What’s the difference between lupus and fibromyalgia? You Should Be Aware!

Two diagnoses that can get mixed up are lupus and fibromyalgia.  Lupus is diagnosed based partially on the American College of Rheumatology criteria (see below).  Sometimes the symptoms arrive sequentially and are not all there at one time.  The diagnosis is easier if there is something specific to biopsy such as a lupus rash or lupus kidney disease.  But the collection of symptoms and abnormal autoimmune antibody laboratory tests allow a rheumatologist or other physician to make the diagnosis of lupus.

Because lupus often involves joint pain, women with a lot of joint pain and fatigue are often concerned that they may have lupus, especially if they have a positive ANA (antinuclear antibody) test in the blood.

Some of those women have a lot of pain and sometimes have pain virtually all over.  They often have fibromyalgia.  Fibromyalgia can occur concurrently with lupus, but most of the time lupus and fibromyalgia are separate diagnoses.  In fibromyalgia, sometimes people are tender over their painful joints and muscles, but at least they have a lot of pain that is widespread and associated with poor sleep, fatigue, and difficult concentration.

The treatment for lupus and fibromyalgia are completely different.  Lupus is treated with autoimmune medications such as Plaquenil, steroids, immunosuppressive medicines and the new biologic Benlysta.  Fibromyalgia is treated with low-dose antidepressants, muscle relaxants, nerve medications, and other drugs.

Lupus is frequently characterized by a facial rash that stays around for a while. The rash does not tend to come and go on a daily basis, but it is there for at least several weeks over the face and sun-exposed areas of the body.  The joints sometimes get a little bit swollen, and stiffness is characteristic.  Sometimes chest pain with deep breathing or pleurisy or pericarditis can occur.  In fibromyalgia, pain and fatigue are the main symptoms.