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Community > Expert Q & A > Fibromyalgia > Fibromyalgia, Lupus, or Both?
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Fibromyalgia, Lupus, or Both?

Q: My family doctor, suspecting I might have lupus, referred me to a rheumatologist, who diagnosed fibromyalgia. Is it possible to have symptoms of lupus, but actually have fibromyalgia?

A: Figuring out whether a patient has lupus, fibromyalgia or both – which is entirely possible – requires a thorough medical history, physical examination and laboratory tests. Diagnosing lupus and fibromyalgia can be difficult because the conditions share some symptoms.

During the medical history, fibromyalgia patients usually describe fatigue and a generalized muscle pain or soreness of the muscles that often is made worse by lack of quality sleep. Lupus patients may also have fatigue and muscle soreness, but initial symptoms may include a rash across the cheeks and nose that gets worse in sunlight, kidney problems, difficulty breathing or a blood clot, stroke or heart attack.

Physical examination of a person with fibromyalgia shows joints that move normally and are not swollen. However, people with fibromyalgia usually have tender areas over muscles, and pressing those areas causes discomfort. The examination of a person with lupus may reveal joint pain, stiffness, swelling or abnormal movement.

In most cases, a patient's history and physical examination lead to a diagnosis; lab tests usually confirm the diagnosis. A blood test that measures the level of antinuclear antibody (ANA) usually is positive in people who have lupus, but it also can be positive in those with mixed connective tissue disease, rheumatoid arthritis (RA), scleroderma and Sjögren's syndrome. Therefore, a rheumatologist will run several other special tests to confirm lupus. In people with fibromyalgia, all blood tests usually are normal.

A proper diagnosis is important because the treatments for lupus and fibromyalgia are different. When a person has both fibromyalgia and lupus, corticosteroids or disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, should be prescribed to prevent lupus-related damage to the internal organs. Physical therapy, counseling and antidepressant medications can help improve muscle aches, sleep and mood changes associated with fibromyalgia

Robert Shaw, MD, Rheumatologist

Kris Schaugaard
26 Feb 2010, 08:16
Yes, I too have both fibromyalgesia and systemic lupus. The symptoms are similar. What I would tell anyone with these diseases is to find a good pain clinic and let them help you find out what is happening. I was suicidal for many years and found many doctors who did not believe that I had anything wrong with me, but after 20 years of hell, I found a good pain doc and he put a pump inside my abdomen that delivers a small amount of morphine into my spine. It relieves about half of my pain. I also have degenerative disc disease. He also gave me some morphine tablets for pain not covered by my pump. These doctors have been in school half their lives, and a few of them really know what they are doing. Unfortunatly, there are some really bad docs out there and you have to perservere. I feel for all of you with your pain. I know how you feel and how you have been treated by many of the very people who should be helping you. We have built and sold 5 houses to pay for my medical bills. I don't have any insurance because my husband owns his own business (he designs homes) and with this economy, I can't afford it. We no longer have a car. We have to borrow my mother-in-law's car. I also had a heart attack at 47- I'm 57 now. I have GERD which has caused chronic pneumonia caused by aspiration. I had cervical cancer which I beat. I'm sick of my life, but I would end it all without my family and my pain clinic. I wish you all well.
















