Treatment Options For Rheumatoid Arthritis
Early diagnosis and treatment can help prevent the organ and joint damage caused by RA.
The goal of treatment is to get the disease into remission and stop the progression. This can be accomplished through several options.
- Steroids Corticosteroids are initially prescribed to reduce inflammation and pain. Steroids are used short-term and tapered gradually
- NSAIDs either over-the-counter or prescription
- DMARDs Disease-modifying antirheumatic drugs can slow the progression of RA
- Biologic agents This newer class of DMARDs also slow the progression of RA and can be used in combination with DMARDs
- Occupational or physical therapy to instruct patients how to keep joints strong and flexible
- Lifestyle modifications such as a healthy diet, low impact exercise and adequate rest
Science has not been able to pinpoint the exact cause of rheumatoid arthritis. Research shows that genetic and environmental conditions could activate this disease.
Current theories indicate that a virus, infection or trauma could trigger the onset of symptoms in those who are genetically vulnerable.
Even with medication and lifestyle modifications, rheumatoid arthritis can flare. A flare is a sudden increase in disease activity and symptoms.
If RA flares, the rheumatologist may want to increase or change medications to better control the condition.
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.
Treating Ra And Fibromyalgia
People living with both fibromyalgia and RA will need to pursue treatment options for both conditions. Because they arise from different causes , this will often involve pursuing two treatment tracks at the same time.
Some treatments, such as over-the-counter pain relievers like nonsteroidal anti-inflammatory drugs , may overlap for both conditions. However, treating RA usually involves taking corticosteroids or treating chronic inflammation with disease-modifying antirheumatic drugs , biologic medications, and more. On the other hand, some people with fibromyalgia do well when they take antiepileptic medications or antidepressants.
Working with physical and occupational therapists can help with both fibromyalgia and RA. Other ways to manage your symptoms include:
Treating RA and fibromyalgia together involves working closely with your rheumatologist and health care team. They will be able to determine the right treatments for you and help maintain or increase your overall quality of life.
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Fibromyalgia And Rheumatoid Arthritis Differences
Can Fibromyalgia and arthritis be completely different things? Not necessarily. Like a pinata can be made out of several different kinds of rice, each condition’s exact causes and symptoms can vary. It is also possible that there are no true differences between Fibromyalgia and arthritis – but rather that both are symptoms of different underlying causes. For instance, Fibromyalgia is often caused by an imbalance of the central nervous system. However, the cause of arthritis can be due to many different things, such as age, genetics, and other internal and external factors. Here are some key differences between the two conditions:
When To See A Doctor
If youre experiencing any of the symptoms associated with either RA or fibromyalgia, make an appointment with a doctor or other healthcare professional. Even though these conditions share similar symptoms, the treatment and outlook for people with RA differ from those for people with fibromyalgia.
A doctor can help diagnose the condition and recommend the right treatment. Its also important to treat RA early because RA may lead to serious complications as it progresses.
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Low Or Normal Inflammatory Markers
If inflammatory markers are low or in the normal range, it can help point to an FMS diagnosis, which is a diagnosis of exclusion. Depending on your symptoms, your healthcare provider may order more blood tests or imaging to rule things out.
Once other possible causes of your symptoms are eliminated, your healthcare provider can confirm an FMS diagnosis in two ways: a tender-point exam or scores on a specially designed evaluation.
What Is The Difference Between Fibromyalgia And Myofascial Pain Syndrome
Myofascial pain syndrome is similar to fibromyalgia, but there are important differences in symptoms and treatment. One big difference is that myosfascial pain is confined to a specific area and is associated with trigger points. For more information, see the Made for This Moment myofascial pain syndrome page.
A person can have both fibromyalgia and myofascial pain syndrome. That makes it especially important to consult with a medical specialist who can diagnose the difference and apply the proper treatments for each condition.
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What Are The Risk Factors For Fibromyalgia
Known risk factors include:
- Age. Fibromyalgia can affect people of all ages, including children. However, most people are diagnosed during middle age and you are more likely to have fibromyalgia as you get older.
- Lupus or rheumatoid arthritis. If you have lupus or rheumatoid arthritis , you are more likely to develop fibromyalgia.
There are other characteristics that have been linked to fibromyalgia, but more research is needed to confirm these relationships. These possible risk factors include:
- Sex. Women are twice as likely to have fibromyalgia as men.
- Stressful or traumatic events, such as adverse childhood experiences, car accidents, or post-traumatic stress disorder .
- Repetitive injuries. Injury from repetitive stress on a joint, such as frequent knee bending.
- Family history.
Most Important Differences Between Fibromyalgia And Rheumatoid Arthritis
Fibromyalgia and rheumatoid arthritis are common joint and bone diseases that are sometimes misdiagnosed. In this article, 7 main differences of these diseases are stated that doctors can easily diagnose the disease because of these differences.
Do I have rheumatoid arthritis or Fibromyalgia? This is a question for many of you, as well as those who have muscular pains and other nervous system problems. This question is sometimes difficult to answer even for doctors because the two conditions have many similar symptoms that can lead to misdiagnosis. However, because of the distinctions in some Rheumatoid arthritis and Fibromyalgia symptoms, the two can be distinguished somewhat. What’s the difference between Fibromyalgia and rheumatoid arthritis? That’s a question we’ll answer in the remainder of this article.
