Autoimmune Conditions | Digestive Conditions | Pain-Related Conditions | Genetic Conditions | Other Conditions | Mental Health Conditions
What Other Conditions Could You Have With Fibromyalgia?
Fibromyalgia often occurs at the same time as other chronic illnesses, and it’s important to treat as many of these as possible.4 This will improve your overall health and reduce other conditions that aggravate fibromyalgia symptoms. Common comorbid conditions include autoimmune disorders, other pain-related conditions, Lyme disease, irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis, genetic conditions like Ehlers-Danlos syndrome, mental health conditions and more.
Before doctors really started to understand fibromyalgia, they thought it was an autoimmune condition, which are caused when your immune system gets confused and attacks healthy cells in your body. Instead of producing antibodies to protect your system, your immune system creates autoantibodies that attack healthy tissues and cause problems.22
After more research, doctors found fibro isn’t caused by a wonky immune system, even though your immune system is involved in some capacity. However, many people do have an overlapping autoimmune condition in addition to fibromyalgia, including lupus and rheumatoid arthritis. Sometimes the symptoms can look similar.
Lupus is an autoimmune condition that can impact any part of your body, including your skin, joints or organs.22 The condition can “imitate” other chronic illnesses because many of the symptoms overlap — fatigue, joint pain and swelling, sensitivity to light, rashes on your face, and your fingers turning white or blue when they’re cold. Like fibromyalgia, there isn’t a single test that can diagnose lupus, so your doctor will likely rely on your medical history, a series of blood tests to see what your immune system might be up to and other medical tests.
Considered the most common autoimmune arthritis condition, rheumatoid arthritis (RA) leads to pain and swelling in the small joints in your wrists, hands and feet.5 Usually the stiffness in your joints will be most apparent in the morning. You might also have other symptoms like a low-grade fever, lack of energy or loss of appetite. RA is typically diagnosed using a combination of blood tests, X-rays and ultrasound images along with a physical exam and medical history.
Sjögren’s syndrome is an autoimmune condition that you’re likely to have along with another autoimmune condition like rheumatoid arthritis.18 It’s also common among people with fibromyalgia. The main symptoms of Sjögren’s include dry or burning eyes or a dry mouth because it most commonly affects your tear and saliva glands. When Sjögren’s syndrome occurs with another rheumatologic condition (like lupus, rheumatoid arthritis or fibromyalgia) it’s referred to as “secondary” Sjögren’s syndrome.
Though one of the biggest fibromyalgia symptoms is pain, the condition can also affect your digestive system. Your autonomic nervous system — the part of your body responsible for regulating automatic bodily functions — controls your digestive system. When you’re in fight-or-flight mode, your sympathetic nervous system redirects energy partly by putting a pause on digestion.
Normally once your system gets out of danger mode, your parasympathetic nervous system would take over and digestion goes back to normal. However, this process gets interrupted often when you have fibromyalgia. As a result, you may experience a variety of digestive conditions sometimes referred to by doctors as “somatic dysfunction.”
GERD (Acid Reflux)
Gastroesophageal reflux disease (GERD or acid reflux) happens when acids or other contents in your stomach travel back out and up into your esophagus.9 This causes a burning feeling in your chest area. It’s the sensation of heartburn, but you may also experience asthma, nausea, a sore throat or vomiting, especially when it’s chronic. It can often be treated with over-the-counter medications or prescriptions from your doctor.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is about what you’d expect based on the name — disruptions in your digestive process that can cause an upset stomach, constipation and diarrhea.3 The exact cause of IBS isn’t well understood and typically a doctor makes a diagnosis based on a review of your medical history and symptoms. IBS changes the way the muscles in your colon contract and doesn’t lead to damage in your digestive tract, which is what distinguishes it from inflammatory bowel disease.23
Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes symptoms like digestive pain, bleeding, diarrhea, constipation and seemingly unrelated symptoms like fever, weight loss or fatigue21 Crohn’s occurs when your immune system mistakenly attacks safe bacteria in your gastrointestinal tract (GI tract) and causes damage.
With Crohn’s the area of your GI tract typically most affected is your ileum, the end of your small intestine. The beginning of your colon may also be involved, and additional damage can occur anywhere along your GI tract.21 The condition can flare and enter remission, but you may still experience symptoms even when you are technically in remission.
Like Crohn’s, ulcerative colitis is an inflammatory bowel disease (IBD) where your immune system attacks non-harmful cells and food in your digestive system. This leads to chronic inflammation that causes damage in your colon, specifically ulcerations in the lining of your colon.23 If you have ulcerative colitis, you might experience diarrhea, blood in your stool, crampy abdominal pain and low energy or fatigue. You may have periods with almost no sign of the condition and then have a flare when all the symptoms come back.
Fibromyalgia and pain are closely related, so you’re probably not surprised to learn other pain conditions can be both a symptom of fibromyalgia or a separate condition. This could include migraine, myofascial pain syndrome or temporomandibular joint dysfunction (TMJ), which are fairly common when you have fibro.
