Difference between fibro and polymalgia?

[Stroppymoo]

Was down to 6mg and now gone up to 14mg pred after trying 10mg which never touched the hip pain. Having a Dexa scan on Tuesday as suggested by this post. However, how can I be sure I,ve got pmr when fibromyalgia has similar symptoms? Btw 15mg did cure all my pains last year (May)

[PMRpro Ambassador]

It is very simple: PMR is an inflammatory condition and may have raised ESR and CRP (in 80% of patients). Because it is inflammatory pred will clear the inflammation providing you are taking enough and relieve the symptoms.

Fibromyalgia is a problem with the perception of pain, there are never raised inflammatory markers and pred does nothing for the pain.

[Car00b]

My daughter was diagnosed with fibromyalgia 4to 5 years ago . She was 36 at the time . Both are painfull but PMR is treated with steroids which give some relief . After two and half years on steroids having at long last been to see a PMR specialist , she has queried the PMR diagnosed . After examining me she suspect Fybromylgia is possible there are two matching points on either side of my body which in various places are tender and some times painful . I believe the blood test can show fibro is different to the one done for PMR

However until the specialist sees me , am having MRI Dexa scan cervical exray ( tests I have wanted my doctor do over the last 2.5 years ) I will then know what I have . She also suspects Rhumatoid arthritis in my neck as most of my pain is into my head and down both arms but the right hand swells badly .

Fybromyalga causes pain on both sides of the body . Affects all the joints knees at times and agrivates the muscles .

My daughter is in pain most of the time an finds ice packs help . There is no steroids given for this condition and it is for life . She takes various painkillers for this condition , which give her little relief Sorry to ramble on but it's the only way to explain how I have got to this conclusion . Hope you soon get sorted . But if you are on steroids there is no race to get off them . Steady and slow . If you get a flare stay at the last level for a while , if things don't improve ask your doctor for a blood test and she will tell you what to do . Good luck with this journey , this group is good to have . 💐💐

[PMRpro Ambassador in reply to Car00b]

Did you have a raised ESR/CRP blood test? It is normal in fibro. Did pred improve your pain when you started on it? If it did, it wasn't due to fibromyalgia. And why is she only NOW deciding it may not be PMR?

Before I was diagnosed I worked out what I had (seemed beyond the GP) and there were some things that overlapped for PMR and fibro. One was the paired painful points on either side of the spine plus one or two others. 15mg of pred sorted them all eventually. Some of them can be due to myofascial pain syndrome - typically paired trigger points n either side of the spine in shoulders, about rib level and low back. They can lead to referred pain because of trapping/irritating nearby nerves. Treating these trigger points has removed the recurrent but not continuous problems I have due to MPS.

[Car00b in reply to PMRpro]

Not sure if your replying to me . I have only just been referred to a rheumatologist after being kept in A&E overnight with suspected GCA . They referred me to see her .I was diagnosed by GP 2.5 years ago with raised ESR &CRP . Although my ESR never came down below 35 she said it was obviously normal for me . So I asked to be referred several time but she didn't see any point . Now that I have seen rheumatologist after examination she suspects RA and possible myofacial pain and some areas with fibromyalgia . When I have had all the test which am having at the present time plus blood tests she will give me her opinion . Also I have asked several times to go to a pain clinic , which she has arranged and I start tomorrow . My daughter is the one diagnosed with fibromyalgia and is suffering quite badly but as I have had pain since my early 30s it is now being checked out . Hopefully soon will have a diagnosis I can trust .

Sorry for giving confusion .

[PMRpro Ambassador in reply to Car00b]

It was the bit about you saying the rheumy suspects you don't have PMR - and she mentioned fibro. But if there is a possibility of RA that would account for everything just about.

That was very naughty of your GP - because you were presenting atypically with the ESR remaining raised. And atypical means the MIGHT be something being missed.

But my main point was that myofascial pain syndrome has trigger points that overlap with fibro but there are fewer of them. There are 18 points for fibro and the criterion is 11 out of 18 being tender. I managed about 7 or 8, not enough for a fibro dx, and they are almost all involved in MPS.

[tangocharlie in reply to PMRpro]

At the dental hospital yesterday (being investigated for swollen saliva glands) they said I probably have myofascial pain syndrome as well as TMJ and advised all sorts of exercises including smiling more and rolling my tongue on the roof of my mouth, relaxing more, and applying heat pads. That's a new one on me, is that connected to PMR then? I said I not only have pain in my jaw but also neck, shoulders, chest, hips, legs and feet and when I take steroids it all feels a lot better so think it's more to do with PMR. So hard to know what's what.

[PMRpro Ambassador in reply to tangocharlie]

MPS is often found alongside PMR and is caused by the same inflammatory substances as PMR except they are concentrated in the trigger points in the form of inflamed and hardened muscle fibres that you can feel as hardened areas. They also cause inflammation in the fascia of the muscles - the transparent skin you will be familiar with from joints of meat and pultry. Taking pred helps - often the results at higher doses are really good but the pain returns as the dose reduces.

I have both, I know which pains are related to the MPS - and a flare of PMR always starts with a flare of the MPS. If the MPS is dealt with quickly the PMR flare is less bad.

[Stroppymoo]

99% sure it's pmr. For pain in hip tried Gabapentin. Too strong for me, so paracetamol. Now on 9mg preds and everything seems fine, so not to rush off them.