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What Causes Ra And Fibromyalgia
Scientists are not sure exactly what causes fibromyalgia. The condition occurs twice as often in women than in men, according to the Centers for Disease Control and Prevention . People who have a family history of fibromyalgia are also at a higher risk though it doesnt appear to be directly inherited from parents.
Moreover, a person can develop fibromyalgia after experiencing:
- A serious or significant illness, such as viral infections
- Injuries caused by repeated stress
Having osteoarthritis, RA, or lupus is also a potential risk factor for fibromyalgia, according to Mayo Clinic.
Researchers arent sure why these brain and the spinal cord changes occur in some people but not in others. Some believe repeated nerve stimulation may boost the amount of chemicals in the brain that signal pain. Additionally, the brain may develop a memory of past pain, causing a person to experience unusually strong, painful reactions to signals that may or may not actually be painful.
RA occurs when the immune system attacks the bodys healthy tissues. As with fibromyalgia, scientists dont fully understand the underlying biological processes that cause RA. However, theyve identified several hereditary and environmental risk factors for the condition.
Like fibromyalgia, RA is more prevalent in women than in men, according to the CDC.
Fibromyalgia Is A Centralized Pain Condition
Fibromyalgia is a chronic condition that causes extreme fatigue and pain in the tendons, ligaments, and muscles throughout the body.
The pain can range from a dull, all-over ache to intensely sharp burning or stabbing pain.
Fibromyalgia can be a debilitating condition but does not cause inflammation or damage to the joints or organs.
Unlike rheumatoid arthritis, fibromyalgia is classified as a chronic syndrome rather than a disease because it presents a group of symptoms that affect all systems of the body.
While fibromyalgia does not cause damage, the condition can be difficult to treat successfully.
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Experiencing Fibromyalgia And Arthritis Together
Although fibromyalgia and arthritis are very different medical conditions, they can still occur in the body at the same time.6This coexistence can make the symptoms of each condition worse, especially joint pain on both sides of the body, fatigue, and depression. Over-the-counter pain relievers, pain relief creams like JointFlex, non-steroidal anti-inflammatory medications, and COX-2 inhibitors may be used to treat patients with fibromyalgia and arthritis together. Meanwhile, reducing daily stress, getting an adequate amount of quality sleep, and exercising a little every day goes a long way in managing symptoms of fibromyalgia and arthritis together.
The Pain Centre Versus Arthritis
In partnership with the University of Nottingham and local NHS Trusts, Versus Arthritis supports the worlds first national centre for research into pain.
The aims of the centre are to improve our understanding of pain and ways to stop it, through existing and new treatments.
The centre has experts in rheumatology, neuroimaging, psychology, neuropharmacology, neurosciences and orthopaedic surgery.
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What Are Rheumatoid Arthritis And Fibromyalgia
It is best to briefly look at these two diseases before discussing the difference between rheumatoid arthritis and Fibromyalgia.
Rheumatoid arthritis is an autoimmune disease in which your immune system targets your healthy joints and organs. This causes inflammation, pain, and damage.
Fibromyalgia is a condition that causes extensive musculoskeletal pain and tiredness, sleep, cognitive, and mood problems. There is currently no known definitive cause, but certain external factors, including genetics and stress, may predispose a person to the condition.
There are some similarities between Rheumatoid Arthritis and Fibromyalgia. Both conditions cause painful joints and muscles, along with other body symptoms. Rheumatoid arthritis affects the larger joints of the hands, feet, and legs more than the smaller joints like the knees or hips. The swelling in the joints and muscles is what gives both conditions the name.
Fibromyalgia has many of the same symptoms as arthritis. Joint and muscle pain, low energy, fatigue symptoms, loss of sleep, and stiffness are common to both conditions. Both conditions cause inflammation, which can make it difficult for the body to move. People with Fibromyalgia sometimes report bad feelings when they are around people who seem happy and active. However, the two conditions are very different, and symptoms will probably vary in frequency and severity for each condition.
A Fibromyalgia Chiropractic Doctor Can Help
Its hard to cope with everyday work or personal tasks when you have fibromyalgia or rheumatoid arthritis. You might have days when you cant get out of bed without wincing in pain. Thankfully, you can try natural remedies like fibromyalgia chiropractic care.
Upper cervical care is a holistic and integrative approach to healing the body and eliminating pain. It focuses on restoring the balance in your spinal columna critical factor in reducing risks for chronic disorders like fibromyalgia and rheumatoid arthritis.
The upper neck bones are the main focus of an upper cervical chiropractor because they can easily get dislodged after an accident or a forceful extension of the neck. Unfortunately, when they move from their original place, your C1 and C2 bones can easily disrupt signal transmission between your nervous system and other parts of the body.
The cervical bone misalignment can also impact the brainstem, which regulates several body functions such as your sleeping cycle, digestion, and blood pressure regulation.
