Polymyalgia Rheumatica vs Fibromyalgia: How to Tell Them Apart

Are you dealing with ongoing pain and wondering if it might be polymyalgia rheumatica or fibromyalgia? Polymyalgia rheumatica (PMR) and fibromyalgia are two separate conditions that can produce substantial discomfort and interfere with daily activities.

While they share certain symptoms, they have distinct underlying causes, treatment options, and effects on individuals. For a more accurate diagnosis, you need to know the key differences between polymyalgia rheumatica and fibromyalgia, what sets these conditions apart, and how they affect people’s lives.

Understanding Polymyalgia Rheumatica and Fibromyalgia

Polymyalgia rheumatica (PMR) is a condition that mainly affects adults over 50 years old. It generates muscular discomfort and stiffness, particularly in the neck, shoulders, hips, and thighs. Many people report that their symptoms worsen in the morning or after sitting for a long time. PMR is an autoimmune illness in which the body’s immune system erroneously assaults healthy tissues, resulting in inflammation in the joints and surrounding areas.

On the other hand, fibromyalgia is a long-lasting pain condition that causes widespread pain all over the body. People of all ages can experience it, but middle-aged women tend to experience it most frequently. Fibromyalgia, unlike PMR, is associated with the brain and nervous system’s processing of pain, not inflammation. Common symptoms include widespread pain, tiredness, trouble focusing (often called “fibro fog”), sleep problems, and emotional issues like anxiety or depression.

Differences Between Polymyalgia and Fibromyalgia

When comparing polymyalgia rheumatica vs. fibromyalgia, several key differences emerge:

Symptoms

While both PMR and fibromyalgia cause muscle pain and stiffness, they affect the body in different ways:

Location of Pain

PMR: Pain and stiffness are usually felt in specific areas like the shoulders, neck, back, and hips.
Fibromyalgia: Pain is spread all over the body and often happens in specific “tender points” on both sides.

Onset and Duration

PMR: Symptoms can come on quickly, sometimes even overnight. The stiffness usually gets better within an hour after waking.
Fibromyalgia: Symptoms tend to appear gradually and may change over time. The stiffness can last all day.

Associated Symptoms

PMR: Some of these signs may be like the flu, like being tired and losing weight.
Fibromyalgia: Often comes with trouble thinking clearly (fibro fog), sleep problems, headaches, and issues with digestion like irritable bowel syndrome (IBS).

Both polymyalgia and fibromyalgia can lead to feelings of depression due to the challenges of living with ongoing pain. A 2017 study found that people with fibromyalgia have higher rates of PTSD. Many individuals with fibromyalgia also say they struggle to concentrate or feel mentally foggy.

Causes

The reasons behind PMR and fibromyalgia are quite different:

Polymyalgia Rheumatica: It’s thought to be an autoimmune disease, which means that the body’s immune system attacks healthy tissue, which leads to swelling.

Fibromyalgia: Not an autoimmune condition. It is believed to be caused by overactive nerve signals that make the body more sensitive to pain, even without any actual injury.

Diagnosis

Doctors diagnose these conditions in different ways:

Polymyalgia Rheumatica: Higher amounts of C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) in the blood are signs of inflammation. Sometimes, imaging tests are used.

Fibromyalgia: There aren’t any specific lab tests for fibromyalgia. It is diagnosed by looking at your symptoms, medical history, and a physical check that feels for sore spots.

Treatment Approaches

The treatments for PMR and fibromyalgia are different because the causes of these conditions vary:

Polymyalgia Rheumatica Treatment:

• Medications: PMR is treated with corticosteroids (like prednisone) to reduce inflammation quickly. Most people feel better within days or weeks.
• Supportive Therapies: You may also be told to try physical training to help with function and movement.

Fibromyalgia Treatment:

• Multimodal Approach: Treatment usually involves a combination of medications (such as antidepressants), lifestyle changes (like regular exercise), cognitive behavioral therapy (CBT), and sometimes alternative therapies like acupuncture.
• Pain Management: Since fibromyalgia doesn’t respond well to anti-inflammatory drugs like steroids, treatment focuses on managing pain using different methods tailored to the individual.

Polymyalgia Rheumatica or Fibromyalgia: Which Is Worse?

Deciding which condition is “worse” depends on each person’s experience.

Polymyalgia Rheumatica (PMR): People with PMR often have severe stiffness that can make it hard to move. However, most find relief with corticosteroid treatment, and many improve within a few months to a few years.

Fibromyalgia: People with fibromyalgia experience constant, widespread pain that can have a big effect on their quality of life. It often causes tiredness and problems with thinking, which can be hard to deal with in the long run.

Diseases Similar to Fibromyalgia

Several conditions share symptoms with fibromyalgia, making diagnosis challenging. Some diseases similar to fibromyalgia include:

• Chronic Fatigue Syndrome (CFS): Characterized by extreme fatigue lasting six months or longer, often accompanied by muscle pain and cognitive difficulties.
• Rheumatoid Arthritis (RA): It is an autoimmune disorder that causes joint pain, swelling, and stiffness.
• Lupus: It is a systemic autoimmune illness that can impact several organ systems, causing fatigue, joint discomfort, and skin rashes.
• Myofascial Pain Syndrome: It is a chronic pain illness characterized by muscular trigger points that cause localized pain.

Polymyalgia rheumatica and fibromyalgia are not the same

While both polymyalgia rheumatica (PMR) and fibromyalgia can cause significant pain and discomfort, they are distinct conditions with different causes, symptoms, and treatments. PMR mainly affects older adults and is linked to inflammation, while fibromyalgia impacts pain processing in the nervous system and can affect people of any age. Knowing the basic differences between these disorders will assist you in obtaining the appropriate diagnosis and treatment. Always communicate with a healthcare expert to establish the best course of action for treating your symptoms.