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What is the Difference Between Inflammatory Arthritis and Fibromyalgia ?

Rheumatoid Arthritis

Certain types of inflammatory arthritis and fibromyalgia are often confused because their symptoms mimic one another in early stages.

While fibromyalgia is considered an arthritis-related condition, it is not a true form of arthritis because it does not cause tissue inflammation nor does it damage joints or muscles. However some consider it a rheumatic condition because it can make the joints and surrounding tissues painful and sore to use.

In general people with fibromyalgia have normal looking X-ray and blood tests results, and family and friends drive them mad by telling them they look fine. A person with arthritis will have abnormal test results and they may also be in visible pain, with swollen or deformed joints.

Distinguishing between the two to yield a proper diagnosis is important to ensure proper treatment. Both are chronic disorders earmarked by long-lasting pain.

Inflammatory Arthritis

There are several types of inflammatory arthritis which include:

  • rheumatoid arthritis
  • ankylosing spondylitis
  • lupus
  • psoriatic arthritis

Inflammatory arthritis leads to inflammation of the joints and surrounding tissues. Long-standing inflammatory arthritis can result in joint deformation and disability.

Typical Signs of Rheumatoid Arthritis/Osteoarthritis  Osteoarthritis

Rheumatoid Arthritis
Rheumatoid Arthritis

• Pain in affected joints, particularly after repetitive use.
• Stiffness, you may feel creaky first thing in the morning.
• Creaking joint noises, cracking and crunching sounds.

Rheumatoid Arthritis

• Reduced appetite.
• Feeling generally unwell.
• Fatigue.
• Swollen glands.
• General feeling of weakness.


Fibromyalgia affects not only joints, but muscles, tendons, and other soft tissues in the elbows, hips, chest, knees, lower back, neck, and shoulders. Fibromyalgia can develop alone or with inflammatory arthritis.

Common Shared Symptoms

Both fibromyalgia and inflammatory arthritis sufferers have pain and stiffness in the morning. Other common symptoms shared by the two conditions include:

  • fatigue
  • sleep disturbances
  • limited range of motion
  • numbness or tingling

Typical Signs of Fibromyalgia

• Pain in specific points of the body called the fibromyalgia tender points.
• Flu like pain, primarily in the neck and shoulders.
• Depression/anger.
• Feeling anxious.
• Constant extreme fatigue.
• Chronic back pain.
• Bouts of constipation or diarrhea.
• Jaw or facial tenderness (90 percent experience this symptom).
• Headaches and migraines (up to 50 percent of cases).

Diagnosing Symptoms

Tests to distinguish fibromyalgia and inflammatory arthritis include X-rays, blood tests, and ultrasound. Besides inflammatory arthritis, fibromyalgia also shares common symptoms with several other conditions.

  • chronic fatigue syndrome
  • cancer
  • depression
  • HIV infection
  • hyperthyroidism
  • irritable bowel syndrome
  • Lyme disease
What are rheumatoid arthritis and fibromyalgia?

Rheumatoid arthritis (RA) and fibromyalgia are two different conditions with some similar symptoms. These include:

  • pain that may feel like a dull ache
  • sleep disturbances
  • fatigue
  • feelings of depression and anxiety

The causes of these conditions are very different. RA is an autoimmune disorder that causes the body’s immune system to attack its joints. Fibromyalgia is a disorder marked by musculoskeletal pain and symptoms of fatigue, trouble sleeping, and problems with memory and mood.

RA and fibromyalgia progress very differently. Fibromyalgia usually causes constant pain that may worsen with poor sleep and stress. On the other hand, RA can flare up and grow progressively worse without treatment.

Talk to your doctor about your symptoms, and give them as much detail as you can. Knowing what you’re experiencing can help your doctor make a more accurate diagnosis.

How are the symptoms different?

While both conditions have similar symptoms, the causes of each symptom, as well as the way people with each condition experience them, can be different.


Experiencing pain is common in each condition, but the triggers aren’t the same. One of the biggest differences between RA and fibromyalgia is inflammation. Fibromyalgia pain is not from inflammation.

In RA, joint inflammation is one of the key symptoms. People with RA often notice that their joint pain appears on both sides of their body. For example, if you have a painful joint in your right wrist, you also may have corresponding pain in your left wrist.