Thankfully, with the help of an upper cervical chiropractic practitioner, you can address the bone misalignment and begin your healing process. Regardless of whether you have rheumatoid arthritis or fibromyalgia, upper cervical care may come in handy because studies show a strong link between these diseases and cervical spine health.
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Can Fibromyalgia Be Mistaken For Rheumatoid Arthritis
In a recent study from the University of Illinois’ College of Medicine, researchers have found that Fibromyalgia and Rheumatoid Arthritis are often misdiagnosed. Of the 495 patients involved in a study, over half had been misdiagnosed with Rheumatoid Arthritis. In contrast, only fifteen percent had been diagnosed with Fibromyalgia. This inaccuracy is probably because Fibromyalgia and rheumatoid arthritis are so similar that the term “fibromyalgia” does not accurately describe its diagnosis or treatment. The classification of Fibromyalgia as a chronic disease is currently not recognized by the American College of Rheumatology. However, the condition is recognized by the World Health Organization and the United States Department of Health and Human Services.
Ra And Fibromyalgia Share Some Symptoms
The aching or throbbing pain caused by fibromyalgia tends to be spread throughout the body, while the soreness or stiffness caused by RA tends to be concentrated around the joints, especially the hands and wrists. But some people with fibromyalgia also experience joint stiffness and tenderness, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases . Brain fog and fatigue can also be common among the two, Dr. Yu says.
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How Is Fibromyalgia Treated
Dr. Clauw says one of the most common misconceptions is that there are no effective therapies for fibromyalgia.
Fibromyalgia requires both pharmacological and nonpharmacological therapies, he explains. Pharmacological therapies address pain processing, and nonpharmacological therapies address the functional consequences of pain. So, for instance, we know activity is extremely important. Research has repeatedly shown that regular activity is one of the most effective treatments for pain syndromes, just as it is one of the most effective treatments for arthritis. I tell people to take it slowly because if they try to do too much at first, they get frustrated.
Deep, restorative sleep is also essential for reducing chronic pain, but for many people with fibromyalgia, thats easier said than done. Pain interferes with normal sleep, and lack of sleep makes pain worse. Conversely, a good nights rest can significantly improve fibromyalgia symptoms.
Relaxation techniques, meditation, massage, deep breathing and cognitive behavioral therapy a type of therapy that can help change certain thought and behavior patterns are also helpful for relieving pain and fatigue.
Nonpharmacologic approaches are particularly important because the three drugs approved to treat fibromyalgia pregabalin , duloxetine and milnacipran are only moderately effective. Dr. Clauw emphasizes that most patients find relief with a combination of treatments.
Linda Rath for the Arthritis Foundation
Getting The Right Diagnosis
There’s no one test for fibromyalgia. Doctors make that diagnosis if you have widespread pain that’s not from another medical condition for more than 3 months. Because its symptoms overlap with other conditions, it’s often hard to spot. On average, it takes 5 years to diagnose fibromyalgia.
Many fibromyalgia symptoms are like those of RA. But there are some key differences:
- RA causes inflammation in the joints. The pain can come and go. With fibromyalgia, the ache is constant, and it happens all over your body. You feel dull pain that lasts at least 3 months.
- With fibromyalgia, you often feel tenderness when someone touches you. It can also hurt to sit for 45 minutes.
It’s important to get diagnosed. If you have both conditions, your doctor may chalk up the fibromyalgia pain to your RA. As a result, you may get stronger or higher doses of RA medicines than you may need. Talk to your doctor if you think you may have fibromyalgia.
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How Is Fibromyalgia Diagnosed
Diagnosing fibromyalgia can be frustrating for the doctor and the patient. Even a physician experienced with fibromyalgia needs to take time to rule out other conditions with similar symptoms.
Prior to a fibromyalgia diagnosis, the patient is typically tested for rheumatic diseases, such as lupus and rheumatoid arthritis, and for neurological disorders such as multiple sclerosis and myasthenia gravis.
Once these conditions have been ruled out, the doctor bases a fibromyalgia diagnosis on several factors.
For a fibromyalgia diagnosis, pain must persist for three months or longer. There must also be pain above and below the waist and on both sides of the body, and located in at least 11 of 18 tender points according to Mayo Clinic.
Research And New Developments
Versus Arthritis is funding a number of research studies into the causes, effects and treatment of fibromyalgia. Some examples include:
- A study at the University of Cambridge is looking at why things that wouldnt normally be painful, such as sound, light and gentle touch become painful for people with fibromyalgia, and whether brain signals that process pain differ in people with fibromyalgia.
- Research underway at the University of Sussex is examining how the bodies natural fight and flight response to stress might be altered in people who have fibromyalgia. This work is also looking at the role inflammation might have in this process.
- We are funding work at the University of Liverpool investigating how the brain processes pain signals. It has been found that in people with long-term pain such as fibromyalgia there are differences in the structure and activity in the parts of the brain that process pain signals. Using mathematical modelling, this work could help to match people up with the best treatment option for them.
- We are also investigating how to improve healthcare services for people with fibromyalgia. Research being carried out at the University of Aberdeen is looking at how long it took people with fibromyalgia to get diagnosed and where in the system improvements can be made.
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