Thursday, July 31, 2008 Jules asks

Q: Fibromyalgia and RA

Wondering if most people with RA have Fibromyalgia too???  Also, wondering if the RA treatments (like MTX) help the Fibro symptoms as well.  AND, can you take Cymbalta with MTX???  For those of you with Fibro symptoms, does Cymbalta make a big difference?  I am having trouble with the "anti-depresent" thing...I have never been one to be depressed, and I am not depressed now and am unclear as to how an anti-depressent will help me with the Fibro pain.  I have terrible muscle pain in neck and shoulders, and TERRIBLE  Costochrondritis (chest pain).  And, the Brain "Fibro Fog" is driving me crazy, not to mention embarassing.

Thanks.

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Answers (2)
Lene Andersen, Health Guide
8/ 1/08 12:20pm

Yes, you can absolutely have RA and fibromyalgia (FM) at the same time - I'm in the same boat. I've had RA for 40 years and developed FM in 2003/2004 and in the beginning, found fibro symptoms much more difficult to deal with an RA symptoms. But we humans are wonderfully adaptive creatures and you learn tips, tricks and medications that help you deal with the symptoms. We are taught to avoid a reliance on medication, but once you develop a chronic illness, you have to reframe your thinking - try to keep in mind that meds are a tool to help you live your life.

 

One of the interesting things about FM is that medications like narcotics and regular painkillers tend not to work very well for the pain. Instead, they have found that antidepressants can be very helpful. Anti-depressants elevate certain chemicals in the brain, including serotonin and it turns out that low serotonin levels happen not just in depression, but are also associated with pain and fatigue. As well, antidepressants help regulate sleep and one of the symptoms of FM is interrupted sleep cycles (the worse your sleep is, the more pain and foggy thinking you have). I'm pretty sure that the meth doesn't directly influenced fibro, but suspect that if it decreases your RA pain, the tense muscles of fibro might relax a little, too. As well, I'm pretty sure that your doctor wouldn't prescribe Cymbalta if it interacted with meth, but you might want to double check with your doctor and/or pharmacist about that.

 

Down the road, if you're still experiencing FM pain, there are other medications that may be helpful, such as an overnight muscle relaxant and a medication for nerve pain called Lyrica is also very effective for many. The brain fog may stick around in a less intense form, but you learn ways of dealing with it (e,g., I have Post-Its and a pen in every room of my house). On HealthCentral's menopause site, Toni Hurst wrote a great post about how to manage a foggy head (you can find the article here). Equally important, I've also learned to not care as much as I used to - your brain is still in there and once your symptoms are better managed, a significant part of it will come back.

 

I also get horrible neck and shoulder pain and found that it is essential for me to keep that area warm, so I almost always wear a sweater or a shawl/scarf - one that's as fashionable as possible, naturally! - and try to not sit directly under an A/C vent (drafts are your enemy!). HealthCentral's ChronicPainConnection has an entire section on fibromyalgia (click here) and you'll be able to find lots of information and other tips there.

 

Good luck! And please write again if you have any other questions.

 

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8/ 4/09 10:55am

thank you  for posting this information  I have sent the letter  to  family members to read  hoping that  they will read it  as it explains   very clearly that    fibro is a  real illness  and  I am not FAKING or  wanting attention  I  am so  very tired of  pretending that I am ok  to  everyone when I  am NOT. I have been living with this diagnosis  since 2004 and   just recently was  diagnosed with RA   on top of  having  fibro  so  again thankyou for posting this  I can only hope that my family  members will come to understand more about the seriousness of  these illnessess and believe me when I tell them I am not feeling  well. I'm tired  of  fighting  everyday  to  do  simple tasks  and I  push myself to the extreme so many times  a week only to  suffer even more. 

Jan 

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Lene Andersen, Health Guide
8/ 4/09 12:11pm

Karen Lee Richards - one of our experts on our Chronic Pain site - wrote a post a while ago that might be helpful.  It's letters to family and friends about what it's like to live with pain.  As well, i wrote a post on my blog about fibro pain a few weeks ago that may help your family understand, as well.

 

It's hard fighting to get through the day and having to fight to be understood, too.  This post may help or at least give you a laugh (of the dark kind).  Hang in there and remember - you don't have to defend yourself to anyone.  Sometimes, we can get caught up in other people's disbelief and it can be hard to remember that although it doesn't hurt to give people a bit of education in what's going on with you, you don't have to convince them. Having a couple of articles you can print out and hand to them when you don't have the energy to guide them through the process can be helpful.

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9/23/08 6:23am

I've not had any degree of decreased pain for Fibro using Cymbalta. I had hoped it would help, but it has helped with vertigo that other anti depressants gave me. Sorry you're having problems. I wouldn't worry about being on an anti depressant. Sometimes the reason to drug was created has other uses.

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7/11/10 5:25pm

I agree i have not had any help with the cymbalta and have been on it for nearly a year. Then again, i think something else is wrong. I had a herniated disk awhile back and the put me on predisone and loratab. The pain and stiffness in my joints and hands basically went away. I don't know what is best for you. From all that I have read it is all trial and error, when it comes to FM, and many of the autoimmune diseases. No one person is alike. i have read that many people have had lots of luck with Cymbalta jusy not me, either. Want to wean off of it at this point but have heard thats a painfull battle all in its own, at this point I cant bear anymore pain. Good luck to all of you, i hope help comes soon.

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By Jules— Last Modified: 12/24/10, First Published: 07/31/08