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Because of their apparent similarities, it’s possible for PMR to be misdiagnosed as fibromyalgia or vice versa. It’s also possible for either condition to be overlooked in someone who’s already diagnosed with the other.
These two conditions, however, are very different and require different treatments. Knowing the symptoms of both can help you recognize whether you may have a new or undiagnosed condition that needs to be addressed.
What Is Fibromyalgia?
In fibromyalgia, the central nervous system takes pain signals and “turns up the volume” through a complex mechanism that’s believed to involve extra nerve structures, abnormal nerve function, and neurotransmitter imbalances in the brain.
While fibromyalgia does involve some amount of immune-system dysfunction and some cases may have aninflammatory component, this condition is not classified as autoimmune or inflammatory. (Some subgroups may involve autoimmunity but research is still inconclusive on that.) Fibromyalgia is a neurological condition that many experts consider to be on the spectrum ofcentral sensitivity syndromes. It’s sometimes referred to as a neuroimmune or a neuro-endocrine-immune condition because of its complexity.
The most common fibromyalgia symptoms include:
Fibromyalgia pain is not confined to certain areas and it can be all over the body. By definition, pain must be present in the spine and in all four quadrants of the body. Each individual can have places where their pain is typically worst, but most people with this illness have some degree of pain all over their bodies.
This condition can cause any of a few dozen other potential symptoms, as well. The effects may come on suddenly, especially after an illness or physical trauma (surgery, car accident, childbirth), or develop slowly over several months or even years.
The Big List of Fibromyalgia Symptoms
What Is Polymyalgia Rheumatica?
PMR is an inflammatory disease that’s believed to beautoimmune, meaning that the body is attacking its own healthy tissues because it mistakes them for infectious organisms such as viruses or bacteria. This condition is seen almost exclusively in people over the age of 50.
Among people older than 50, about 0.5% have PMR, making it a rare disease. (To give you a comparison, fibromyalgia impacts between 2% and 4% of the U.S. population.)
A 2014 study inRheumatology Internationalsuggested that PMR may be present in about 3% of people with fibromyalgia. If that’s true, it’d make it considerably more common in people with fibromyalgia than in the general population.
PMR generally causes muscle pain and stiffness in specific parts of the body, including the:
The stiffness is almost always worst in the morning when it can severely limit the ability to perform basic tasks, such as getting out of bed and getting dressed.
PMR can include other symptoms as well, such as:
When this disease strikes, symptoms generally come on quickly.
Is Polymyalgia Rheumatica Worse Than Fibromyalgia?
Every person’s experience is different, so it’s impossible to say definitively whether one disorder is worse than another. However, there are aspects of fibromyalgia that may make it harder to manage than PMR.For instance:
The pain associated with fibromyalgia, while real, is not dangerous or life-threatening. However, untreated inflammation, such as that which can occur in PMR, can lead to joint damage, as well as increased risk of cardiovascular morbidity and mortality.
Rheumatism: Characteristics of a Group of Diseases
Diagnosis
No single blood test can diagnose PMR. Healthcare providers consider the full range of symptoms along with blood tests that measure C-reactive protein and bloodsedimentation (or “sed”) rate. Elevated results for either test indicate inflammation.
Why Is Polymyalgia Mistaken for Fibromyalgia?
The difficulty in diagnosing PMR can lead to confusion and a possible misdiagnosis at first. Cases in which the circumstances match common fibromyalgia situations, such as women who feel pain in the shoulders and arms, are more likely to be initially classified as fibromyalgia until further tests can show it to be PMR.
Treatment
PMR is generally treated with steroids and can often be well controlled. Steroids are not considered effective in fibromyalgia and achieving control is difficult. Fibromyalgiatreatmentregimens generally include multiple approaches, including:
Make sure to discuss treatment options and any side effects you experience with your healthcare provider to determine the best ones for you.
A Word From Verywell
If you suspect you have one or both of these conditions—polymyalgia rheumatica and fibromyalgia—bring it up with your healthcare provider. You’re the expert on your pain, which is invisible to the healthcare provider, so be prepared to describe its nature, triggers, and timing in detail. The diagnostic process may not be easy, but it’s important to be patient and persistent so you can ultimately get the right management plan to relieve your symptoms.
