Fitting a Diagnosis: Do I Have MS or Fibromyalgia?
Multiple Sclerosis (MS) and Fibromyalgia are two different conditions that sometimes get mistaken for one another before a doctor has the chance to make a concrete diagnosis.
This is due to the fact that MS and Fibromyalgia share some overlapping symptoms. They also share some similarities with symptoms of various autoimmune diseases.
Regardless of whether you have MS, Fibromyalgia, or another similar disease, you will have to undergo some testing in order to receive a diagnosis.
If you have not made the call to your doctor about your health concerns, you should take note of the differences between symptoms listed in this article and prepare a list of questions for your physician.
What is Multiple Sclerosis?
As Dr. Marvin M. Goldberg writes, Multiple Sclerosis (MS) is a chronic neurological condition that damages your central nervous system’s (CNS) myelinated axons by attacking the protective myelin sheaths around the axon.
MS triggers inflammatory and autoimmune reactions within the body, although it is difficult to predict just how MS is going to impact every person who has it.
While MS tends to start out with some noticeable changes in your neurological abilities (including dizziness and feeling fatigued), these symptoms will progress over time.
Unfortunately, about half of those who have MS will end up being unable to walk without assistance within approximately 15 years of the disease’s onset.
Most will develop issues with mobility over time and lose their sense of balance and coordination.
Doctors tend to group each patient with MS into one of the four following MS categories based on the symptoms they present with:
- Relapsing-remitting MS
- Secondary progressive MS
- Primary progressive MS
- Progressive-relapsing MS
Relapsing-remitting MS (RRMS) affects about 85% of those diagnosed with MS. In fact, this is the first type of MS that people are diagnosed with.
In this type of MS, you will experience flare-ups followed by recovery periods in which you feel more like your usual self.
As time goes on, you will likely experience more long-lasting flare-ups than recovery periods and move into one of the more progressive types of MS.
Secondary progressive MS (SPMS) tends to succeed the relapsing-remitting stage for most of those with MS. This tends to be where bladder and bowel problems develop, muscle stiffness or weakness worsens, and cognitive and motor skills further diminish.
Primary progressive MS (PPMS), which is relatively rare, is characterized by the fact that there are no acute periods of flare-ups and remissions. It is a progressively deteriorating condition from the beginning.
Progressive-relapsing MS (PRMS) only impacts about 5% of those with MS and is characterized by flare-ups that become worse over time without any periods of remission.
What is Fibromyalgia?
Fibromyalgia Syndrome (FMS) is, like MS, a debilitating disease characterized by flare-ups and remission periods.
Those with FMS experience chronic pain and fatigue, as well as confusion. In fact, this state of cognitive impairment is sometimes referred to by those with FMS as “fibro fog” or “brain fog”.
It is not currently fully clear as to what causes FMS, but there is evidence to suggest that FMS has some sort of genetic basis.
Although the disease does not have a series of progressive steps like MS, it can be triggered by stressful or emotional events such as traumatic losses and the endurance of any type of abuse.
FMS tends to affect significantly more women than men but can manifest in both sexes, as well as in young children (although individuals are mainly diagnosed between ages 20 and 50) and those of various ethnic backgrounds. Arthritis is a common comorbidity, as well as depression and other mood disorders.
Why Are These Illnesses So Commonly Mistaken For Each Other?
Both MS and FMS involve the experiencing of chronic pain and fatigue. Those who suffer from FMS or MS will likely endure moderate to severe headaches, tingling or loss of feeling in some or all of the extremities, and a decline in short-term memory processing and retrieval.
The sad fact of the matter is that modern medicine and science are still struggling to understand these highly complex illnesses. That makes it all the more difficult for us common folk to tell them apart.
There are also a number of autoimmune diseases, such as Sjogren’s Syndrome (SS) and Lupus, that are extremely similar to both FMS and MS.
FMS is more commonly diagnosed than MS, and there are no blood tests that can concretely tell the difference between them.
In fact, when it comes to receiving a diagnosis, blood work is not going to be your doctor’s go-to method for providing a diagnosis.
Blood work will likely be done only as a way to rule out other illnesses, such as Lupus and Sjogren’s.
How Can I Tell the Difference Between Them?
The biggest difference between MS and FMS is that MS can be detected through an MRI. With MS, lesions in certain areas of the brain will appear over time.
This is not the case with FMS. If you have brain lesions, they will show up on an MRI as either dark or white spots in either hemisphere of the brain.
There might only be a few or many lesions that show up, although this doesn’t provide a tell-tale sign of the severity of your MS.
With FMS, you will be diagnosed based on your doctor’s assessment of your symptoms.
You will be diagnosed based on the Widespread Pain Index (WPI) and/or symptom severity (SS).
In order to meet the criteria, you must have a WPI of 7 or greater and an SS of 5 or greater or a WPI ranging between 3 and 6 and an SS of at least 9.
Additionally, those with FMS tend to report having symptoms of depression and other mood-related disorders more so than those with MS, although those with MS can experience depression.
How Are These Diseases Treated?
FMS and MS both require a lot of preventative care and management. Non-pharmaceutically-based treatment methods can help decrease the severity of symptoms in both MS and FMS.
These therapeutic tools can include Cognitive Behavioral Therapy for learning pain management skills, meditation, yoga, walking, art and music therapy, acupuncture, massages, and other forms of alternative healing.
There are herbal supplements available over-the-counter that some doctors might recommend for specific symptoms.
Nootropics (which are supposed to enhance cognition and memory skills) are becoming more popular among those with both MS and FMS.
There are prescription medications available for both diseases. Those with FMS might be prescribed NSAIDs (like Ibuprofen) as well as Paracetamol and anti-depressants.
Prescription medications for MS are somewhat different. Medications that are typically prescribed for those with MS include immunosuppressants, anti-inflammatories, and steroids.
Plasma exchanges might also be required in order to help you better cope with MS flare-ups.
You might also need to occasionally use laxatives or stool softeners to help you defecate more easily, as constipation and other gastrointestinal or digestive issues can be a major issue for those with MS.
What’s My Prognosis?
It is important to understand that, while MS and FMS have no known cures, early detection and treatment can help to ease the severity of symptoms and possibly slow the progression of MS.
Getting on the right medications can certainly be beneficial, but as most doctors and specialists will tell you, you will have to adapt to a new lifestyle.
And this means that you will likely have to make some pretty significant changes in terms of your diet and exercise habits.
Although exercise can seem excruciating when you are experiencing chronic pain, light to moderate exercise can be beneficial.
Walking is especially crucial for those with MS, as they will tend to lose mobility in their legs over time.
You might find yourself struggling to run or jog like you used to if you have MS, and, if you have FMS, you might find that running causes your pain levels to increase.
Sticking with a walking routine is, therefore, far more beneficial. Yoga is also encouraged, as it can help you rebuild some of your core strength, tone the muscles in your arms and legs, and reduce some of your physical and emotional stress.
While there are not yet any known cures for Multiple Sclerosis or Fibromyalgia, there are certainly ways to find out which one you have and how you can best treat your symptoms.
Know in advance that you will likely go through multiple doctors and specialists just to get your diagnosis and that claiming a disability without these diagnoses can be downright difficult.
You will likely be at or beyond the point of feeling sick and tired of being sick and tired by the time you get your diagnosis.
However, with your diligence and knowledge of your symptoms, you can start to find ways of handling your symptoms on your own while starting on your diagnostic path with the right medical team.