pain

It’s possible for fibromyalgia to be linked to pain in the muscles of the jaw and face (temporomandibular joint disorder) or to myofascial (skeletal muscle) pain in one part of the body. Such occurrences could be considered forms of regional or localized or incomplete fibromyalgia.

Fibromyalgia and Arthritis: What’s the Link?

The relationship between fibromyalgia and different types of arthritis can be complicated. For one thing, there’s misdiagnosis: Depending on how your symptoms present, you could be told you have fibromyalgia when you actually have a kind of arthritis, or vice versa. Read about how ankylosing spondylitis and fibromyalgia can be mistaken for each other, for example.

At the same time, having a painful chronic disease like arthritis may in turn trigger the onset of fibromyalgia. Inflammatory diseases like arthritis can affect the way your central nervous system processes pain, creating a double-whammy of having both diseases at the same time.

If you suspect your combination of symptoms could be fibromyalgia, it’s a good idea to start with your primary care doctor. Because fibromyalgia is a diagnosis of exclusion, you’ll likely need a through physical exam, blood tests, and imaging tests to figure out what could be causing your symptoms.

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03/31/2021
Arthritis in Your Toes: Signs of Toe Arthritis, and What to Do About It
When you think of arthritis, you might think of creaky knees, stiff hips, or painful, swollen fingers. Yes, arthritis commonly attacks joints in the hands, knees, and hips. But it can happen anywhere you have joints — including the toes. So, if you can’t bend your big toe or have swelling around your toes, this toe pain may be caused by arthritis too.

Toe arthritis can be caused by wear and tear of the cartilage in your toe joints, as well as inflammation of the toe joints. Arthritis most often attacks the big toe, but the other toes may be affected, too. Learn more about what causes toe arthritis and how it is treated.

Symptoms of Arthritis in Toes

Common symptoms of toe arthritis may include:

You have pain in the toes that can take hours or days to subside.

You have swelling and inflammation around the toe joints.
- With rheumatoid arthritis and psoriatic arthritis, swelling and edema is associated with redness.
- With osteoarthritis, there is more bone enlargement of the toe joints as a result of bone spur formation, says podiatrist Krista A. Archer, DPM, a podiatric surgeon who is on staff at Lenox Hill Hospital in New York City. Bone spurs are bony projections that develop along bone edges, often due to joint damage from arthritis.
You have restricted range of motion due to swelling or damage to cartilage (a rubbery substance on the edges of bones that lubricates the joint) in any joints that are in the toes, midfoot, rearfoot, and ankle, says Dr. Archer. Bone spurs will often develop around the joint, restricting movement.

You may be unable to bend your big toe upward and have pain when doing so, says Chadwick Hampton, MD, an orthopedic surgeon at Palm Beach Gardens Medical Center in Palm Beach Gardens, Florida. That can make it difficult and painful to walk.

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Your toe may become bent permanently downward and can’t be positioned flat on the floor.

Your pain worsens with weight-bearing activities like jogging, walking, and climbing stairs. “It depends on how severe the deformity is to predict what kind of activities will be painful,” says Dr. Archer.

You may have a bump form (a pressure sore) when the joints rub together. It resembles a callus or bunion.

You may have pitted, separated, or thick toenails.

You may have curling of the toes, such claw toe or hammertoe.

You may have pain in joints in the in the midfoot (cuboid, cuneiform, metcuneiform) and rearfoot (talonavicular, calcaneocuboid).

You may have numbness, burning, or tingling in the foot or ankle.

Types of Arthritis that Affect the Toes

If you have arthritis in your toes, it’s important to understand the type of arthritis that might be causing it, because each type of arthritis has specific medications and treatments. Here are some of the more common types of arthritis that strike in toes.

Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease where the cartilage that cushions the ends of a joint wears away gradually. Osteoarthritis often occurs because of typical wear and tear on a joint that happens with age; it can also occur as a result of injury to the joint. OA most commonly occurs in the joint at the bottom of the big toe, which is called the metatarsophalangeal or MTP joint.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the body’s immune system attacks itself, causing inflammation and pain in the joints. RA can affect several small joints in the foot at the same time, including those in the toes. RA often occurs in the small joints of the hands and feet first, though it can affect other joints, such as the knees, elbows, hip, and neck. Around 90 percent of people with RA will have foot problems.