Frequently Asked QuestionsResearchers have been looking at cases in which COVID-19 may have caused PMR, but the data is not conclusive and more studies are being done.Learn MoreCOVID-19 News and UpdatesNo. A blood test won’t specifically detect PMR, but it can check for inflammation, a sign of PMR.It can also be used to rule out other diseases that might cause the pain you’re experiencing.Learn MorePreparing for a Blood DrawOther conditions that are similar to PMR include:Giant cell arteritis, an inflammatory disease that affects the arteriesPolymyositis, a rare disease that causes weakening of muscles and connective tissueFibromyalgia, a chronic disorder in which you may feel pain throughout the body.Learn MoreWhat You Should Know About Polymyositis
Frequently Asked Questions
Researchers have been looking at cases in which COVID-19 may have caused PMR, but the data is not conclusive and more studies are being done.Learn MoreCOVID-19 News and Updates
Researchers have been looking at cases in which COVID-19 may have caused PMR, but the data is not conclusive and more studies are being done.
Learn MoreCOVID-19 News and Updates
No. A blood test won’t specifically detect PMR, but it can check for inflammation, a sign of PMR.It can also be used to rule out other diseases that might cause the pain you’re experiencing.Learn MorePreparing for a Blood Draw
No. A blood test won’t specifically detect PMR, but it can check for inflammation, a sign of PMR.It can also be used to rule out other diseases that might cause the pain you’re experiencing.
Learn MorePreparing for a Blood Draw
Other conditions that are similar to PMR include:Giant cell arteritis, an inflammatory disease that affects the arteriesPolymyositis, a rare disease that causes weakening of muscles and connective tissueFibromyalgia, a chronic disorder in which you may feel pain throughout the body.Learn MoreWhat You Should Know About Polymyositis
Other conditions that are similar to PMR include:Giant cell arteritis, an inflammatory disease that affects the arteriesPolymyositis, a rare disease that causes weakening of muscles and connective tissueFibromyalgia, a chronic disorder in which you may feel pain throughout the body.
Other conditions that are similar to PMR include:
Learn MoreWhat You Should Know About Polymyositis
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Guggino G, Ferrante A, Macaluso F, Triolo G, Ciccia F.Pathogenesis of polymyalgia rheumatica.Reumatismo. 2018;70(1):10-17. doi:10.4081/reumatismo.2018.1048Leeb BF, Bird HA, Nesher G,et al.EULAR response criteria for polymyalgia rheumatica: results of an initiative of the European Collaborating Polymyalgia Rheumatica Group (subcommittee of ESCISIT).Annals of the Rheumatic Diseases.2003;62:1189-1194. doi:10.1136/ard.2002.002618Haliloglu S, Carlioglu A, Akdeniz D, et al.Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.Rheumatol Int. 2014;34:1275. doi:10.1007/s00296-014-2972-8Acharya S, Musa R.Polymyalgia rheumatica. In: StatPearls [Internet]. Treasure Island (FL): StatPearls.Arthritis Foundation.What is the Difference Between Fibromyalgia and Polymyalgia?Coppens E, Van Wambeke P, Morlion B, et al.Prevalence and impact of childhood adversities and post-traumatic stress disorder in women with fibromyalgia and chronic widespread pain.Eur J Pain. 2017;21(9):1582-1590. doi:10.1002/ejp.1059Creaky Joints.What Is Polymyalgia Rheumatica? These Are the Signs You Could Have It.Theoharides TC, Tsilioni I, Arbetman L, et al.Fibromyalgia syndrome in need of effective treatments.J Pharmacol Exp Ther. 2015;355(2):255–263. doi:10.1124/jpet.115.227298Hsu TYT, D’Silva KM, Patel NJ, Fu X, Wallace ZS, Sparks JA.Incident systemic rheumatic disease following COVID-19.The Lancet Rheumatology. 2021;3(6):e402-e404. doi:10.1016/S2665-9913(21)00106-5American Academy of Family Physicians.Giant Cell Arteritis and Polymyalgia Rheumatica.National Organization for Rare Disorders.Polymyalgia Rheumatica.Additional ReadingCaro XJ, Winter EF, Dumas AJ.A subset of fibromyalgia patients have findings suggestive of chronic inflammatory demyelinating polyneuropathy and appear to respond to IVIg.Rheumatology (Oxford).2008;47(2):208-211. doi:10.1093/rheumatology/kem345Caro XJ, Winter EF.Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications.Arthritis Rheumatol.2014;66(7):1945-1954. doi:10.1002/art.38662Docken WP.Polymyalgia Rheumatica. American College of Rheumatology.Liptan, GL.Fascia: A missing link in our understanding of the pathology of fibromyalgia.Journal Bodyw Mov Ther. 2010;14(1):3-12. doi:10.1016/j.jbmt.2009.08.003
