Fibromyalgia vs. Reactive Arthritis?

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EveSasser
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   Posted 2/11/2007 2:33 AM (GMT -7)   
Hi, guys -
 
On my LAST visit to my previous doctor, I noticed the notation FM (fibromyalgia) on the notes that the doc handed to me. I have since changed docs for various reasons. I thought at first that she must be mistaken, but then I realized that I was having more and more widespread pain and aches in my muscles and tendons. I have been on/off of Enbrel since August. A good deal of the time I cannot take it because I have an infection. I went to see my shrink a few days ago and asked for Sinequan (doxepin) because I know that it helps with pain in some people with fibromyalgia. For me, it has significantly reduced the pain that I am experiencing and works better than all of the narcotics that I tried. I did some research and found out that the tricyclic antidepressants are now the gold standard in treating neuropathic pain. I am also taking a small dose of an NSAID. I have not taken Enbrel in about 10 days.
 
Has anyone on this board been misdiagnosed with arthritis when you really had fibromyalgia? Also, is there anybody with both arthritis and fibro who is taking Enbrel? I recognize that a person could have both conditions,but I am seriously wondering if I have arthritis at all. I also have a diagnosis of lyme, but I think it is lame because I only have two reactive bands on the Western blot. Would like to hear from anybody with a similar experience.
 
Eve

Keah
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   Posted 2/15/2007 7:16 AM (GMT -7)   
Eve, how was the Dx of arthritis made? Have you had a bone scan? That would probably be the best way to determine what is going on with your joints as it often shows arthritic changes years before they can be seen on an x-ray.

Another consideration with reactive arthritis is that it could be affecting the soft tissues, such as tendons which could cause pain up into muscles. My calves kill me from the achilles tendonitis. I also have severe muscles spasms caused by inflammation around my spine putting pressureon the nerves. Thos nerves then travel through or alongside muscles and in order to try and protect the nerve, the muscles spasm. This of course can put more pressure on the nerve and create a snowball effect making the pain and spasm worse.

I hope that you can find some answers and relief soon.
Keah a.k.a. Wormy
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EveSasser
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Date Joined Mar 2006
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   Posted 2/15/2007 10:17 AM (GMT -7)   
Hi, Keah, I have had two doctors give me a clinical examination. I meet the diagnostic criteria for reactive arthritis and ankylosing spondylitis (I don't have AS). My arthritis is in the spine and hips. I have also had MRIs of the cervical and lumbar spine. I think the MRIs were normal. This tendonitis and muscle pain are not new, but they are more widespread than before. I am going to start physical therapy soon. I am hoping that will help. I need to get out of bed. I have been sedentary for a long time. That is making the problem worse.

Thanks for your suggestions.

Keah
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Date Joined Nov 2003
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   Posted 2/15/2007 10:57 AM (GMT -7)   
Eve, I'm confused. You say that you met the diagnostic criteria for reactive arhtritis and AS but that you don't have AS. How was that determination made? The difference between the two is really just semantics. Both are a form of Spondyloarthropathy (SpA). Have you been tested for HLA-B27? A positive result would go a long way towards a definitive Dx. A negative result doesn't really rule out AS though.
 
I tested negative, but have like you, meet the diagnostic criteria. My Rheumy believes that at some point, I will develop the fusion that would move me into the AS catagory. I have all the hallmarks of AS - just none of the fusing - yet.
 
All of the symptoms that you've described sound exactly like mine and that makes me think that you need to persue more info regarding the arthritis. The stiffness, soft tissue problems and specifically the spinal and hip pain really do sound much more like SpA than anything else.
 
I'd suggest that you read through some of the info at spondylitis.org. I've learned so much through there and was able to get myself out of the care of a Rheumy who only wanted to treat me with NSAIDS even though I have Crohn's Disease and can't tolerate them without a severe gut flare.

EveSasser
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Date Joined Mar 2006
Total Posts : 808
   Posted 2/15/2007 11:08 AM (GMT -7)   
No, I tested negative for HLA-B127. My doctor made the determination based on a clinical examination. I have read a great deal about arthritis including the site that you provided. I have a Harvard educated physician who did his internship at NIH. I think I am getting very good care, but I don't like the treatment with Enbrel. I am sure the docs will carefully monitor me for signs of AS. The MRI of the lumbar spine will help to see what is going on. There is a list of "official" AS criteria that was recently revamped and I meet them. It includes having pain at specific places in the spine.

Thanks for your comments.

EveSasser
Veteran Member


Date Joined Mar 2006
Total Posts : 808
   Posted 2/15/2007 11:09 AM (GMT -7)   
One of the main reasons that the doc doesn't think I have AS is my age. I am 52. Onset of AS is usually at a young age. Onset of this reactive arthritis was at the age of 49.

Eve

Ides
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   Posted 2/16/2007 4:36 PM (GMT -7)   
Eve, if you don't like Enbrel, then you are not required to take it. There are other medications that treat the inflammatory process of arthritis. A recent study has shown that Enrel does not prevent the formation of new bony growth and/or fusion. It does help significantly with the inflammation. Just one study, but a topic that needs to be followed.

I was diagnosed with AS when I was 2 years older than you. Often women are slower to develop the radiographic signs that lead to diagnosis. For years AS was thought of as a disease that primarily only affected men. Therefore women, their pain, and physical symptoms were dismissed for years.

I'm glad that you have a physician that you trust and like that appears to have excellent credentials. Just remember, every medical school class had someone that graduated last......my first GI appeared to be one of those...now he's my EX GI.
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CD, Ankylosing Spondylitis, peripheral neuropathy, Sjogren's Syndrome
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Ducky
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Date Joined Mar 2005
Total Posts : 3199
   Posted 2/16/2007 10:55 PM (GMT -7)   
Hey Eve.. when do you see the rheumy again? How are you feeling?
Moderator of Arthritis/Epilepsy Forums
Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs
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Baybreeze
Regular Member


Date Joined Oct 2005
Total Posts : 315
   Posted 2/17/2007 6:51 AM (GMT -7)   

Hi,

I was told I have fibromyalgia due to muscle pains and tender points, etc. I was also give a low does antidepressant that was supposed to help with pain & sleep called Elavil (10 mg every evening). It did help me greatly with sleep..I usually zonked out an hour after taking it, even after being on it for a year. However, it did not seem to help with my muscle pains nor any other joint pains I had. But I was at least happy that I could pretty much sleep.

After doing some research and reading through posts, I am wondering if I have fibro at all. I do have OA in various joints and spine and lupus. But when I took prednisone for a bad flare for the first time, it completely eradicated every muscle (and other pain) that I had. I was actually able to exercise again without feeling that horrible deep muscle burn, I had no tenderness anywhere....I felt normal again with no pains whatsoever. And from what I keep reading (even on medical websites) is that prednisone is an enemy of fibro & makes it worse. In my case, my so-called fibro completely disappeared. It's now back again ever since i've tapered off the pred. BUt it also disappeared for a few days while on Medrol Dose packs and also went away when I got epidural steroid injections into my spine. I'm also getting alot of tendon, muscle, and/or ligament problems in my shoulders, hips, hands, and might have detached tendons in my right ankle now as it's now collapsed over time. Strange that my spine surgeon, hip specialist, and PT all said it could actually be lupus related. My rheumy never mentioned that, though....but I will ask him about it at my next appt.

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