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Gout

For many people, pain and swelling in the big toe, especially at the joint where the toe meets with the foot, is the first symptom of gout. Gout is a type of arthritis that occurs because elevated levels of uric acid in the blood accumulate in and aggravate joints, causing inflammation. Gout attacks can affect other joints aside from the big toe, including the ankles, foot, knees, or elbows. Lumps of uric acid, called gout tophi, may become visible underneath the skin around the toes, ankles, and other joints after you’ve had gout for years or if you have severe gout that is not well controlled.

Psoriatic arthritis

Psoriatic arthritis is an inflammatory arthritis linked to psoriasis, an autoimmune skin disease that causes red, silver, scaly rashes on the skin. It’s characterized by pain, stiffness, and swelling in the joints. People with psoriatic arthritis might notice pain, stiffness, and swelling in the “knuckles” of the toes, says rheumatologist Arthur M. Mandelin, MD, PhD, associate professor of medicine at the Northwestern Medicine Feinberg School of Medicine in Chicago. People with PsA are likely to have problems with their toenails, such as pitting and crumbling, as well as swollen fingers and toes, a condition called dactylitis that makes them appear sausage-like. Enthesitis, or inflammation at the sites where tendons and ligaments attach to bones, is also common in PsA. This can affect the Achilles tendon at the heel or cause plantar fasciitis along the bottom of the foot.

Infectious Arthritis

Also called septic arthritis, this type of arthritis typically causes extreme pain and difficulty using the affected join. Septic arthritis is caused by bacteria or fungi that are carried through the bloodstream from another area of the body, usually settling in one joint. A bacterial infection from an injury or opening from a surgical procedure can also cause infectious arthritis by bringing germs directly to the joint. Pain worsens with movement and comes on rapidly in hours or days. It may include a swollen, red, and warm joint accompanied by fever, chills, fatigue/weakness, and the inability to move the affected joint.

How Arthritis in the Toes Is Diagnosed

The diagnosis of arthritis in toes begins with taking your medical history and a physical exam of your foot. The doctor will look at your entire foot, not just your toes. They’re looking for pain, deformity, and loss of function, says Dr. Archer. Your doctor will likely order an X-ray of the foot to help determine whether there is joint damage or changes in the alignment of bones in the foot.

If your doctor suspects you could have a type of inflammatory arthritis, such as RA or PsA, they may order blood tests to look for signs of inflammation (such as C-reactive protein or erythrocyte sedimentation rate) as well as antibodies (such as rheumatoid factor or anti-CCP). If your doctor suspects you could have gout, they may give you a blood test to look for elevated levels of uric acid and draw fluid from the joint to look for uric acid crystals.

How Arthritis in the Toes Is Treated

Treatment for arthritis of the toes depends on the type of arthritis that you have. It typically starts with conservative measures.

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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter medications like ibuprofen (Advil) and naproxen (Aleve), as well as prescription NSAIDs, can help relieve pain and swelling in the joints. However, even though many NSAIDs are available over the counter, they can have side effects (such as causing stomach ulcers, increased heart attack risk, and kidney problems) especially when taken for the long term and/or in high doses. NSAIDs are a first-line of treatment in OA to reduce pain and stiffness. In inflammatory arthritis and gout, they can be used along with other kinds of medication to treat inflammation, pain, and swelling.

A topical gel like diclofenac (Voltaren) may be prescribed for toe arthritis, says Dr. Hampton. Topicals are good if you can’t take oral medications or medications aren’t helping with the pain.

Steroid injections

This medication can help treat and relieve inflammation. An occasional shot can be given in any toe and offer temporary pain relief and reduce inflammation. Injections shouldn’t be done repeatedly; frequent injections can damage cartilage. “I give a certain dose and I won’t give it more than three times a year or no more than once every four months,” says Dr. Hampton.

