What Is the Difference Between Rheumatoid Arthritis vs. Fibromyalgia?

Reviewed on 3/23/2022
Illustrations of fibromyalgia pain
Rheumatoid arthritis (RA) is an autoimmune disorder that causes persistent joint pain, swelling, and stiffness. Fibromyalgia is a chronic condition that causes widespread pain, sleep problems, fatigue, and depression.

Both rheumatoid arthritis (RA) and fibromyalgia are chronic conditions that can cause pain. 

What Are Symptoms of Rheumatoid Arthritis vs. Fibromyalgia?

A common symptom of both rheumatoid arthritis and fibromyalgia is pain; however, RA causes joint pain while fibromyalgia causes pain all over the body.

Other symptoms of RA and fibromyalgia that are similar include: 

Rheumatoid arthritis usually affects the same joints on both sides of the body (symmetrical). Joint pain and stiffness of rheumatoid arthritis usually begins in the small joints, such as those joints at the base of the fingers, the middle of the fingers, and the base of the toes, or it may occur in a single, large joint, such as the knee or shoulder, or it may shift from one joint to another

As the condition progresses, joint pain and inflammation become more prominent and symptoms include: 

  • Joint pain and stiffness that may affect the:
    • Hands
    • Wrist 
      • Difficulty bending the wrist backward
    • Elbow 
      • Numbness or tingling in the fingers
    • Shoulder 
      • Pain and limited motion
    • Foot 
      • Standing and walking with weight on the heels due to pain at the base of the toes
      • Top of the foot may be swollen and red, and the heel may be painful
  • Ankle
    • Numbness and tingling in the foot
  • Knee 
    • Difficulty bending the knee 
    • “Baker's cyst” (a fluid-filled cyst in the space at the back of the knee)
  • Hips
    • Difficulty walking
  • Neck 
    • Painful and stiff neck
    • Difficulty bending the neck and turning the head
  • Cricoarytenoid joint (a joint near the windpipe) 
  • Other symptoms of rheumatoid arthritis may include:

Symptoms of fibromyalgia include:

What Causes Rheumatoid Arthritis vs. Fibromyalgia?

It is unknown what causes both rheumatoid arthritis and fibromyalgia. 

Risk factors for both rheumatoid arthritis and fibromyalgia include: 

  • Age: middle-aged or older
  • Being female: females are twice as likely as men to develop either condition
  • Genetics: tends to run in families

Triggers that can increase the chances a susceptible person will develop rheumatoid arthritis, include:

Risk factors for developing fibromyalgia include: 

How Is Rheumatoid Arthritis vs. Fibromyalgia Diagnosed?

The diagnosis of rheumatoid arthritis or fibromyalgia involves a combination of clinical, laboratory, and imaging information. 

Laboratory studies used to diagnose rheumatoid arthritis include:

Imaging studies used to diagnose rheumatoid arthritis include:

Joint aspiration and analysis of synovial fluid may also be indicated.

Fibromyalgia is diagnosed with the patient's history and physical examination, along with tests such as: 

  • Blood tests
  • X-rays

Criteria used to help diagnose fibromyalgia may include:

  • A history of widespread pain and symptoms lasting more than three months
  • The number of areas throughout the body in which pain has occurred in the past week, based on the total number of painful areas out of 19 parts of the body, plus the level of severity of these symptoms: 
    • Fatigue
    • Waking unrefreshed
    • Cognitive (memory or thought) problems
  • No other health problems that explain the pain and other symptoms

What Is the Treatment for Rheumatoid Arthritis vs. Fibromyalgia?

Rheumatoid arthritis is treated with medications, surgery, and other therapies such as physical therapy.  

Medications used to treat rheumatoid arthritis include:

  • Nonbiologic disease-modifying antirheumatic drugs (DMARDS) 
  • Biologic tumor necrosis factor (TNF)–inhibiting DMARDs 
  • Biologic non-TNF DMARDs 
  • Corticosteroids 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) 
  • Pain relievers (analgesics)
  • Topical skin products

Surgical treatments for rheumatoid arthritis include:

  • Synovectomy 
  • Tenosynovectomy 
  • Tendon realignment 
  • Reconstructive surgery or arthroplasty 
  • Arthrodesis 

Other therapies for rheumatoid arthritis include:

  • Heat and cold therapies 
  • Orthotics and splints 
  • Physical therapy and exercise 
  • Occupational therapy 
  • Adaptive equipment 
  • Joint-protection education 
  • Energy-conservation education 

Treatment for fibromyalgia may include lifestyle changes, medications, therapy, and complementary therapies: 

Reviewed on 3/23/2022
Image Source: iStock Images