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Guggino G, Ferrante A, Macaluso F, Triolo G, Ciccia F.Pathogenesis of polymyalgia rheumatica.Reumatismo. 2018;70(1):10-17. doi:10.4081/reumatismo.2018.1048Leeb BF, Bird HA, Nesher G,et al.EULAR response criteria for polymyalgia rheumatica: results of an initiative of the European Collaborating Polymyalgia Rheumatica Group (subcommittee of ESCISIT).Annals of the Rheumatic Diseases.2003;62:1189-1194. doi:10.1136/ard.2002.002618Haliloglu S, Carlioglu A, Akdeniz D, et al.Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.Rheumatol Int. 2014;34:1275. doi:10.1007/s00296-014-2972-8Acharya S, Musa R.Polymyalgia rheumatica. In: StatPearls [Internet]. Treasure Island (FL): StatPearls.Arthritis Foundation.What is the Difference Between Fibromyalgia and Polymyalgia?Coppens E, Van Wambeke P, Morlion B, et al.Prevalence and impact of childhood adversities and post-traumatic stress disorder in women with fibromyalgia and chronic widespread pain.Eur J Pain. 2017;21(9):1582-1590. doi:10.1002/ejp.1059Creaky Joints.What Is Polymyalgia Rheumatica? These Are the Signs You Could Have It.Theoharides TC, Tsilioni I, Arbetman L, et al.Fibromyalgia syndrome in need of effective treatments.J Pharmacol Exp Ther. 2015;355(2):255–263. doi:10.1124/jpet.115.227298Hsu TYT, D’Silva KM, Patel NJ, Fu X, Wallace ZS, Sparks JA.Incident systemic rheumatic disease following COVID-19.The Lancet Rheumatology. 2021;3(6):e402-e404. doi:10.1016/S2665-9913(21)00106-5American Academy of Family Physicians.Giant Cell Arteritis and Polymyalgia Rheumatica.National Organization for Rare Disorders.Polymyalgia Rheumatica.Additional ReadingCaro XJ, Winter EF, Dumas AJ.A subset of fibromyalgia patients have findings suggestive of chronic inflammatory demyelinating polyneuropathy and appear to respond to IVIg.Rheumatology (Oxford).2008;47(2):208-211. doi:10.1093/rheumatology/kem345Caro XJ, Winter EF.Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications.Arthritis Rheumatol.2014;66(7):1945-1954. doi:10.1002/art.38662Docken WP.Polymyalgia Rheumatica. American College of Rheumatology.Liptan, GL.Fascia: A missing link in our understanding of the pathology of fibromyalgia.Journal Bodyw Mov Ther. 2010;14(1):3-12. doi:10.1016/j.jbmt.2009.08.003
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Guggino G, Ferrante A, Macaluso F, Triolo G, Ciccia F.Pathogenesis of polymyalgia rheumatica.Reumatismo. 2018;70(1):10-17. doi:10.4081/reumatismo.2018.1048Leeb BF, Bird HA, Nesher G,et al.EULAR response criteria for polymyalgia rheumatica: results of an initiative of the European Collaborating Polymyalgia Rheumatica Group (subcommittee of ESCISIT).Annals of the Rheumatic Diseases.2003;62:1189-1194. doi:10.1136/ard.2002.002618Haliloglu S, Carlioglu A, Akdeniz D, et al.Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.Rheumatol Int. 2014;34:1275. doi:10.1007/s00296-014-2972-8Acharya S, Musa R.Polymyalgia rheumatica. In: StatPearls [Internet]. Treasure Island (FL): StatPearls.Arthritis Foundation.What is the Difference Between Fibromyalgia and Polymyalgia?Coppens E, Van Wambeke P, Morlion B, et al.Prevalence and impact of childhood adversities and post-traumatic stress disorder in women with fibromyalgia and chronic widespread pain.Eur J Pain. 2017;21(9):1582-1590. doi:10.1002/ejp.1059Creaky Joints.What Is Polymyalgia Rheumatica? These Are the Signs You Could Have It.Theoharides TC, Tsilioni I, Arbetman L, et al.Fibromyalgia syndrome in need of effective treatments.J Pharmacol Exp Ther. 2015;355(2):255–263. doi:10.1124/jpet.115.227298Hsu TYT, D’Silva KM, Patel NJ, Fu X, Wallace ZS, Sparks JA.Incident systemic rheumatic disease following COVID-19.The Lancet Rheumatology. 2021;3(6):e402-e404. doi:10.1016/S2665-9913(21)00106-5American Academy of Family Physicians.Giant Cell Arteritis and Polymyalgia Rheumatica.National Organization for Rare Disorders.Polymyalgia Rheumatica.
