Re: Difference between Fibromyalgia and RA

January 12, 2005

,

I have both, so here goes.

RA is an autoimmune disease, that is, your immune system is

attacking the tissues lining your joints. RA can strike any age

group, including children. The symptoms include

* pain and inflammation (swelling, redness and sometimes heat) in

ANY movable joint.

* both sides of the body are affected equally.

* multiple joints are involved, especially in the hands and feet.

This is frequently where RA shows up first.

* a low-grade fever may be present (99 to 100 degrees)

* extreme fatigue

* it is possible for RA to attack other tissues in the body besides

the joint lining and cartilage.

* if left untreated, the cartilage at the ends of the bones can be

destroyed, leaving fingers and toes severely deformed and unusable.

RA treatment usually involves anti-inflammatory drugs and " Disease

Modifying " drugs which usually work by interfering with the immune

system. Anti-inflammatory drugs include the " non-steroidal " class

like Advil, Alleve, Celebrex and Viox. Steroid anti-inflammatory

drugs include prednesone. Steroids are normally only used for a

short time due to their serious side effects. Methotrexate (sp?) is

an example of a " disease modifying " drug. The newest drugs are

the " biologicals " like Enbrel - typically given by injection or IV

infusion. These are heavy-duty drugs which are up there with anti-

cancer drugs.

BTW, Tylenol is NOT an anti-inflammatory drug. If it is used with RA

then it is included ONLY for it's mild pain relief. It usually is

combined with one of the narcotic pain drugs. Percocet and Vicodin

are examples of Tylenol + narcotic drugs.

Fibromyalgia appears to be a dysfunction of the pain signalling

nerves and perhaps has some endocrine (chemical messengers) problems

mixed in. Fibromyalgia does NOT cause inflammation and is never

treated with anti-inflammatory drugs nor with drugs which modify the

immune system. Symptoms of fibromyalgia

* a number of painful tender spots exist in specific locations on

the body. These spots hurt when pressure is applied.

* all-over generalized muscle pain. This can run the gamut from

achey to burning to stabbing. Pain can range from mild to

excruciating.

* extreme fatigue

* sleep disturbances

* mental difficulties such as memory problems and difficulty in

focusing. People refer to this as " fibro fog. "

* exercise and exertion can cause the general muscle pain to

increase. If someone with fibro has an active, productive day it is

frequently followed by a period of days when the person can barely

get out of bed.

There is no really good therapy for fibromyalgia. Research into it's

origins has made little headway, to date. High or chronic stress

levels frequently precede it's onset. The medications used are aimed

at improving sleep, relaxing muscles and/or reducing pain. Elavil

and other similar anti-depressants are typically used to improve

sleep. Flexeril or other muscle relaxants can soothe muscle spasms.

Pain control frequently includes narcotic pain medications. Mild to

moderate pain is typically treated with a combination of Tylenol

plus a low dose of a narcotic. Examples include Vicodin and

Percocet. Higher levels of pain may justify narcotic-only drugs such

as Oxycontin or the new " patches " such as a Duragesic patch. The

newer " SSRI " anti-depressant drugs are frequently prescribed to

people with chronic pain. They are reputed to alter pain perception

for the better. This is an " off-label " use since the FDA has not

approved this use of SSRIs.

Nina

January 12, 2005