How can you tell if you have Fibromyalgia

Hi everyone,

I have posted before because my rheumatologist believes I may have fibromyalgia rather than PMR. My symptoms began in Aug 2015 - headaches, weight loss, chills, fever and then muscle pain. My ESR and CRP were both elevated. I was started on prednisone 40 mg in Oct 2015. I had a wonderful response to prednisone. In Oct 2016 while on prednisone 5 mg I had a repeat ESR and CRP which were normal even though my muscle pain had been increasing. It was at this point that my rheumatologist decided I must have fibromyalgia. I continued to reduce prednisone and the pain became very severe in Dec 2016 but miraculously in Jan 2017 I was completely pain free (on prednisone 2 mg). Six weeks later the pain had returned and I became quite debilitated (I had finished tapering off prednisone as the pain began to return). I saw my family doctor and asked to be restarted on prednisone (I was unable to get an appt with my rheumatologist). Since starting prednisone 15 mg four weeks ago I am 80-90% improved. I saw my rheumatologist this week who still believes I have fibromyalgia vs PMR. Can those of you who have both please describe to me the different symptoms and how you which is which.

Thanks so much

16 Replies

  • It is possible to have both PMR and fybromyalgia. It does sound as if you might have PMR if pred worked so well. Pred does not touch fybromyalgia. PMR and fybromylagia are two totally different things, it is like comparing a headache and toothache.

  • Good morning. Sorry you have such a dilemma. I have been diagnosed with fibro some years ago and the pain was very general. In my pmr it was quite specific across my shoulders and top of my arms and across my back and thigh muscles. It was very much more severe in pmr. In fibro my esr and crp were not raised. It would not have been responsive to steroids. It does seem strange that your problem improves with steroids and it is a question well worth asking your rheumatologist. Hope it all gets sorted soon.

    Love Liz.

  • Hi, Firstly I am treated for GCA only and have not experienced PMR. Having read many posts here, I think I know it quite well but on paper only now. I was diagnosed with Fibro' about 15 years ago and I can't say it sounds like PMR. It seems to be brought on by stress, trauma..blah blah, all the usual suspects for PMR/GCA. When it started, I was under enormous stress with two under fives with Tourette's and ADHD and no help. Anyway, I only get it now if I have more than a few nights' under 6 hours sleep and high stress and I can nip it in the bud.

    Anyway, on paper I can see differences between PMR and PolyM. PolyM started with waking in the morning feeling like I hadn't been to bed and a head tiredness and brain fog all day. I was also very sensitive to pressure being put on very specific points on my body and these are easy to find online. This pain became all the time rather than just on pressing and could be quite intense, my response to pain was exaggerated. There was NO actual loss of function, just pain that could be mistaken for stiffness but it wasn't really as the muscles were ok. There was no fever, weight loss, chills or systemic illness other an an overwhelming fatigue and like I had too many pain receptors in my body that just fired off because they were confused. The Rheum'y who diagnosed was convinced it was PolyM because all my tests including the inflammatory markers were negative and I was essentially well. One big difference is that exercise, if you can force yourself, is actually beneficial.

    PMR seems different in that it seems like more of a systemic disease that is affecting tissues because you are attacking them, hence the real loss of function and flu like symptoms. I can't imagine any of you going out for a good run and feeling better like with PMR! Pred won't help as there is no inflammation and painkillers work to an extent but I think the whole pain system is in overdrive so it isn't an easy fix for long. Sleeping well, psychological support and I found some sort of complimentary/gentle touch therapy is good because it re-educated my body to feel beneficial sensation again without going into overdrive. Husband's man of steel shoulder rub wasn't quite the ticket!

    I agree with piglette that you could have both.

  • Can't walk with PMR to the bathroom never mind a run .

  • Indeed! That's the big difference!

  • " I can't imagine any of you going out for a good run and feeling better like with PMR!"

    This is a description of PMR activity that I don't recognise. I haven't been able to go 'out for a good run' for more years than I care to remember, let alone it making me feel better.

  • Hi I do understand the bit about going out for a run I've not been able to walk even with crutches without excruciating pains I have upped the steroids

    2mg now taking 10mg which has taken edge and hoping doc will say can up it a bit more as after at least 8 months of this pain I can't take it much longer so when I read people are going work and running etc it makes me feel as if I am making all my pain up or is it possible that they have all managed to hold back pain with extra steroids

  • No! I meant with PolyM a run helps! Can't imagine anything worse for PMR by peoples' descriptions.

  • What's "run"? I couldn't even hurry across the road!

  • Oh no! I've just realised my mistake! My steroid addled brain! Goodness knows what why I wrote PolyM instead of Fibro. The point, badly put across is that PMR is clearly affecting (damaging?) the muscles in a profound way and therefore their function. With FIBRO you can do that run/exercise as it essentially more like an overactive pain register. Careful exercise makes it better.

  • Bramwater, you can download a paper on Fibromyalgia versus Polymyalgia written by an ex-Chair/Trustee of PMRGCAuk together with a member of the Fibromyalgia Association UK by clicking on the following link:

  • Found it! Oops indeed Snazzy.

  • Thank you all so much for this information. From the description of Fibromyalgia, ie. that gentle exercise can help, I believe I have PMR. When the pain is bad, I can barely walk and I do force myself to walk (having osteoporosis as well). The walking NEVER makes it better, only worse if anything. I also don't seem to have the fatigue. I did have it at the very beginning when I had all the other systemic effects but not now. I think the prednisone at this dose (15 mg) doesn't allow me to sleep very well but if I take Benadryl at bedtime I can get a good sleep and feel rested in the morning. I don't seem to have brain fog.

  • Try taking some of your calcium about half an hour before bedtime. It may help you sleep - it appears to have cured my lifelong intermittent insomnia - over year now sleeping well every night with only a couple of exceptions!

  • Thanks Heron,

    I do take Calcium 500 mg at bedtime currently. I think it is just the prednisone 15 mg dose causing the sleep problems because I normally sleep well. Thanks for the thought.

  • Then hopefully the sleep issue will resolve as you lower your pred. I actually never really minded being awake at night. Used to get up and sit in a comfy chair in living room and do something mildly boring, and generally fell asleep again....

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