Guggino G, Ferrante A, Macaluso F, Triolo G, Ciccia F.Pathogenesis of polymyalgia rheumatica.Reumatismo. 2018;70(1):10-17. doi:10.4081/reumatismo.2018.1048
Leeb BF, Bird HA, Nesher G,et al.EULAR response criteria for polymyalgia rheumatica: results of an initiative of the European Collaborating Polymyalgia Rheumatica Group (subcommittee of ESCISIT).Annals of the Rheumatic Diseases.2003;62:1189-1194. doi:10.1136/ard.2002.002618
Haliloglu S, Carlioglu A, Akdeniz D, et al.Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.Rheumatol Int. 2014;34:1275. doi:10.1007/s00296-014-2972-8
Acharya S, Musa R.Polymyalgia rheumatica. In: StatPearls [Internet]. Treasure Island (FL): StatPearls.
Arthritis Foundation.What is the Difference Between Fibromyalgia and Polymyalgia?
Coppens E, Van Wambeke P, Morlion B, et al.Prevalence and impact of childhood adversities and post-traumatic stress disorder in women with fibromyalgia and chronic widespread pain.Eur J Pain. 2017;21(9):1582-1590. doi:10.1002/ejp.1059
Creaky Joints.What Is Polymyalgia Rheumatica? These Are the Signs You Could Have It.
Theoharides TC, Tsilioni I, Arbetman L, et al.Fibromyalgia syndrome in need of effective treatments.J Pharmacol Exp Ther. 2015;355(2):255–263. doi:10.1124/jpet.115.227298
Hsu TYT, D’Silva KM, Patel NJ, Fu X, Wallace ZS, Sparks JA.Incident systemic rheumatic disease following COVID-19.The Lancet Rheumatology. 2021;3(6):e402-e404. doi:10.1016/S2665-9913(21)00106-5
American Academy of Family Physicians.Giant Cell Arteritis and Polymyalgia Rheumatica.
National Organization for Rare Disorders.Polymyalgia Rheumatica.
Caro XJ, Winter EF, Dumas AJ.A subset of fibromyalgia patients have findings suggestive of chronic inflammatory demyelinating polyneuropathy and appear to respond to IVIg.Rheumatology (Oxford).2008;47(2):208-211. doi:10.1093/rheumatology/kem345Caro XJ, Winter EF.Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications.Arthritis Rheumatol.2014;66(7):1945-1954. doi:10.1002/art.38662Docken WP.Polymyalgia Rheumatica. American College of Rheumatology.Liptan, GL.Fascia: A missing link in our understanding of the pathology of fibromyalgia.Journal Bodyw Mov Ther. 2010;14(1):3-12. doi:10.1016/j.jbmt.2009.08.003
Caro XJ, Winter EF, Dumas AJ.A subset of fibromyalgia patients have findings suggestive of chronic inflammatory demyelinating polyneuropathy and appear to respond to IVIg.Rheumatology (Oxford).2008;47(2):208-211. doi:10.1093/rheumatology/kem345
Caro XJ, Winter EF.Evidence of abnormal epidermal nerve fiber density in fibromyalgia: clinical and immunologic implications.Arthritis Rheumatol.2014;66(7):1945-1954. doi:10.1002/art.38662
Docken WP.Polymyalgia Rheumatica. American College of Rheumatology.
Liptan, GL.Fascia: A missing link in our understanding of the pathology of fibromyalgia.Journal Bodyw Mov Ther. 2010;14(1):3-12. doi:10.1016/j.jbmt.2009.08.003
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