Fibromyalgia & Lupus: Comorbidity of Illnesses

Fibromyalgia, also known as ‘fibro’ or FMS, is a chronic condition that causes generalize and widespread pain. And it’s common alongside lupus.

Lupus and fibromyalgia are two conditions that are similar to one another. They cause similar symptoms to the point where they’re often misdiagnosed for one another.

In some cases, a person might suffer from both conditions simultaneously. When a person is experiencing two (or more) chronic illnesses at the same time, the diseases are said to be ‘comorbid.’ Comorbidity offers special challenges as the diseases may interact in unexpected ways and certain treatment options may not be viable.

It is important to work with your lupus treatment team to evaluate comorbid conditions and develop treatment plans that work for all health conditions.

What is fibromyalgia?

Fibromyalgia classifies as a rheumatic or arthritic condition that affects the muscles and soft tissue. Experts believe the condition occurs as a result of how the brain processes pain signals. It seems to be a malfunctioning of the central nervous system that results in amplified transmission and interpretation of pain signals.

Unlike lupus, fibromyalgia does not cause inflammation or damage to the muscles, joints or other tissue in the body. Rather, fibro is an ‘invisible illness’ that makes the activities of daily living incredibly challenging. Common symptoms include:

• Widespread pain
  • Occurs both above and below the waist on both sides of the body
  • Could be a constant ache that exists for many months
• Extreme fatigue
  • Sleep often is interrupted by pain
  • Research has found a reduction in delta sleep and an increased number of arousals in people with fibromyalgia which may contribute to individuals waking up unrefreshed and feeling exhausted
• Cognitive difficulties
  • Challenges with concentration or focus
  • Known as ‘brain fog‘
• Tender areas particularly over muscles
  • Pressing on tender areas causes discomfort
• Anxiety or depression
• Numbness of the extremities (called paresthesia)

What causes fibromyalgia?

Doctors are not sure of the root cause of fibromyalgia. However, they have identified a number of risk factors:

1. Genetics
   • It tends to run in families suggesting a genetic component.
   • Research has found potential important factors in the serotoninergic, dopaminergic, and catecholaminergic systems
   • For an exploration of the genetic markers linked to each system, click here to read more
2. Environmental triggers
   • Illnesses, repetitive injuries, and emotional trauma may serve as triggers for fibromyalgia
   • However, 21% of people participating in one study could not identify a trigger for the illness
   • 73% of participants indicated that an emotional trauma or chronic stress was the potential trigger

Lupus & Fibromyalgia

It is relatively common for a person with an autoimmune disease, like lupus, to also develop fibromyalgia. Two studies attempted to ascertain the likelihood of having both conditions (comorbidity).

Published in 2009, one study relied on a survey of people with lupus (SLE). Fibromyalgia was measured using a separate survey. The researchers found that 22.1% of people with lupus also had fibromyalgia.

This finding was similar to what was found in a review published in 2012. The author of the review found 8 studies exploring the comorbidity between lupus and fibro. The average prevalence was 16.2% (the range was 12.2-19.8%).

There are other common comorbidities with fibromyalgia including:

• rheumatoid arthritis (RA) (15.4%)
• ankylosing spondylitis (30.4%)
• hypothyroidism (34%)
• Crohn’s disease (26%)

These prevalence findings are important to researchers who are looking expand the understanding of fibro. Comorbidity hints at other relevant factors and challenges.

Diagnosing fibro

Both lupus and fibromyalgia can cause symptoms that are similar to one another. This is one of the reasons that it can be challenging to diagnose these diseases. It is necessary for clinicians to consider lab tests, a person’s medical history, and a physical examination to make a diagnosis.

Though it can be challenging, the diagnostic process is crucial. Dr. Robert Shaw, a rheumatologist, shares: “A proper diagnosis is important because the treatments for lupus and fibromyalgia are different.”

If you think you are experiencing the symptoms of fibromyalgia, be sure to bring it up with your clinician. And, if you are having issues sleeping, check out these strategies and tech tools that aim to improve sleep.