Disease-Modifying Antirheumatic Drugs (DMARDs)

If you have an inflammatory arthritis like rheumatoid arthritis, disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate are used as a first-line therapy to help reduce the immune system activity that triggers inflammation and pain. DMARDs are not used for osteoarthritis.

Biologics

Biologics are a newer class of DMARDs that target specific immune system pathways to reduce immune system activity that is causing inflammation and pain. They’re used to treat inflammatory types of arthritis, such as rheumatoid arthritis and psoriatic arthritis, and are typically offered after patients haven’t responded to conventional DMARDs like methotrexate.

Gout medications

There are two main kinds of drugs used to treat gout: those used during a flare to reduce inflammation and pain and those used preventively to lower uric acid levels and prevent future flares from occurring. Medications used to treat inflammation in an acute gout flare include NSAIDs, oral corticosteroids or steroid injections, or a drug called colchicine. Medications called xanthine oxidase inhibitors limit the amount of uric acid your body produces. These include allopurinol (Zyloprim and Aloprim) and febuxostat (Uloric). Another class of drugs called uricosurics help your kidneys remove uric acid from the body. These include probenecid (Probalan) and lesinurad (Zurampic). An infused drug called pegloticase (Krystexxa) can help the body eliminate uric acid in people whose gout hasn’t been well controlled with other medication.

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If your gout attack is limited to one or two joints and your pain is mild to moderate, you may only need one of these medications to control the inflammation. However, if your pain is severe, and if one or more of your larger joints (not just a toe) are involved, you may need a combination of treatments to get it under control. Also, if one drug doesn’t work well enough to treat your gout attack symptoms, your doctor may switch you to a different medication or try a combination of medications.

Physical Therapy for Arthritis in Toes

Your doctor may send you for physical therapy to help improve your range of motion and strengthen the muscles around your foot. “Physical therapy can increase pain-free range of motion and strengthen the muscles of the foot to take pressure off the painful joint,” says David Geier, MD, an orthopedic surgeon, sports medicine specialist, and author of That’s Gotta Hurt: The Injuries That Changed Sports Forever. These exercises relieve stiffness and increase your ability to move your joints through their full range of motion.

Home Remedies for Arthritis in Toes

You can do some things on your own to help remedy your toe arthritis.

Modify your footwear

You want to wear shoes that take pressure of your toe joints to relieve some of the stress from arthritis of the toes. Look for footwear with a more rigid, stiff sole (which will provide support) and wide toe box to help prevent excessive stress and bending forces on the toe joints. Ditch high heels; they put your foot in an unnatural position that takes a toll over time.

Soothe with ice and heat

Cold therapy can provide relief for inflamed joints in the wrist. Cold constricts the blood vessels in the muscles, which decreases blood flow to the joint area to help reduce swelling and inflammation. Heat therapy warms the skin and the joints, which causes blood vessels to dilate, and sends more oxygen and nutrients to the joints and muscles. Try both and see which makes you feel best.

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Exercise to maintain a healthy weight

Control your weight with regular, low-impact aerobic exercise that doesn’t hurt your toes. Cycling on a recumbent bike or swimming are good options. Keeping your weight close to your ideal body mass index (BMI) is one of the best things you can do to control your toe pain. Being at a healthy weight “balances the pathomechanics [the mechanics of damaged bones, tendons] of the entire foot and relieves stress on toes,” says Dr. Archer. It’s also a good idea to do specific exercises that strengthen your Achilles tendon (the cord at the back of your heel) as well as the tendons in the balls of your feet and toes. You can even simply wiggle your toes.

Eat a clean diet

Maintaining a healthy weight helps reduce stress on the joints. Feet are a weight-bearing joint, so obesity makes arthritis worse. Losing excess pounds can lead to less pain and better function. You especially want to eat healthfully since your exercise abilities may be limited if you have a lot of pain in your toes. Aim to eat foods that may help reduce inflammation, called anti-inflammatory foods.

Surgery for Arthritis in Toes

Surgery isn’t usually necessary for arthritis of the toes. It’s usually a last resort since you may still have discomfort and have an increased risk of infection after surgery. But several surgical procedures outlined below can be done if other treatments for toe arthritis have not helped.

