Rheumatoid Arthritis vs. Fibromyalgia

  • Medical Author:
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Rheumatoid arthritis (RA) vs. fibromyalgia facts

  • Rheumatoid arthritis and fibromyalgia have similar symptoms, including joint and muscle pain, fatigue, and sleep disturbances.
  • Rheumatoid arthritis is a systemic inflammatory autoimmune disease where the immune system attacks the joints and causes joint damage and can affect other organs.
  • Fibromyalgia is a chronic pain syndrome that causes muscle, joint, and bone pain and tenderness, fatigue, and many other symptoms. It does not cause elevated inflammation levels in the bloodstream. It does not cause joint damage and is not organ-threatening.
  • Many people with RA have fibromyalgia simultaneously. But having fibromyalgia does not increase the chance of developing RA.

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Autoimmune diseases are illnesses that occur when the body's tissues are mistakenly attacked by their own immune system by an abnormal, misdirected immune system response. Inflammation of the joints and tissue around the joints are characteristic features of rheumatoid arthritis that are caused by the autoimmune process. Because it can affect multiple other organs of the body, RA is referred to as a systemic illness (in fact, sometimes it is referred to as rheumatoid disease).

What is fibromyalgia?

Fibromyalgia syndrome is a chronic pain condition that affects 4% of people in the United States. Many patients experience pain all over their body. Sleep that is not restful is another hallmark of fibromyalgia, causing chronic fatigue. While patients with fibromyalgia may feel as though their joints, muscles, tendons, and tissues are inflamed, measurable levels of inflammation in blood testing are normal. Fibromyalgia can be very painful and greatly affect a patient's quality of life in many ways, but it does not cause damage to organs or joints.

Rheumatoid Arthritis Symptoms & Signs

Rheumatoid arthritis usually inflames multiple joints and affects both sides of the body. In its most common form, therefore, it is referred to as a symmetric polyarthritis. Early RA symptoms may be subtle. The small joints of both the hands and wrists are often involved. Early symptoms of rheumatoid arthritis can be pain and prolonged stiffness of joints, particularly in the morning. Symptoms in the hands with rheumatoid arthritis include difficulty with simple tasks of daily living, such as turning door knobs and opening jars. The small joints of the feet are also commonly involved, which can lead to painful walking, especially in the morning after arising from bed.

What are causes and risk factors of rheumatoid arthritis and fibromyalgia?

The causes of rheumatoid arthritis are partially genetic and partially environmental. Certain genes predispose people to developing rheumatoid arthritis, and that is why it runs strongly in some families. Environmental risk factors for RA include cigarette smoking and female sex.

Fibromyalgia is in part genetic and can be triggered by stressful events. The stressful event can be physical, such as a car accident, or emotional. The chronic pain of autoimmune diseases such as RA and systemic lupus erythematosus can sometimes trigger fibromyalgia.

What are signs and symptoms of rheumatoid arthritis and fibromyalgia?

The defining feature of rheumatoid arthritis is joint inflammation, which causes joint pain, swelling, and redness. The swelling is present for more than six weeks and is usually on both sides of the body in the same joint (for example in both wrists).

The defining features of fibromyalgia are fatigue with widespread pain and tenderness. Patients with fibromyalgia may have many other symptoms as well, including brain fog (fibro fog), tingling or numbness in the feet or hands that comes and goes, anxiety, depression, bowel irritability, and many others.

What tests do health care professionals use to make a diagnosis of rheumatoid arthritis and fibromyalgia?

Rheumatoid arthritis is diagnosed based on persistent joint inflammation for more than 6 weeks. Blood tests are commonly abnormal in rheumatoid arthritis, including the erythrocyte sedimentation rate (ESR) inflammation level, and rheumatoid factor (RF), and citrulline antibody (anti-CCP antibody).

The diagnosis of fibromyalgia is made based on symptoms of chronic widespread pain and fatigue and signs of widespread tenderness. Many people have both rheumatoid arthritis and fibromyalgia, but fibromyalgia does not cause rheumatoid arthritis or progress into it.

What are home remedies and treatment options for rheumatoid arthritis and fibromyalgia?

The treatment of fibromyalgia always involves getting enough sleep, exercising, and stress reduction. Medications can be used to treat fibromyalgia pain as well as improve sleep.

Getting enough sleep, exercising, and stress reduction are also very important in the treatment of rheumatoid arthritis. However, medications are necessary to reduce joint inflammation and prevent joint damage. Without treatment, RA grows progressively worse and damages joints. There are many medications that have been proven to slow or stop the course of rheumatoid arthritis.

What is the prognosis of rheumatoid arthritis and fibromyalgia?

The prognosis of fibromyalgia is very good, in that people with fibromyalgia do not suffer damage to their joints, muscles, or organs. However, fibromyalgia pain is chronic and improves with lifestyle changes and medications to a manageable level.

There have been tremendous advances in the treatment of rheumatoid arthritis in the past decade, and many medications are now available to stop or slow the disease. Currently, the goal of treatment is low disease activity or disease remission, where patients have few or no swollen and tender joints and low systemic inflammation blood levels.

Is it possible to prevent rheumatoid arthritis or fibromyalgia?

There is no known prevention of rheumatoid arthritis or fibromyalgia. Living a healthy lifestyle, eating healthy foods (including vegetables, fruits, whole grains, and lean meats), getting plenty of sleep, not drinking excessive alcohol, not smoking tobacco, and not using drugs may help the body function at its best.

Medically Reviewed on 7/5/2017

Bhana, S. "Fibromyalgia." March 2017. <https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia>.

Murphy, J. "Rheumatoid Arthritis." March 2017. <https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/>.

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