Can polymyalgia be misdiagnosed for fibromyalgia and vice versa?

[Pr0jection]

My mother apparently had both polymyalgia and fibromyalgia. I hope this isn't a silly question but I do wonder if either of them can be misdiagnosed particularly where blood work isn't elevated. I can't remember what treatment Mum was on for fibromyalgia but I do know she was on steroids for polymyalgia. Whatever the dose she was never free from pain. I believe that steroids won't touch fibro.

[PMRpro Ambassador]

I think it happens a lot - especially for PMR without raised markers. It is claimed that pain in a set of trigger points characterises fibro - but before I was diagnosed I had trigger points that overlapped the fibro ones. Many are common with those found in myofascial pain syndrome and that can be part of PMR (it is for me). I suspect a lot of cases of PMR in younger patients are put down to fibro - especially as they often present in an atypical manner. It is also of course possible to have both at the same time - in which case pred will work for part of the symptoms. There are several on the forum who have both, some had fibro long before PMR appeared, and they say they can tell which is which.

[Pr0jection in reply to PMRpro]

Thanks for your reply and it would be good if some of those who have both could respond here. My reason for asking is that I was diagnosed with fibro before being diagnosed with PMR, but it was finally put down to PMR because of elevated blood work and the fact that I responded well to prednisolone. However, just recently I have some other symptoms have appeared....

[PMRpro Ambassador in reply to Pr0jection]

If they don't - put up a post asking if anyone has both. A lot of people don't read every post, they look at titles that interest them or are relevant

[redyrun]

Yes , I was diagnosed 4 yrs ago with Polymyalgia Rheumatica on the basis of me having classic symptoms with no inflammation markers and my almost immediate response to corticosteroids . I was also informed by my rheumatologist that this was the case with about 20% of his patients with PMR .

[PMRpro Ambassador in reply to redyrun]

Wish he'd spread the news to his colleagues!

[piglette]

I think one big difference between Polymyalgia and fibromyalgia is that steroids act like magic with polymyalgia and have no effect on fibromyalgia, while painkillers have pretty well no effect on Polymyalgia but do on fibromyalgia.

[Pixix in reply to piglette]

well put! I have both & that’s the case! But my examination for each disease were completely different. Your question appears to be whether either can be misdiagnosed (& you think your mother may have been, but sadly she’s no longer with us?!) My answer is anything can be misdiagnosed, surely? There’s no specific yes or no test like Covid has, & it’s the experience of the doctor that counts! Or am I wrong…

[piglette in reply to Pixix]

Even Covid can be misdiagnosed, but there are diagnostic tools. They reckon that at the first visit to a GP 40% of patients are not diagnosed or mis diagnosed. If people come back the GP will put in a bit more effort!!

[Pixix in reply to piglette]

Absolutely. Sorry, I meant that a test kit exists, whilst there’s no ‘test kit’ or blood test that can individually diagnose the other diseases, though hints can be found in blood test results eg CRP, but as we know that can be normal! I was diagnosed yesterday with folate anaemia…my symptoms, amongst others, were awful fatigue, which could easily be because I’d just tapered from 4mg to 3mg (adrenals?!) but my GP ran a huge barrage of tests as he knew I’m having a lot of other issues, especially with my joint (two finger dislocations in 3 weeks and subluxation of wrist & ankle)! I also had Reynauds syndrome diagnosed, which was easy for him to diagnose by examining & squeezing my hands etc.

[piglette in reply to Pixix]

The trouble is a lot of illnesses have very similar symptoms, that is why we keep reading about people being diagnosed with a headache when they actually have a brain tumour for example. Something is in the papers pretty well daily.

[Pixix in reply to piglette]

Don’t I know it…still trying to get diagnosed myself…lack of being able to see a rheumy, with a year’s wait, puts it all on the shoulders of my GP, which is very unfair. He says my case is very interesting, & he’s determined to help, so I’m lucky.

[piglette in reply to Pixix]

I went privately to a rheumie in the end I was in so much pain. My GP kept saying I had a virus.

[Pixix in reply to piglette]

If my doctor can’t manage to bring the referral earlier, I’ve said we will pay. David & I discussed it before I went to the surgery. But, otoh, my doctor is actually doing something about it all…& my problems are part neurology, part rheumie & part osteo…connecting that lot us hard! Dreadful that your gp fobbed you off with diagnosis of a ‘virus’!!

[piglette in reply to Pixix]

I did say to my GP do you think it is PMR? I sort of shrugged. He said whatever it was, it was nothing serious! You may find just one visit to a rheumie might not be too pricey.

[Pixix in reply to piglette]

Yes, hoping to pay for one good session, then if he needs MRI or scan to move into NHS mode! After Friday, I’m waiting to see how the Folic Acid & the Depo Medrone injection help…will be two weeks before I see improvement. I see the podiatrist tomorrow, and she may have some influence in the rheumy dept to get me seen..time will tell! S xx

[piglette in reply to Pixix]

Sounds like you have things organised.

[bright-horizon in reply to piglette]

I had PMR but now the rheumatologist has as decided it is more likely fibromyalgia because the prednisone didn’t help my pain much once I was down to 15mg and lower. My problem now is to find a medication to lessen the fibro pain without turning me into a fat zombie!

[piglette in reply to bright-horizon]

Steroids do not help fibromyalgia at all. A friend of mine takes Tramadol for the pain of fibromyalgia. It is steroids that can cause weight gain.

[PMRpro Ambassador in reply to bright-horizon]

Ignorance rules - if it were fibro it is unlikely pred would work at 20mg either.

[Esradral]

Hi, I have been suffering with Fibro for 10yrs now, seemed to come on after a car accident where all over pain was present and wouldn't leave. In Feb 21 I couldn't get out of bed, I felt as though I was pinned to it. Even though I have an adjustable bed and sleep sat up, I still could not get out whatever I tried. In the end I had to wait for my partner to come back in, I asked him to swing my legs around so that I could sit on the side of the bed to get dressed. I took all my medication straight away to hopefully help resolve the situation. I could not raise my arms so dressing took ages, but as I have had 2 shoulder ops previously (rotator cuff repairs) I wondered if this was the situation again. However my meds appeared to help the situation but I struggled for a week before ringing the doc (during Covid) I had by this time remembered my father had suffered the same thing so when I actually spoke to the doc I mentioned it. She prescribed 15mg Pred and the following day I managed to get out of bed without any help, such is the miracle work of steroids for PMR. I am currently reducing very slowly by half a mg ever 4-6 weeks and am down to 8mg. I am due a knee replacement very soon and don't want to mess anything up so staying put until the op is over and I am back on my feet. So in my case there were very different symptoms and responses to meds.