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James
26 Feb 2010, 04:45
All of these doctors are crack heads. I am literally laying on my death bed at only 27 years. I have been diagnosed with Fibro and have been treated like a lab rat. I am not on my 5th medication that have ALL been unsuccessful and meanwhile they are watching me suffer every single day. I really want to know who approved these boot-leg non working medications for fibro. I am really starting to think that we are some huge joke at a circus for all of these doctors entertainment. Another day of hell that I will enter. And in regards to lady above talking about hope, Um there is none. I cannot move half of the days and I was completely normal only two short years ago. Now all the sudden I feel like I have been hit by a train every single day, only to wake up day by day being literally tortured from the center of my soul. Good LUCK everyone, but unfortunately there is NONE that is going to find us. Lets accept our misery without ANY understanding.
Susan
19 Feb 2010, 23:41
It is so confusing. I have been through so much in life..surgery's , just things (as we all have)..but I have always had the most strange things happen that most do not get.. pain that most do not have..a simple hysterectomy ...I had internal bleeding..almost did not make it. TIREDNESS....lived in a beautiful condo..found out there was mold. I can go on to so many blameful things. Going from Dr. to Dr. they say fibro...I know I am not making up my pain. I cannot even keep my eyes open...now! I eat well...my problem is I do not look sick and please do not take that wrong. I am glad..but I was liteally dying in the hospital and no one believed me, I saved my own life and sure enough had to have blood transfusions. I do not know what to do...Not that I want anyone to feel sick or bad..but reading this I do not feel alone. I feel like I am always trying to "make someone believe me". I feel guilty when I am tired. I feel guilty that I had to move into my parents home at my age. I was always the life of the party....I want to believe that it will change. Thank you all for sharing your stories.I hope we all will feel so much better soon and will help others too. God Bless...Susan
Glenda Cope
02 Jan 2010, 22:50
I am 55 yrs. old, Current job since 1992. For 2 1/2 yrs. I have gone from Dr. to Dr. to find the cause of my 24/7 pain. On medical leave at this point. Was sent home from work and put on admin. leave for a couple of days, seems the cymbalta was not a good choice for me. Would have been nice if my co-workers could have told me, but...at least I don't have to get permission from my boss to go for a Dr. appointment or therapy. Fibromyalgia rates right up there with shingles for me. Some days, I just want to cut my feet off or what ever is hurting, yes there have been times that I just want to end it all. There has to be an answer out there somewhere, still looking for it, along with my memory, brain, money,and teeth! Please let me know if you find them. I deal with the Raynauds, summer and winter, 20 yrs. now. The tightness in my face/jaw and 4 broken crowns. No one knows whats wrong, they look at you like you are nuts! Now I know it's the FM. I have narrow angle Glaucoma with cupping of optic disc. 2 new pairs of glasses, Blurred vision, each eye sees a different color, focus on near and far is a problem. Now I know it's not all the Glaucoma, FM plays a part in this as well. This also limits the medications I can take for pain. The neurontin does help with the IBS, believe it or not, YES! This FM is worse than the Shingle flare-ups I have. I would not want to wish this on my worst enemy. My Neurologist,Psychiatrist,Therapist have been a God send:) My Rhuematologist, has left the practice and the new one does not believe that Fibromyalgia is a disability. Time to get a new Dr. Maybe the one I have now, needs to have my 24/7 pain and then she could judge. I would let her have it for Free. Depression yes, for many reasons. The only time I don't have the pain is when all the drugs I take at night knock me out. Even at home, everyday seems to be a struggle to get up, remember where you are, where you were, or what you were doing does not change. Everyone says, it's the stress at work, yes. Being at home does not make this nightmare go away. And the more I read, it's there for the rest of my life. I use to look forward to retirement, I am not even there or never will be. Maybe this is a dream and I will wake up tomorrow and it will be ok. Wish me luck. Thanks for listening.
Sybil Saldana-Heilweil
13 Dec 2009, 13:44
I have fybromialgia, mixed connective tissue disease, lupus discoid, lupus erym, thyroid disease, neuro disorders, ect....
to those that are curious if you can have more than one thing, im afraid that its true!!
Its(my disease) has turned into the nightmare!! of chasing my tail...I go from dr to dr. all of whom have been helpful and understanding. I feel like a hypocondric, unfortunatly im not.
I find that the best thing to do is what works for you, unfortunatly this is a disease that is different for all of us..Yet we can all understand.
1. Rest when you can, listen to your body.
2. take your medication as prescribed, you are the only one that knows what works for you! Do not listen to friends, family members if they don't understand. your dr. knows best!
3. You will always have bad days, I don't know what a good day is. Always in pain, always tired, confused, swollen hands feet, unbearable back pain, leg pain, shoulder pain. What would I do without my meds? I'm afaid to find out!sometimes id like to just climb under a rock...
4. I have children I was diagnosed 18yrs ago with fybro, and 13 yrs ago with lupus. My children were babies and then teenagers. I have no idea how i got through it. But, you just have to be strong and move forward... Even when you want to just say the "hell with it all. I can't go on anymore." How many times have I said that? More than I can count.
5. There are many people like us out there, you just need to talk to others and trust me you will find them.
your family's need you, and they will find a cure, hopefully in our lifetime!!
Happy Holidays to all of my fellow sufferer's.
My God bless you, and help you get through one day at a time!!
Susan Taaffe
19 Nov 2009, 22:58
I was diagnosed with fibromyalgia 3 weeks ago by a pain manag.Dr., he said I had 16/18 "trigger points" put me on Lyrica,,,,awful,awful awful drug. I had some bouts of lost vision,could hardly walk it hurt so bad, stayed on it for 5 days, that is all I could stand. Then yesterday my primary Dr. called to tell me my ANA test was positive for Lupus, just wondering if someone can actually have BOTH lupus and fibromyalgia. Neither Dr. will prescribe narcotics, but that is the only thing that helps the pain that is ALWAYS there :( I do not want to live on narcotics forever, just would like to have them available when needed. Wondering if I could have been misdiagnosed with the Fibromyalgia?????
Barbara
13 Nov 2009, 13:47
Hello to all those people, I to have fibro and I to fill your pain but I am taking Cymbalta, robaxin, lodine,clozapam and I do fill a lot better than I did but I fined that if you don't take it on a daily bases than you will hurt even worse than before, and it's like has a set baack I take my meds. starting at 5.30 am and it is 3 times a day. I also have a dairy that I write when I'm fill like when there is a change in my body. It can be like anything from muscle aches to stiffness to headaches, to brian fog. You really have to listen to your body and write things down because if you are not aware of the signs that you are filling than you will not beable to fine out what is going on. I have lupus in my family but I was diagnosis with fibro and I also have bad knees, bad back and stuffers with bad headaches.
cindy
15 Aug 2009, 08:03
I was tested positive for ANA, I have seen a RA Dr, which has done blood tests, she says my ANA went down, and will test it again later, I feel tired most times, and my ankles have pain they ache all the time, over the counter meds dont seem to help, the Dr dont give me nothing to relieve my pain.. I want to find out whats wrong, before its too late, I fear I might have lupus. I wish the Dr would do more to help me.
Andrea Morrison
19 May 2009, 00:45
Doc prescribed me B12, steroids, and Naproxen as a backup. Have to immediately start taking the B12 and steroids. If no improvement, then initiate the Naproxen.

I'm still to continue with the Cymbalta also.
Finally getting custom knee brace fitted for a second time; then hopefully get issued same day.

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