How to Tell if it’s Fibromyalgia or Multiple Sclerosis

There is so much mystery in the world of fibromyalgia, in large part because it effects everyone differently. Another reason for the mystery is due to the similarity in fibro symptoms compared to other diseases and syndromes. Fibromyalgia is sometimes misdiagnosed as a different problem and vice versa. This is because the myriad of symptoms associated with fibro are commonly found in other illnesses such as multiple sclerosis, also known as MS. So how can you tell if it’s fibromyalgia or multiple sclerosis?

WHAT EXACTLY IS MS?

The National MS Society defines it as follows: “Multiple sclerosis (MS) involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves.” If you or a loved one live with fibromyalgia, you can definitely spot some familiar buzz words and phrases, can’t you? Specifically, “immune system,” “abnormal response,” and “central nervous system.” In fact, the similarities in symptoms become quite striking when you review a side-by-side comparison. Note that most, not all, of the fibromyalgia symptoms overlap with MS symptoms, making it difficult to distinguish whether it’s fibromyalgia or multiple sclerosis:

MS SYMTPOMS	FIBROMYALGIA SYMPTOMS
Fatigue	Fatigue/Exhaustion
Numbness or Tingling	Numbness &/or Tingling
Weakness	Muscle Weakness
Dizziness & Vertigo	Dizziness
Pain	Pain
Emotional Changes	Anxiety
Walking (Gait) Difficulties	Impaired Coordination
Spasticity (i.e., muscle stiffness and spasms)	Muscular aching, throbbing, & twitching
Vision Problems	Vision Problems
Bladder Problems	Bladder Problems
Bowel Problems	Irritable Bowel Syndrome
Cognitive Changes	Cognitive Problems
Depression	Depression
Tremor	Restless Leg Syndrome
Headache	Headaches/Migraines
Swallowing Problems	Dry Eyes & Mouth
Itching	Itching &/or Burning
Sexual Problems	Insomnia/Poor sleep
Speech Problems	Ringing in the Ears
Breathing Problems	Neurological Symptoms
Seizures	Skin Sensitivities & Rashes
Hearing Loss It is plain to see many similarities in symptoms between fibromyalgia and multiple sclerosis, including clear neurological connections associated with pain, numbness, and tingling. However, experts explain that unlike MS, fibromyalgia does not show up as brain lesions on an MRI. Furthermore, while both conditions have no known source, MS is distinctly categorized as an auto-immune disease, but fibromyalgia is not. So that is one way to determine if it’s fibromyalgia or multiple sclerosis. A key difference in MS is that the patient actually accrues long-term nerve damage which leads to physical and cognitive impairments. In fact, some types of MS are progressive. Primary Progressive MS (PPMS), for example, “is characterized by worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions.” While fibromyalgia, on the other hand, is often mistakenly considered an arthritic condition, it does not actually cause damage to joints, muscles, or tissues. JUST WHAT IS FIBROMYALGIA? Fibromyalgia is primarily characterized by chronic and wide-spread pain. A close second is the debilitating fatigue. But as you can see from the chart above, the symptoms are quite broad. The problem many patients run into is that fibromyalgia resembles so many other conditions that it’s usually difficult to nail down a diagnosis. However, some physicians are more inclined to spot it than others. HOW ARE MS AND FIBROMYALGIA EVALUATED? The University of Maryland Medical Center explains that a fibromyalgia diagnosis is comprised of a detailed muscle exam that includes checking for tenderness at specific locations on the body. Rating the severity of specific symptoms is another key part of the exam. The symptoms must be present for at least three months. They add that there are no blood, urine, or laboratory tests which can provide a conclusive fibromyalgia diagnosis. However, fibro diagnosis also means that no other disorder or condition can explain the symptoms. Diagnosing MS, however, is quite different because it causes several more neurological symptoms than fibromyalgia. Thus, exams tend to focus on brain and nerve function, including a brain MRI and sometimes a spinal tap. Even though MS can also be difficult to diagnose, it is often easier than fibromyalgia. This is because the evaluation requires searching for lesions or damaged areas to the central nervous system. HOW CAN I TELL IF IT’S FIBROMYALGIA OR MULTIPLE SCLEROSIS? It’s true that the similarities between multiple sclerosis and fibromyalgia are striking. But given the neurological damage caused by MS, it is a condition that is slightly easier to target than fibromyalgia. Patients with MS are usually treated by a neurologist. But so are many fibro patients. As such, a neurologist likely has a keen eye in making the distinction between the two. Only tests will be able to tell. Were you misdiagnosed? How did it effect you? Tell us your story, please!