Fibromyalgia-Lupus Connection

Reviewed by: HU Medical Review Board | Last reviewed: January 2020

Most people with lupus feel pain and fatigue sometimes. The type and location of the pain may change, but it usually gets better if inflammation and the disease are controlled. However, about 30 percent of people with lupus will also be diagnosed with fibromyalgia, another disease that causes fatigue and widespread and sometimes extreme pain and sensitive spots on the body.1

Like lupus, doctors do not understand fibromyalgia very well. They know that it tends to cause pain on both sides of the body at the same time, and often in the neck, shoulders, chest, hips, knees, and elbows.

Fibromyalgia is a neurological disease that affects more women than men and tends to start in middle-age. People with any rheumatic disease are at higher risk of developing fibromyalgia.

How are fibromyalgia and lupus different?

People with fibromyalgia often talk about fatigue and all-over muscle pain or soreness that becomes worse when they don’t get enough sleep. Widespread body pain is the most common symptom. Their joints usually move normally and are not swollen. However, they do tend to have tender areas over muscles that are uncomfortable to the touch.2

People with lupus also feel tired and achy, but their joints are painful, swollen, and may not move normally due to cartilage damage caused by arthritis. They also get symptoms such as skin rashes that get worse in sunlight, kidney problems, headaches, or chest pain.

How is fibromyalgia diagnosed?

Doctors diagnose fibromyalgia based on a person’s symptoms and the number of tender places found during an exam. There is no test to say that you have fibromyalgia. Your doctor may order a series of lab tests or X-rays to rule out other health problems. Fibromyalgia is often confused with lupus or rheumatoid arthritis, even though these diseases cause inflammation in the joints and tissues and fibromyalgia does not.1-3

How is fibromyalgia treated?

Every person may find a different combination of treatments works for their individual symptoms. However, research says that physical exercise is the most effective treatment. Aerobic exercise, along with Tai Chi and yoga, can ease pain and other symptoms.3

Cognitive Behavioral Therapy (CBT), which includes meditation, mindfulness, and other stress-relieving activities, has been shown to improve symptoms. Alternative therapies such as acupuncture, acupressure, and massage also help some people.3

A variety of drugs may be used to treat fibromyalgia. These include:

  • Duloxetine (Cymbalta)
  • Milnacipran (Savella)
  • Amitriptyline (Elavil)
  • Cyclobenzaprine (Flexeril)
  • Other antidepressants
  • Pregabalin (Lyrica)
  • Gabapentin (Neurontin)3

How is the pain of fibromyalgia treated?

In some ways, pain for fibromyalgia is treated in the same ways that lupus pain is treated. Pain medicines like NSAIDs (ibuprofen and naproxen) and acetaminophen (Tylenol) are sometimes helpful, but since this class of medicine may interact poorly with other drugs, it is useful to know about other ways to reduce or manage pain. Non-drug alternatives include:

  • Moist heat like a hot shower or heated moist towel for joint and muscle pain relief.
  • Cold is recommended only for strained, injured muscles.
  • Behavioral techniques that distract or teach your mind to handle pain better include meditation, yoga, Tai Chi, self-hypnosis, focused breathing, and guided imagery.
  • Alternative therapies such as biofeedback, acupressure, or acupuncture work for some.1,3

Opioids should be avoided for fibromyalgia pain. Any sleep problems caused by fibromyalgia may be improved by treating pain with drugs such as cyclobenzaprine (Flexeril), amitriptyline (Elavil), gabapentin (Neurontin) or pregabalin (Lyrica).3

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