If you’re living with unexplained muscle pain, stiffness, or chronic fatigue, you may have one of two chronic conditions: fibromyalgia and polymyalgia. The two are often confused with each other because they both cause muscle pain throughout the body, and they have very similar names. However, they are different disorders with different causes, symptoms, and treatments. Below, we’ll cover everything you need to know about the difference between fibromyalgia and polymyalgia, starting with what they both are.
Understanding the Two Conditions
Fibromyalgia is a chronic disorder that is characterized by widespread musculoskeletal pain. It is often accompanied by fatigue, sleep disorders, and memory or mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.
Fibromyalgia can be hard to understand, even for healthcare professionals. The symptoms of fibromyalgia often mimic those of other conditions, and there are currently no tests to confirm a diagnosis. Due to this, fibromyalgia is often misdiagnosed.
It’s estimated that nearly 4 million adults in the United States, roughly two percent, have been diagnosed with fibromyalgia. Most people with fibromyalgia receive a diagnosis in middle age, but the condition can occur at any time and at any age.
Polymyalgia rheumatica, referred to more commonly as polymyalgia, is a chronic inflammatory condition that causes muscle pain and stiffness in various parts of the body. As the name suggests, polymyalgia is a form of arthritis. The most common areas affected by polymyalgia are the shoulders, neck, arms, and hips, but can occur elsewhere.
The symptoms of polymyalgia often appear suddenly and without warning, and are often worse in the morning. While it can occur earlier in life, polymyalgia typically affects people over the age of 65. It’s also more likely to occur in women than in men, although the reason why is unclear.
Some people with polymyalgia rheumatica are also diagnosed with a related disorder called temporal arteritis, also called giant cell arteritis. This condition causes inflammation of the blood vessels in the scalp, neck, and arms.
Both conditions cause muscle-related pain, which can make getting a proper diagnosis difficult. Next, we’ll take a look at the symptoms of fibromyalgia and polymyalgia, and examine how they are similar, and how you can tell them apart.
Fibromyalgia vs Polymyalgia: Symptoms
Both fibromyalgia and polymyalgia are musculoskeletal conditions with symptoms that may be hard to tell apart. That said, there are some differences between the two when it comes to their symptoms. Similarities and differences in symptoms of fibromyalgia and polymyalgia include:
- Location of Pain: People with fibromyalgia will typically experience pain in a more widespread manner than those with polymyalgia, usually in 18 key places around the body. For people with polymyalgia, pain is typically felt around the shoulders, back, and hips, although it can occur elsewhere.
- Sleep Difficulties: Many people with fibromyalgia report having difficulty sleeping, or struggling with chronic fatigue.
- Mental Health: Both fibromyalgia and polymyalgia can cause mental health conditions like depression related to living with a painful chronic condition. People with fibromyalgia are more likely to develop mental fog or difficulties with concentration, and one 2017 study found that they were also more likely to develop post-traumatic stress disorder (PTSD).
- Morning Stiffness: While both conditions can cause widespread muscle pain, people with polymyalgia often experience morning stiffness and higher levels of pain in the morning.
Other symptoms unique to fibromyalgia include:
- Dry eyes
- Pain or aches in the lower abdomen
- Bladder problems such as interstitial cystitis
Other symptoms unique to polymyalgia include:
- Loss of appetite
- Sudden, unintentional weight loss
- Malaise (a general sense of being unwell, often accompanied by fatigue)
- Flu-like symptoms such as a low-grade fever
While there are many overlaps in symptoms, there are a few distinct characteristics that can help you tell the difference between fibromyalgia and polymyalgia.
What’s the Difference Between Fibromyalgia and Polymyalgia?
The main difference between fibromyalgia and polymyalgia is what causes them. Polymyalgia is considered to be an autoimmune disease, meaning that the body attacks otherwise healthy tissue by mistake. Unlike fibromyalgia, polymyalgia is an inflammatory disease, which may explain why pain is more localized.
Fibromyalgia, on the other hand, is not an inflammatory condition. It is caused by abnormal sensory processing in the central nervous system. These overactive nerves are what researchers think causes the body to perceive pain despite there being no physical injuries. This means that fibromyalgia may occur because of the way that the brain and nerves perceive sensation, while polymyalgia develops due to a problem with the immune system.
Another major difference between fibromyalgia and polymyalgia is how they are diagnosed. Fibromyalgia is a diagnosis of exclusion. This means that when if you have widespread pain, and your doctor cannot find any other cause, they may diagnose you with fibromyalgia. There are no tests that can determine if you have fibromyalgia, however, a physical examination for specific pain points can help.
Polymyalgia can usually be diagnosed by a blood test. Since polymyalgia is an autoimmune disease, most people with the condition will have elevated levels of inflammatory proteins in their blood. They may also show changes in their red blood cells that are characteristic of inflammation.
Treatments for Fibromyalgia vs Polymyalgia
When it comes to understanding the difference between fibromyalgia and polymyalgia, one of the most important things to know is that they require different treatments. Since polymyalgia has more of a “known” cause, treatment typically focuses on reducing inflammation. Treating fibromyalgia emphasizes more pain management, and aims to reduce central sensitization.
The main treatment of choice for polymyalgia is medication, more specifically, corticosteroids. Corticosteroids are so effective at treating polymyalgia that if they do not reduce symptoms, it’s more than likely not the right diagnosis. One of the most common corticosteroids used to treat polymyalgia is prednisone, which can quickly relieve symptoms related to inflammation.
Treating fibromyalgia usually involves a combination approach to fight fatigue as well as pain. Depending on what symptoms you have, your doctor may recommend over-the-counter medications such as Tylenol or ibuprofen to help with pain. Since many people with fibromyalgia struggle with depression, they may also prescribe antidepressant medications to help with their mental health and sleep problems.
Alternative treatment methods and complementary therapies can also help with fibromyalgia, these include things like:
- Massage therapy
- Dietary changes
- Stress management
- Cognitive behavioral therapy (CBT)
There is little evidence that these above-mentioned therapies help improve polymyalgia symptoms.
Both fibromyalgia and polymyalgia are chronic, musculoskeletal conditions that can produce many of the same symptoms. Both conditions may change with time but are unlikely to go away, as there are no known cures for either.
Experiencing the symptoms of either polymyalgia or fibromyalgia can be challenging and frustrating. The first thing to do is keep track of your symptoms. Keeping a journal is a great way to make sure you’re accurately remembering your symptoms and can be useful when talking with your doctor. Once you receive a diagnosis, your doctor can help you find the right treatment methods and put you on the right path.
Corticosteroids are typically the first option that your doctor suggests to combat the discomfort of polymyalgia, but they’re not the only thing that can help. An anti-inflammatory diet, regular exercise, and good sleep can make a big difference in managing symptoms.
People with fibromyalgia may try several remedies before finding one that is best for them. In addition to dealing with pain and fatigue, they may also sometimes feel misunderstood by others who don’t have the condition, even those in the healthcare community.
Understanding the difference between fibromyalgia and polymyalgia is an important first step towards a proper diagnosis. Use what you know about your condition to seek support from friends, family, community members, as well as your healthcare providers. With the right chronic pain resources, you can begin to manage your symptoms and feel more in control.
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