Cheilectomy for Arthritis in Toes

The most common surgery, cheilectomy, involves removing bone spurs that have formed around joints that have become arthritic. It’s typically done when arthritis is in the big toe. It can help relieve discomfort around the joint and improve the movement of the joint. The toe may stay swollen for several months, but you’ll likely experience long-term relief. However, removing bone spurs doesn’t address the worn-out cartilage within the joint. So bone spurs often return in the future. “This surgery has a high revision rate because you’re treating the arthritis as it’s in progression. So [the condition] continues to progress.” says Dr. Hampton. “You’ve removed the bad parts of the bone but you don’t actually replace the joint.”

Arthroplasty for Arthritis in Toes

Here, joint surfaces are removed and replaced with an artificial joint. This procedure is geared for older adults who aren’t as physically active.

Fusion for Arthritis in Toes

This surgical procedure stimulates bone growth across the joint. The joint is fused together permanently with pins, screws, or a plate. When bone grows across the toe joint, it won’t bend anymore. But since the joint is fused, pain is also relieved. Dr. Archer says that she rarely does this type of surgery. “It’s usually done in active laborers, like carpenters and mechanics, to give them a stable joint with no pain,” says Dr. Geier.

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For More Information Related to Fibromyalgia Visit below sites:

References:

Fibromyalgia Contact Us Directly

Click here to Contact us Directly on Inbox

Official Fibromyalgia Blogs

Click here to Get the latest Chronic illness Updates

Fibromyalgia Stores

Click here to Visit Fibromyalgia Store
03/31/2021
Does Fibromyalgia Cause Back Pain?

Fibromyalgia — a disorder that causes widespread chronic pain and tenderness — affects 2 to 4 percent of women and men in the United States (women ages 20 to 50 are the most affected) and impacts patients in many different ways.

Thus, fibromylagia remains mysterious, and questions still linger — like why are more women affected by fibromyalgia than men? And why is fibromyalgia so hard to diagnose and treat? Why do some patients with fibromyalgia have more back pain than others?

“What causes fibromyalgia has puzzled many scientists for a long time,” says Elena Schiopu, MD, a rheumatologist and internist at Michigan Medicine in Ann Arbor. While the exact cause of fibromyalgia isn’t certain, doctors do know that the disorder can be triggered by an injury, surgery, infection, psychological trauma (like an extremely stressful period), or even just from an accumulation of symptoms that leads to the eventual classification of fibromyalgia.

The reason for the heightened pain? Fibromyalgia may affect the way your brain interprets pain signals. “Fibromyalgia is basically a miscommunication between the central, peripheral, and autonomic [vegetative] nervous system, which results in abnormal or amplified sensations,” says Dr. Schiopu. This is known as central pain sensitization. It causes your nervous system to become “wound up” and in a constant state of hyperactivity, which creates a lower threshold for experiencing pain.

When you poke someone without fibromyalgia, for example, it might be no big deal, but for someone with fibro, that same level of touch can cause significant pain or discomfort.

The Nature of Pain in Fibromyalgia

Unlike arthritis, in which pain occurs in specific joints, the pain that fibro patients experience is more in the muscles. It’s a widespread pain, which means you feel pain all over you body. According to the latest diagnostic criteria for fibromyalgia, patients must experience pain in four out of five general regions of the body. These include left upper, right upper, left lower, right lower, and low back.

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What Causes Back Pain in Fibromyalgia?

People with fibromyalgia may experience long-term back pain along with a number of other symptoms. “Back pain that’s patient-reported and physician-observed — called paraspinal lumbar tenderness — is very common,” says Dr. Schiopu. “All the areas of the body that are being ‘used’ on a regular basis could hurt, like your hands, neck, or upper or lower back.”

“The back is a common area to have pain in fibromyalgia because muscles in general are often painful in fibromyalgia, and the human back has a large quantity of muscle fibers to support posture,” says Amanda Sammut, MD, a rheumatologist and assistant clinical professor of medicine at Columbia University Medical Center in New York City.

Also, says Dr. Schiopu, patients with fibromyalgia could have a degree of wear-and-tear arthritis of the lumbar spine, which is amplified by fibro. In fact, it’s common to have fibro at the same time as other diseases, such as inflammatory arthritis or osteoarthritis.

