Tuesday, December 30, 2008 BlackWdow6669, Community Member, asks

Q: MS or Fibromayalgia

How can I tell if i have ms or Fm? Or is it possible to have ms and fibrom ? Ive been experienceing alot of pain thoughout my body for 16 months now...2 doctors think i have ms one doctor i beleive took the easy way out and said i have fibromayalgia...i took a mri they found white matter spots on brain but says it has to do with fibromayalgia i have weakness in legs and arms i limp alot and right leg drags sometimes cause pain is so bad i have tingling all over body and cold water sensation running down my leg arm baack butt neck...my breathing is off i can get out of bed fine no stiffness hurts when i start starting my day ..does ms come and go ..i have this pain through all the seasons spring summer fall and winter...my fingers are numb ankles hurt toes hurt top and bottom of feet hurt fingers hurt swollen ankle swollen palms hurt top of hand hurts back and neck hurt all the time butt hurts i need help....

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Answers (1)
Lisa Emrich, Health Guide
12/31/08 6:12pm

Hi there,


You certainly are having a lot of pain.  I'm so sorry.  Let me try to answer your question and give you a few things to read.


First off, it is completely possible to have both multiple sclerosis and fibromyalgia.  There is a MS message board which I used to read that had members diagnosed with both MS and FM.  Some of the medications used for pain (anti-seizure meds) in one are also used in the other.


Please keep in mind that I have MS and do not have fibromyalgia (although my mother does).  For a nice description of FM, check out this article at the Mayo Clinic which does include the description of wide-spread pain, as do you.  Fatigue, depression, dizziness are also included. 


The NIH MedlinePlus website has links to lots of really great information about fibromyalgia., including this news article which describes abnormalities seen in the brain scans of women who have FM. 


A rheumatologist is the appropriate doctor to consult for diagnosing and treating fibromyalgia.  There is no single diagnostic test to determine FM, but other diseases which might cause the same symptoms must be eliminated, such as multiple sclerosis.


A neurologist is the appropriate doctor to consult for diagnosing and treating MS, preferably a neurologist who specializes in MS.  Again, there is no single diagnostic test and it's a process of elimination.  Even MS is not the only cause for "white spots" to appear in a brain MRI, some lesions can develop as we age.


In diagnosing MS, there are generally the following tests needed: blood tests to eliminate other causes of symptoms (such as Lyme disease, B12 deficiency, etc.); MRI scan of the brain (and c-spine if suspected) performed with and without a contrast agent injected into a vein; evoked potentials; and lumbar puncture to test cerebral spinal fluid (also called spinal tap).


Have you seen a neurologist or rheumatologist?  Have you undergone each of the tests mentioned above?


To my layman's ears, swelling of joints can accompany fibromyalgia, rheumatoid arthritis (which I am as well), lupus, and other rheumatological diseases.  Symptoms of MS can include the odd sensations and pain you describe (parathesias and dysesthesias), but they can also be seen in FM as well as Lyme disease.


Also, with MS, evidence of demyelination needs to be proven to be separated by time and location.  Were you diagnosed with "probable/possible MS"?  If so, then you are living in limbo until further developments.  The National MS Society (US) has quite a bit of information which you may find useful.


I'm sorry that I probably haven't helped you much, but hopefully you will find the information in the links to be helpful.  Thank you for your question.



mysteryme1, Community Member
9/20/09 1:44am

Hi  im a 46 yr old woman with fibromyalgia.  Although my neuro doc sees spots on my mri and says i may have ms or lyme. My question to you is,  the reply to the person  you gave you mentioned  that the mayo clinic  new newsletter about women with fibro having white spots on brain, .  I have tried to click on that link you have in there but it does not work.  Could you please tell me where i can read about this?  i have  tried keywords mayo clinic and fibromyalgia , white spots brain  fibro,  nothing comes up.  I really would apprecaite your help. i have been suffering with so called fibro for 12 yrs  im getting worse, maybe due to hormonal changes , im not sure  but the spots on my brain  scare me and my neuro  doc wants to do a lumbar spinal  tap test ,  and im putting it off  because of the the extreme fear i have of this test.  please help if you can.   thank you  Lisa

Lisa Emrich, Health Guide
9/20/09 2:58am

Hi Lisa,


I tried the link as well and apparently the article was temporarily located there.  Sorry about that.  However, I think I've found what the article was related to - Scans Reveal Brain Abnormalities in Fibromyalgia Patients

I also found a different research article which discusses changes in brain anatomy - Accelerated Brain Gray Matter Loss in Fibromyalgia Patients: Premature Aging of the Brain?


I know how scary it is to have a spinal tab done.  However, if you follow the doctor's recommendations, they you will experience much less pain and after effects.  Lie completely still for a significant length of time afterwards (I think that I was laying down in the doctor's office for a couple of hours before going home).  Drink plenty of fluids, including ones with caffeine.  If you develop a spinal headache, return for a blood patch.


Also, going through the diagnosis process for MS is scary enough.  If you have any questions about that, please feel free to ask.

mysteryme1, Community Member
9/20/09 3:56pm

Hi , thank you so much for replying.  I cant have caffiene,   never could my entire life even chocolate makes my head spin.  I always stay away from caffiene.   I really havent gotten much info on my spots on my brain from my doctor, except he says they do look like ms.  but hes not ruling out lyme either.   i am so sickly im so afraind the lumbar puncture is going to harm me.  my back is very bad, bulging disc at L4 AND L5    and i get much nerve pain from  that  especially in my genitals. im trying so hard to avoid th elumbar puncture, and i was thinking of calling nyu or other large hospitals. i live in ny state but not in the city im about 3 hrs from the city.  And then i was thinking if i found a doc in the city that i felt was more experienced with lumbar punctures   then how  would i get home.  i coul d only take a train there. you cant really drive into the city.  im very confused about everything.   and yes at my age of 46  im even more scared for some reason.   thank you for your help, and taking out the time to reply to my post.   Lisa

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By BlackWdow6669, Community Member— Last Modified: 11/13/10, First Published: 12/30/08