A 2002 study showed that people with RA and those with fibromyalgia both had more trouble paying attention than those in the control group.

Many people with fibromyalgia report lower back pain, and it’s not uncommon to experience these symptoms:

  • frequent headaches
  • joint pain
  • muscle spams
  • tingling

Another study compared people with fibromyalgia and RA to a healthy control group before and after exercise.

Researchers found that people with RA showed decreased pain after exercise. The results were not significant for people with fibromyalgia.

Sleep disturbances and fatigue

Both conditions can cause sleep disturbances and fatigue. But sleep problems in people with fibromyalgia tend to be more draining.

A preliminary study found that women with fibromyalgia reported greater daytime sleepiness and fatigue than women with RA. However, multiple sleep latency tests (MSLTs) on participants showed that women with fibromyalgia had less objective daytime sleepiness compared to women with RA.

With RA, fatigue can also be a result of inflammation and anemia. Anemia, or the lack of red blood cells, affects up to 70 percent of people with RA.

Another study found that reduced sleep affected women with fibromyalgia more than women with RA. Women with fibromyalgia reported feeling more daytime sleepiness and needed a longer recovery time.

Depression and anxiety

Feelings of depression and anxiety are common symptoms of fibromyalgia and RA. These feelings can affect your quality of life.

A 2007 study found that these feelings weren’t statistically different between people with RA and fibromyalgia.

Distinct symptoms of RA

With RA, symptoms often flare up, or come and go, periodically. Common RA symptoms include:

  • joint pain, tenderness, and stiffness
  • red, swollen joints, often in your hands or feet
  • a sudden increase in symptoms that intensify for a period of days to months before temporarily subsiding
  • inflammation

Inflammation can affect other parts of your body as follows:

  • eyes: dryness, sensitivity to light, and impaired vision
  • mouth: dryness, irritation, or infection of the gums
  • skin: small lumps around the bone areas
  • lungs: shortness of breath
  • blood vessels: organ, skin, or nerve damage
  • blood: anemia

About 40 percent of people with RA experience these signs and symptoms, according to the Mayo Clinic.

Distinct symptoms of fibromyalgia

The symptoms of fibromyalgia resemble the symptoms of many other conditions. But the pain in fibromyalgia is widespread and tends to occur on specific tender points.

These points are located in symmetrical pairs on the:

  • back of the head
  • collarbone area
  • upper back
  • elbows
  • buttocks
  • knees

You may also have:

  • trouble with memory, often called fibro fog
  • headaches
  • menstrual pain
  • restless leg syndrome
  • sensitivity to temperature, loud noises, or bright lights
  • numbness or tingling
  • irritable bowel syndrome

Fibromyalgia pain can appear in the joints and muscles, but fibromyalgia doesn’t damage your joints the way that arthritis can. It also doesn’t damage your muscles or other soft tissues. The pain of fibromyalgia can worsen arthritis pain.

Getting a diagnosis

Doctors use different techniques to diagnose RA and fibromyalgia. In each case, you’ll want to give your doctor as much information as possible about your medical history and the symptoms you’re experiencing.

Diagnosing RA

There’s no single test for RA, so your doctor will perform a complete medical history and physical examination. They’ll also conduct several tests to help confirm an RA diagnosis. These include:

  • a review of your medical history and that of your family
  • a physical exam to look for joint tenderness, swelling, and pain
  • blood tests to look for inflammation
  • auto-antibody tests for the rheumatoid factor antibody, which in combination with an anti-CCP antibody test increases the chances of an accurate RA diagnosis
  • imaging tests, such as ultrasound, to look for joint damage or inflammation

Your doctor will immediately recommend treatment if you have RA because the condition requires prompt treatment.

If your tests are negative for some of the common markers for RA, it’s still possible RA may present, as these tests often come back negative for people who have RA.

If left untreated, RA symptoms can lead to long-term joint damage. Serious cases of RA can even cause damage to major organs, including your heart.

Diagnosing fibromyalgia

A fibromyalgia diagnosis can be difficult to confirm. While there may be clear signs and symptoms, there isn’t one test or examination that can determine if you have fibromyalgia.

One of the best ways for your doctor to help diagnose fibromyalgia is to rule out other conditions.

There’s no cure for fibromyalgia, but there are treatment options that can make a difference in your quality of life, including lifestyle changes and medication.

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