Back Pain in Fibromyalgia: Could It Be Something Else?

Lower back pain is an extremely common medical complaint — some 80 percent of Americans experience it at some point in their lives. So if you have lower back pain, how do you know if it could be from fibromyalgia or something else?

The answer is complicated. If you’re experiencing back pain as well as other symptoms, it’s possible you could have a different health problem entirely — or a health problem plus fibromyalgia at the same time.

Misdiagnoses are common with fibromyalgia — both in terms of not being diagnosed with fibro when you really have it, or in terms of being diagnosed with fibro when you actually have a different health problem.

“Fibromyalgia is technically an exclusion diagnosis,” says Dr. Schiopu. This means you shouldn’t be diagnosed with fibromyalgia until a doctor has fully ruled out the possibility of having other diseases.

That’s why a thorough visit with a rheumatologist is critical. If you’ve already been diagnosed with fibromyalgia but find that your current treatment plan isn’t helping your back pain, you could have a different or additional diagnosis, such as one of the following:

A muscle or ligament strain

Maybe you lifted a heavy box, strained to reach something in a high cabinet, or picked up your child or grandchild, which could have triggered a back muscle strain. A sudden movement can cause a strain, as well as constant use of your back (like doing repetitive motions), especially if you’re not in good physical shape.

Axial spondyloarthritis

If you have lower back pain as well as pain in other places — say, your knees, jaw, neck, or shoulders — it could be from the widespread aches of fibromyalgia, or it could be another condition you may not be familiar with: axial spondyloarthritis (AxSpA), which is an inflammatory type of arthritis in your spine and the area where your spine meets the pelvis (sacroiliac joints). Back pain is a primary symptom of AxSpA, though it can also affect other joints and areas around your body.

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AxSpA is often divided into two categories. Radiographic AxSpA (which is often called ankylosing spondylitis), means that evidence of joint damage is visible on X-rays. Non-radiographic AxSpA (nr-AxSpA) is essentially the same condition, but without joint damage being visible on X-rays.

Fibromyalgia and axial spondyloarthritis are caused by very different things (AxSpA is inflammatory and due to an overactive immune system that’s attacking the joints) and thus have very different treatments. It’s important to get the right diagnosis so you can get on the right treatment and start feeling better.

Scoliosis

You may have never realized it, but your spine could curve to the side, a condition known as scoliosis. The physical changes of scoliosis often start in childhood but the condition might not start causing back pain until middle age.

Bulging discs

The cushiony discs between your vertebrae may bulge or rupture, which can then put pressure on a nerve in your spine. While some people may not feel any pain when this happens, others may find it excruciating.

Osteoporosis

A frustrating part about aging: The vertebrae in your spine may develop compression fractures if your bones become too brittle (a condition known as osteoporosis). These fractures can then lead to back pain.

Common Fibromyalgia Symptoms Aside from Pain

While you may experience back pain if you have fibromyalgia, if you’re experiencing back pain alone, and not other fibromyalgia symptoms, then your pain is likely not due to fibromyalgia, says Dr. Schiopu.

Sleep problems

In addition to pain, sleep problems are a big part of patients’ experience with fibromyalgia.
Even if fibro patients sleep for hours, they still may wake up feeling unrefreshed. That could be due to pain waking people up at night, or they may experience other sleep issues, like restless leg syndrome or sleep apnea. This troubled sleep, in turn, can contribute to debilitating daytime fatigue.

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Fibro fog

Many patients with fibromyalgia complain of fibro fog, in which people feel like they can’t concentrate, hold conversations, or even remember certain things, like plans or where they placed objects. One reason for the fibro fog could be lack of sleep. Another explanation is that there is potentially something happening in the brain that’s unique to people with fibromyalgia.

Co-existing health problems

Fibromyalgia often co-exists with other ailments, like irritable bowel syndrome, migraine, interstitial cystitis (a painful bladder syndrome), and TMJ (a jaw disorder). “That’s all followed by a slew of hypersensitivity to cold, light, noises, smells,” adds Dr. Schiopu. Thus, it can seem like fibromyalgia patients have a laundry list of health woes, which can be incredibly frustrating.

