Migratory pain all over the body, arthritis or fibromyalgia

Sometimes, we encounter a type of patient in the outpatient clinic. The patient has pain in the joints of the hands, wrists, elbows, neck, shoulders, knees, and feet. The pain is migratory in the muscles of the limbs or the whole body. The pain is not fixed or localized. The patient feels dry mouth, low-grade fever and swollen joints, but the doctor cannot see the swelling. In this case, joint problems should be considered, and fibromyalgia should also be suspected. Their symptoms are similar, but the causes and treatments are different. Fibromyalgia does not have the inflammation of arthritis, but its pain is more severe than arthritis and can last for months or even years.

What is fibromyalgia?

Fibromyalgia is not any kind of arthritis. It does not cause inflammation or damage to joints, muscles or other tissues. But it can cause chronic pain and fatigue similar to arthritis, and is sometimes mistaken for rheumatoid arthritis. The cause of fibromyalgia has always been controversial, but in recent years, the view has become more and more unified: most researchers believe that fibromyalgia is a central processing disease accompanied by neuroendocrine and neurotransmitter disorders. Due to abnormal sensations in the central nervous system, mild stimuli become very painful in patients. Fibromyalgia is closely related to anxiety, depression, and neurosis.

Fibromyalgia is characterized by pain and tenderness throughout the body, along with symptoms such as fatigue and insomnia, headaches or migraines, and memory and concentration problems. The pain can occur in multiple parts of the body, such as the head, neck, arms, and legs, but unlike osteoarthritis, fibromyalgia is not a degenerative or inflammatory joint disease, and there is no problem with the joints themselves.

Arthritis pain

There are many different types of arthritis, such as osteoarthritis, rheumatoid arthritis, and gout. Although the symptoms of each type of arthritis vary, they generally involve pain, stiffness, limited range of motion, and difficulty doing daily activities. Rheumatoid arthritis and osteoarthritis are the most common types of arthritis. Rheumatoid arthritis is an autoimmune disease that causes inflammation. Osteoarthritis is a degenerative arthritis that usually occurs in older people due to the wear and tear of cartilage as they age.

Similarities between the two

Some similarities between fibromyalgia and arthritis include:

• Pain : Both can cause joint and muscle pain.
• Stiffness : Both can cause joints and muscles to become stiff, making movement difficult.
• Fatigue : Both can make a person feel tired and lack energy.
• Sleep disorders : Both can cause sleeping problems, difficulty falling asleep, or insomnia.

The difference between the two

Fibromyalgia and rheumatoid arthritis have many similarities, but there are also differences. In addition to the above symptoms,

Rheumatoid arthritis usually causes:

• It mainly affects the lining of the joints, especially in the extremities such as the fingers, wrists, feet and elbows.
• Swollen and red joints.
• There are clear signs of inflammation, such as swollen lymph nodes, increased tenderness, and a persistent low-grade fever.
• It can cause dry eyes, shortness of breath, sensitivity to light, skin discoloration, and anemia.
• Blood tests can help doctors identify markers of inflammation.

In fibromyalgia, there are:

• The pain first affects the muscles and occurs over a wider area. It is not like arthritis which affects only a few joints at most, nor is it just on one side of the body or above the waist. Instead, the pain occurs up, down, left, and right.
• Patients may not experience swelling or obvious signs of inflammation but may experience chronic and severe pain.
• Fibromyalgia has a characteristic fatigue pattern called “fibro fog.” Patients often experience problems with concentration, memory, and mood swings. But it’s not necessarily caused by the pain.
• The fatigue is stronger, and even if you sleep for a long time, you still feel tired, as if you have not slept at all.
• In addition to joint and muscle pain, people with fibromyalgia may also experience irritable bowel syndrome and migraines.
• Diagnostic testing is mainly by exclusion, there is no specific test, and the condition is only considered if the pain persists for at least three months.

In addition, the pain of arthritis is usually limited to the joints, while fibromyalgia can spread throughout the body. The treatment drugs for the two are also different. Arthritis generally uses non-steroidal anti-inflammatory drugs (NSAIDs) and anti-rheumatic drugs for anti-inflammatory and analgesia. In severe cases, surgery can be performed to repair or replace damaged joints. Surgery is ineffective for fibromyalgia. The treatment drugs are mainly convulsants, antidepressants and analgesics, combined with cognitive behavioral therapy, that is, psychotherapy. Fibromyalgia is more like a psychosomatic disease.