Polymyalgia v's Fibromyalgia

Polymyalgia v's Fibromyalgia

The differences between Polymyalgia Rheumatica (PMR) and Fibromyalgia (FM or FMS)

Polymyalgia Rheumatica is an inflammatory condition unlike Fibromyalgia which is not, it causes many painful muscles (poly = many, myalgia = muscle pain).

Fibromyalgia (Fibro = Fibrous Tissue it affects my = muscle algia =pain) is a widespread chronic pain and fatigue syndrome that is not inflammatory plus it is thought to possibly people may have a genetic predisposition to fibromyalgia.

FMS is reported to be Neurological with discussion of Central Sensitisation, please see link below for more information that may be of interest;

painscience.com/articles/ce...

In Polymyalgia Rheumatica the muscles mainly affected are ones of the shoulder and thigh. The two conditions are similar as they often strike suddenly after a flu-like illness and the pain/stiffness is often widespread plus both feel fatigue and extreme tiredness.

Both PMR & FMS have no specific tests, but with PMR you may have blood tests to check for inflammation. However, inflammation ( ESR,PV,CRP) alone isn't enough to confirm a diagnosis of PMR as inflammation can occur in many other conditions, like infections and rheumatoid arthritis. Plus you could also be diagnosed with one condition that may or may not be of inflammatory cause and then be have secondary Fibromyalgia.

With PMR an ultrasound of the shoulders and hips may be used and can often show inflammation in the tissues and your healthcare professional may find tests show Anaemia (a lack of red blood cells) which is quite common in PMR, but you can be Anaemic in other conditions too. During or after a FMS diagnosis, bloods may also show a low Vitamin D or Vitamin B12, which may be treated with the relevant medication depending of the levels.

Steroid treatment can have a powerful effect in reducing inflammation in PMR but doesn't usually help in FMS long term. People with FMS taking steriods may have an initial feeling of improvement but it usually decreases after time. Steriods use in PMR won’t be a long term cure, they may improve symptoms significantly.

"Polymyalgia Rheumatica (PMR) is sometimes associated with painful inflammation of the arteries of the skull. This is called giant cell arteritis (GCA) or temporal arteritis and needs prompt treatment as there’s a risk of damage to the arteries of the eyes. About 20% of people with PMR also develop GCA, while 40–60% of people with GCA also have symptoms of PMR" (Arthritis Research UK)

Also Arthritis Research UK state that "Steroid tablets reduce the amount of calcium absorbed from the gut and increase calcium loss through the kidneys. To counteract this we recommend a daily intake of calcium of 1,000 milligrams (mg) or 1,500 mg if you’re over 60. A pint of milk a day, together with a reasonable amount of other foods that contain calcium, should be enough.

Vitamin D is needed for the body to absorb and process calcium. Your body produces vitamin D when the skin is exposed to sunlight. It’s also obtained from some foods, especially oily fish, and is added to some soya milks and vegetable margarines. It’s sometimes necessary to take a daily supplement containing 10–20 micrograms (μg) (this is the same as 400 to 800 international units (IU)) of vitamin D, especially for people over 60."

More information about Polymyalgia Rheumatica can be found here:

arthritisresearchuk.org/art...

and Fibromyalgia here;

arthritisresearchuk.org/art...

NB: All information based on my personal knowledge (from previous volunteering with the charity) of both these conditions therefore I am not a health professional so note that it is always best to consult your own Healthcare Professional. The information quoted in italics is from Arthritis Research UK and full information links to both conditions are given.

I hope this helps

Best Wishes

Emma :)

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10 Replies

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  • interesting and useful. During my diagnosis process, the GP was looking at polymayalgia

  • Yes I had blood tests for that too 👍

  • Hi Mdaisy , Hope your having a good day.Thanks for the post as I chatted with one of our members last week that has PMR and my intent was to goggle it later, but.....fog did not allow. Thanks again, Peck.🐤

  • Very interesting. Thank you

  • Thanks Emma good post , nice to see you back ,

    Hugs

    Chris xx

  • Hi

    Very well explained both illness can take a long time to be diagnosed .It would appear younger people are now being diagnosed with PMR some in their fifties.

    Rose

  • Fantastic information Mdaisy, thank you for sharing it with us! :) xx

  • Thank you so much for this Emma, it was really interesting. As a matter of coincidence, a few months ago I had the ''Careline'' service installed for Julie and they sent this really nice, friendly guy to see us. He said that he was suffering from ''Polymyalgia,'' and he said that his pain was in his shoulders and thighs.

    All my hopes and dreams for you

    Ken x :)

  • Hi Mdaisy this is what I thought I had with having the spondylosis but GP said no - this is when he came up with FM - it's hard when you are trying to find a cause that can't be seen with X-rays and bloods - maybe someday somebody will find how to detect it - have upped my amitriptalene to 20 mgs but still waking up with stiffness in neck, arms and back - once I get moving it settles down - I really don't want to increase it further as I want to see how it goes until it gets into my system only started them last week - plus I feel I take enough meds as it is for other conditions.

    Take care x

  • Hi. Very interesting article as I was diagnosed with Fibromyalgia 9 years ago and then Polymyalgia and GCA 2 years ago at age 49. It's hard at times to identify the different pain. I also have low iron levels and B12. I take Vit D and Calcium daily as on steroids longterm.

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