How Back Pain in Fibromyalgia Is Treated

If you have fibromyalgia and are experiencing back pain as a symptom, then you’ll want to come up with a treatment game plan with your doctor. “Gentle stretching, warm pool exercises, and even a supportive belt would help,” says Dr. Schiopu. “Daily strengthening of the lumbar musculature [muscles in the lower back] is key as well,” she adds.

Fibromyalgia medications may help relieve back pain. Some antidepressant drugs are prescribed to help ease pain and fatigue; these include duloxetine (Cymbalta) and milnacipran (Savella). Anti-seizure medications can also help manage pain in fibromyalgia. Among these, the FDA has specifically approved pregabalin (Lyrica) for the treatment of fibro.

If you have back pain — especially back pain that’s lasting more than three months and doesn’t improve with your current treatment — it’s important to talk to your doctor about your symptoms and medical history. Your back pain could be due to fibromyalgia, but it could also stem from various other health issues.

“If your back pain continues despite medical therapy and despite physical therapy, patients should then consider seeing a rheumatologist or a pain management specialist,” says Dr. Sammut.

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For More Information Related to Fibromyalgia Visit below sites:

References:

Fibromyalgia Contact Us Directly

Click here to Contact us Directly on Inbox

Official Fibromyalgia Blogs

Click here to Get the latest Chronic illness Updates

Fibromyalgia Stores

Click here to Visit Fibromyalgia Store

03/31/2021
Fibromyalgia vs. Multiple Sclerosis (MS): Differences in Signs & Symptoms
Fibromyalgia and multiple sclerosis are both chronic diseases with no cure. Fibromyalgia and multiple sclerosis can both cause some of the same symptoms. They can both take a long time to get the right diagnosis. They’re both more common in women. But fibromyalgia — often called “fibro” — and multiple sclerosis (MS) are two very distinct health conditions with very different causes and treatments, despite having some features in common. Read on to find out the differences and similarities of fibromyalgia vs. MS.

Fibromyalgia and MS may have some more vague symptoms in common, such as problems with focus and concentration, fatigue, and depression. If you’re Googling potential causes of these symptoms, you may find yourself researching both diseases to see if your symptoms match up. But despite some similarities, “for the most part, there is no mistaking symptoms of MS with fibromyalgia,” says Philip Cohen, MD, a rheumatologist, professor of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University in Philadelphia.

This is especially true once you see a health care provider and start the process of seeking a diagnosis. Fibromyalgia is often diagnosed and managed by a rheumatologist, which is an internal medicine doctor who has specialized training in joint and musculoskeletal diseases. Multiple sclerosis is diagnosed and managed by a neurologist, which is a doctor who specializes in treating disorders of the brain and nervous system.

Read more to learn about the different symptoms of fibromyalgia vs. multiple sclerosis, how fibromyalgia and multiple sclerosis are each diagnosed, and how treatments for fibromyalgia and multiple sclerosis differ.

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The Basics of Fibromyalgia

The Centers for Disease Control and Prevention estimates that about 4 million American adults have fibromyalgia. While doctors don’t know what causes fibromyalgia, it is a disorder in which people often experience widespread chronic pain and sensitivity to touch, in addition to many other symptoms (more on this below).

“Fibromyalgia is poorly understood,” says Dr. Cohen. “But it’s thought by many to be a disorder of pain perception, perhaps due to abnormalities in parts of the brain.”

Unlike MS, fibromyalgia is not an autoimmune disease, which occurs when then body’s immune system mistakenly attacks your own cells and tissues. Fibromyalgia is not related to inflammation, nor is it a joint or muscle disorder caused by physical injury.

People at higher risk of fibromyalgia include women, the middle-aged, and those with certain diseases, including different types of arthritis, or a family history of fibro. While fibro can impair your quality of life, it doesn’t damage your tissues and organs, or cause medical problems like heart disease and cancer. It is not life-threatening.

