8 Facts About Living with Rheumatoid Arthritis and Fibromyalgia

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As many of the visitors to HealthCentral live with both RA and fibromyalgia, Karen Lee Richards - the community leader of our Chronic Pain site - and Lene Andersen, who oversees the RA site, interviewed each other about RA and fibro.

Both cause fatigue

Fatigue is often the most difficult FM symptom to describe to others.  It's a pervasive, all-encompassing exhaustion that can interfere with even the most basic and simple daily activities.  It can be described as feeling like someone pulled the plug and disconnected you from your power source.


The pain of RA feels different than FM

It's two completely different kinds of pain, but they can be similar in intensity. RA pain feels more internal, a bone grinding deep ache, whereas fibro pain feels more like your body is having hysterics.

The coping mechanisms are different

RA pain can be eased by staying still - you don't want to do that too much, though, or you may lose mobility - but if you stay still with fibromyalgia pain, your body seizes up more and the pain intensifies. Another important coping tool is to stay warm and that works for both RA and fibro.

RA and FM have a connection

It's not unusual for FM to occur with another disorder, such as RA, osteoarthritis, lupus, etc.  Researchers think that some people have a genetic predisposition to FM that may be triggered whenever they develop another illness. It's also possible there may be an autoimmune connection between RA and FM. However, that has not been proven.


Both can be difficult to diagnose

Both illnesses can be difficult to diagnose and share a number of common symptoms such as joint pain, fatigue, and flu-like symptoms.  Since blood tests and X-rays may show up as normal in the early stages of RA, it can be hard to pinpoint whether RA or FM is responsible for the symptoms.


Both are misunderstood

Getting that first FDA approval for a medication to treat fibromyalgia signaled a major turning point for the FM community.  It validated the illness in the minds of both the public and the medical community. RA is notorious for being hard to diagnose. It's common to have to see more than one doctor to get a diagnosis. Most good rheumatologists diagnose RA based on a medical history and physical exam, using blood tests to confirm.


There are three FDA-approved drugs for FM

There are three FDA approved drugs for treating fibromyalgia - Lyrica, Cymbalta and Savella. Other drugs that can be prescribed off-label for FM include tramadol, Ultracet, Xyrem, Neurontin, etc.

The prognosis for people with RA has changed

In the past, the prognosis of RA was pretty grim and the goal of treatment was to merely delay deformity and disability. In the last 10 years or so, a new treatment called Biologics has come on the market and made it possible for many to go into remission. This has changed the treatment approach to one of early and aggressive treatment.