Rheumatoid arthritis vs. fibromyalgia

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elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1740
   Posted 11/7/2005 3:26 PM (GMT -6)   
Hi all.  I have a diagnosis of RA (positive rheumatoid factor in addition to symmetrical joint pain).  I have had several days in the past couple of months where I am so completely stiff and achy all over (specifically, neck, shoulders, elbows, wrists, hands, lower back, hips, knees, and ankles).  It's almost like I'm coming down with the flu or something.  NSAIDS helped alot; however, I cannot tolerate them and probably shouldn't take them anyway because I may also have inflammatory bowel disease/crohn's.  I'm currently taking sulfasalazine (SSZ), but that takes several weeks to kick in (at least 6).  How do you know whether you have fibromyalgia versus rheumatoid arthritis?  I would think a positive RA would eliminate the possibility of fibro, but I've also read that having both is common.  If any of you have fibromyalgia and/or RA, how were you diagnosed with it?  What differentiates the two?  Is this something I should mention to my rheumatologist (I see him in a couple of weeks)?  I just feel so horrible that I can hardly sit still.  Sorry for whining.  Thanks in advance for any information you have.
 
Elcamino

erin.K
Veteran Member


Date Joined Mar 2005
Total Posts : 3148
   Posted 11/7/2005 4:28 PM (GMT -6)   

Dear Elcamino,

Was it just recently that you were diagnosed with RA?  You have a few things that are in your favor!  I mean, it's terrible to have to live with CD and RA (I've the same), but at least you have a positive lab for RA, hallmark symmetrical joint pain, and you do respond to NSAIDs...those will all help you & the Drs in treating the RA.

Even though the RA factor is positive, developing fibromyalgia is still possible and you can be getting painful muscles and tissues from the CD, the RA and any inflammatory processes that are going on in your system.  They ach like you have the flu.  And, when one disease flares up, it can trigger the other disease to flare as well.  Also, the CD or RA could have caused the fibro symptoms. 

Many systemic factors attribute to fibromyalgia.  The diagnosis is made by signs and symptoms and also by certain "sensitive/tender" spots on your body which the doc palpates signaling the fibro diagnosis.  It is thought that fibro is a symptom of some underlying disease...which is why we folks who have autoimmune disorders are many times diagnosed and treated for fibro.

When seeing your rheumatologist, make sure he knows that not only do you have bilateral joint pain, but your muscles hurt as well. 

So what are you using for treatment for the RA?

I've been trying to get control of my joint pain since 2001.  Just diagnosed with CD in august.  NSAIDs do a number on my guts...so I can't use them at all. (Had RA since 16, but was not treated until I was 22)  Taking Humira now...but I really want to recieve Remicade therapy since I'm not responding too great to the DMARDs and the remicade is also used to treat CD, so why not have the best thing out there!

Looking forward to hearing from you.  Take good care.

Sincerely,

Erin

 



elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1740
   Posted 11/7/2005 5:22 PM (GMT -6)   

Thanks for your reply Erin.  I was diagnosed with RA two years ago, although I've always suspected that I don't have RA (no swelling) because a positive RF is found in a lot of different autoimmune diseases.  I do not have a definitive diagnosis of cd, but a colonoscopy I had a couple of months ago showed multiple apthous ulcers throughout my colon (which is indicative of early cd).  My rheumatologist thinks I may have early IBD, in which case the arthritis can precede the disease by a number of years.  I am currently being treated for the RA with sulfasalazine because it is easier on the gut.  I cannot take NSAIDS either, although that's what I had been taking prior to my colonoscopy.  I didn't realize that cd can cause soft tissue rheumatism as well.  I'm currently weaning off entocort that my GI doctor put me on; I wonder if that's causing my system to rebel which is causing the stiffness and achiness.  I'll mention this to my rheumatologist in a couple of weeks.  I have not progressed to the DMARDs yet; the sulfasalazine comes closest.  I'm not sure if it is a DMARD, but I've seen it classified as such on the internet.  I understand many people cannot take it because of the sulfa component--I haven't had any problems with that at all.  If fibro is seen as a symptom of some subclinical inflammatory process then it would make sense that it would be common among people who have autoimmune disease.  I think I'll go take a hot bath--the only thing that helps, as I cannot take ibuprophen or any other NSAID while taking the SSZ.  Good luck on your pursuit of remicade treatments.  I think my insurance would squawk if I tried remicade before any DMARDs.

 

Elcamino

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