Common Symptoms of Fibromyalgia

Pain

Though someone with fibro may experience a range of symptoms, the condition’s hallmark symptom is persistent pain in soft tissues and muscles all over the body. “Fibromyalgia pain is diffuse [all over], with particular involvement of what are called ‘tender points,’ or areas of tenderness elicited by pressing in specific parts of the neck, trunk, and extremities,” says Dr. Cohen. Frequently described as a deep ache, the pain may move around, persist for long periods, and disappear.

Fatigue

More than nine in 10 fibromyalgia patients experience unrelenting exhaustion. The sleep problems that often accompany fibro, including light sleep and repeated awakenings, can contribute to fatigue, but treating fatigue in fibromyalgia isn’t just about getting more sleep.

Cognitive issues

People with fibro can have issues with focus, attention, memory and concentration, frequently referred to as “fibro fog.”

Other symptoms

“Fibromyalgia patients often have headaches, irritable bowel symptoms, and depression,” adds Dr. Cohen. “Although these problems may occur in MS, they are less commonly seen.”

The Basics of Multiple Sclerosis

About 1 million Americans are thought to have multiple sclerosis. Unlike fibro, MS is considered an autoimmune disease in which the immune system is attacking part of the central nervous system. Specifically, MS affects the protective sheath (myelin) that covers nerve fibers throughout your body, which can cause a wide range of symptoms depending on which nerves are affected. Over time, multiple sclerosis can permanently damage your brain and spinal cord.

Doctors don’t know what causes MS but believe that it’s due to a combination of genes and environmental factors. Women, Caucasians, people between the ages of 20 and 50, and those who live farther from the Equator have a higher risk of developing MS.

There are four main kinds of MS; symptoms and disease progression depend on what type you have. While many people with MS develop relatively mild issues (especially with newer treatments that can help prevent MS flares and disease progression), those with severe illness can lose mobility and speech and experience other complications.

Common Symptoms of MS

MS symptoms vary among patients, depending on which parts of the nervous system are affected. The most common type of MS — called relapsing-remitting MS, which is what 85 percent of patients are first diagnosed with — is characterized by attacks, or flares, of new symptoms followed by periods of remission. Among the more common symptoms of MS are:

Muscle issues

Numbness and tingling in the limbs often occur with MS, as do muscle spasms. Frequently, someone with MS will feel an electric impulse sensation when they move their neck a particular way; this is called the Lhermitte sign.

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Movement problems

Dizziness and weakness can contribute to balance and coordination troubles. People with MS often complain of feeling suddenly clumsy or report tripping, stumbling, or falling more than usual.

Vision difficulties

When MS affects the optic nerve in your eye, it can cause eye problems such as blurry eyesight, double vision, and vision loss, and may involve eye pain and unexpected movement of the eye. You may find yourself partially color blind and have issues such as picking out clothes that don’t match.

Bladder or bowel problems

People with MS may experience loss of control or other complications with function.

Symptoms That MS and Fibro Have in Common

Though they have few other similarities, MS and fibromyalgia do have some comparable symptoms. These include:

Pain

People with MS may experience eye pain or pain elsewhere in the body. It can be acute or mild, and may be related to neurological issues or musculoskeletal problems. Occasionally, some MS patients do not develop pain. For fibro patients, pain is a defining aspect of the disease. Without its presence, you cannot get a fibromyalgia diagnosis.

Fatigue

Constant weariness is widespread in both MS and fibro. The vast majority of people with either condition often feel physically exhausted, and may find it interrupts their lives at home, school and work.

Cognitive issues

“Fibro fog” is common in fibromyalgia. About half of MS patients report brain fog-like symptoms as well.

When considering your symptoms, it is important to keep in mind that people with multiple sclerosis may experience a wide variety of other issues not common to people with fibromyalgia, such as mobility problems and speech troubles. What’s more, many unusual symptoms may be caused by a condition unrelated to either disease. As a result, it’s crucial to get an an accurate diagnosis.

If you suspect you might have either fibromyalgia or MS, says Dr. Cohen, “begin with [your] internist or general practitioner.” They can assess your symptoms and medical history and refer you to the right specialist for further testing.

Both fibromyalgia and multiple sclerosis can be difficult to diagnose. There’s no single test that confirms you have either disease, and doctors must rule out other conditions that can have similar symptoms. Read more about diseases that can mimic fibromyalgia.

Diagnosing Fibromyalgia

When diagnosing fibromyalgia vs MS, providers must eliminate the possibility of those other illnesses, which include rheumatoid arthritis, lupus, spondyloarthritis, thyroid disorders, and others. To do this, they’ll typically use a combination of patient history, physical exam, and laboratory tests to narrow the field. At the same time, they can look for three diagnostic criteria:
- More than three months of widespread musculoskeletal pain
- Symptoms like fatigue, poor sleep, and cognitive issues
- Where in the body you’ve felt pain over the previous seven days
Read more here about how fibromyalgia is diagnosed.

Diagnosing Multiple Sclerosis

Diagnosing MS is different from diagnosing fibromyalgia since clinicians can rely on certain tests in addition to symptoms, medical history, and a physical exam. Magnetic resonance imaging (MRI), for example, takes pictures of your brain and helps detect damaged nerves. Other tests may include spinal taps, optical coherence tomography — which scans your eyes for symptoms of MS — and evoked response tests, which look at how your nerves respond to certain stimulation.

According to the National MS Society, an official MS diagnosis requires the following:
- The discovery of damage in two or more separate parts of the central nervous system
- Proof the damage happened at different times
- The ruling out of other diagnoses
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Treatment for Fibromyalgia vs. Multiple Sclerosis

While neither illness has a cure, medication can be used to relieve fibromyalgia or MS symptoms. In the case of MS, drugs can also greatly modify the course of the disease. That’s why — though taking medication as prescribed is often key to the treatment of any chronic illness — medication adherence is especially crucial for MS patients.

For fibro patients: Some drugs commonly used to treat depression, called antidepressants, may ease pain and fatigue; these include duloxetine (Cymbalta) and milnacipran (Savella). Anti-seizure medications, frequently prescribed to people with epilepsy, can also help manage pain in fibromyalgia. Among these, the FDA has specifically approved pregabalin (Lyrica) for the treatment of fibro.

For MS patients: There’s been a lot of innovation in recent years to develop different kinds of medications that can help limit damage to the nervous system, reduce relapses, and slow disease progression. These include oral medications as well as medications that are injected or infused. Each medication works differently, but they generally affect immune system activity to prevent it from attacking the nervous system.

People with MS may need additional medication to treat flares, such as corticosteroids, as well as medications to target specific MS symptoms, such as drugs for bladder issues, sexual dysfunction, and muscle stiffness and spasms.

Patients with MS and fibro can also benefit from healthy lifestyle practices, too, including:
- Exercise: Regular physical activity can help manage symptoms of fibro or mild MS, and may improve mood, fitness and function. Swimming, walking, tai chi, and yoga are smart options. Consult a health care provider or physical therapist about a new exercise regimen, so it can be adapted to individual needs.
- Diet: Though there is no specific diet recommended for MS or fibro, a healthy eating plan may boost your immune system, help manage co-existing conditions, and promote overall good health.
- Sleep: Getting adequate rest is vital for both conditions. It’s recommended that adults between ages 18 and 64 should aim for seven to nine hours nightly.
- Complementary practices: Some patients report that activities like meditation, acupuncture, deep breathing and massage help them relax and ease symptoms.
Keeping a consistent daily routine is often suggested for both fibro and MS, as is leaning on family, friends, and professionals for emotional support. “If there is depression or anxiety, referral to a psychiatrist or counselor is often helpful,” says Dr. Cohen.

While MS and fibro may have some symptoms in common, they are ultimately distinct conditions with very different causes and treatments. Visiting a health care provider can help you get to the bottom of your symptoms quickly and begin the correct therapies. The faster you start, the faster you can start feeling better.

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For More Information Related to Fibromyalgia Visit below sites:

References:

Fibromyalgia Contact Us Directly

Click here to Contact us Directly on Inbox

Official Fibromyalgia Blogs

Click here to Get the latest Chronic illness Updates

Fibromyalgia Stores

Click here to Visit Fibromyalgia Store
03/31/2021