Migraine is technically defined as having at least five “unprovoked” headaches that last four to 72 hours each in your lifetime that are severe enough you can’t do your usual routine.15 The classic symptoms include nausea and sensitivity to light or sound. If you live with migraine, you likely know this definition is a little narrow.
Some people with chronic migraine will have many each month and mild or moderate migraines can sometimes last for days. It’s believed migraine is the result of extra sensitivity in the neurons in your nervous system.15 These neurons can be triggered by external changes like the temperature or internal changes like a hormone level drop, which then results in migraine.
You may also experience migraine with aura, which occurs for about 20 to 25 percent of those who have migraine, though not necessarily each time.15 Aura typically happens before a migraine attack and includes sensory disturbances like seeing sparks, dots or jagged lines to tingling on one side of the body or difficulty speaking clearly, which is called transient aphasia.19 It’s also possible to have only aura symptoms or a migraine without pain.15
Myofascial Pain Syndrome
Fibromyalgia and myofascial pain syndrome can appear to be very similar.14 It’s also possible to have both at the same time. However, the subtle difference between the two is tender points (fibromyalgia) and trigger points (myofascial pain syndrome), though you’ll hear both terms used interchangeably.
When you have fibro, you feel pain in tender areas on your body at tender points.14 With myofascial pain syndrome, you may feel pain in similar areas in your muscles, but those pain points are actually a trigger — pain at the trigger site also sets off pain at other points in your body because of bands along your muscle fibers. Myofascial pain syndrome also causes stiffness, muscle weakness and limited range of motion.
Temporomandibular Joint Dysfunction (TMJ)
Temporomandibular joint dysfunction (TMJ) is a general category of issues you may have with the joints that hinge your jaw, which are right in front of your ears.16 Some of the most common symptoms include facial pain, jaw pain or stiffness and earaches. TMJ can also cause ringing in your ears, also called tinnitus.17 Keep in mind tinnitus can be its own condition, typically associated with hearing loss, or a symptom of TMJ.
If you live with another genetic condition, like Ehlers-Danlos syndrome or a mitochondrial disease or disorder, you may also be diagnosed with fibromyalgia. Sometimes it can be tricky to tell these conditions apart because many of your symptoms could overlap. Often genetic conditions can be diagnosed with testing, unlike fibro, which does not have a definitive test yet.
Ehlers-Danlos Syndrome (EDS)
Ehlers-Danlos syndrome is a genetic condition that affects the connective tissue in your body. It impacts your collagen genes, a type of protein that makes up connective tissue, which is all over your body, including your skin, ligaments and even your bones.20 There are 13 different types of Ehlers-Danlos syndrome, but the most common type is hypermobile Ehlers-Danlos syndrome (hEDS). Hypermobile EDS causes you to have loose or flexible joints that dislocate easy and stretchy skin, along with other symptoms that can cause chronic pain like fibromyalgia.
Mitochondrial disease (or disorder) is a genetic condition that impacts the mitochondria in your cells — the part of your cells that generate energy. If you have this condition, you might experience feeling sensations similar to fibromyalgia like muscle pain, weakness, difficulty thinking and other cognitive difficulty, digestive issues and seizures. Mitochondrial disease is progressive and difficult to diagnose and treat.1
Those who live with fibromyalgia also report a variety of other chronic illnesses, such as chronic fatigue syndrome, Lyme disease or hypothyroidism that have many of the same pain symptoms as fibromyalgia. Some of them are also difficult to diagnose and it may take time for you and your doctor to accurately determine which conditions you are experiencing.
Hypothyroidism is one condition your doctor will want to rule out before making a fibromyalgia diagnosis because it can look so similar to fibro. When your thyroid is hypo-active, it isn’t producing enough hormones, which slows down your whole system.12 This leads to symptoms like fatigue, feeling colder than usual, being forgetful, feeling depressed and other symptoms. Hypothyroidism can be diagnosed with a regular blood test.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is almost like a cousin condition to fibromyalgia if you’re considering the symptoms. The main signs of ME/CFS include fatigue, difficulty getting good sleep, memory issues or brain fog, and chronic pain. While fatigue is the main symptom of ME/CFS, there isn’t a test for ME/CFS, so it can be difficult to distinguish from fibromyalgia and you may find out you have both conditions based on your symptoms.4
Lyme disease is caused when you’re bitten by a tick (often a deer tick) carrying the bacteria Borrelia burgdorferi.11 It’s a chronic illness that can cause joint, soft tissue and nerve pain, dizziness and short-term memory problems. While there are tests you can take to get a Lyme diagnosis, like the enzyme-linked immunosorbent assay (ELISA) or Western blot test, tick infections aren’t always caught right away. It’s common to have fibromyalgia as a secondary diagnosis to Lyme disease.
If you’ve ever noticed your fingers turn colors, like blue or white, when it’s cold or you’re stressed, it could be a sign of Raynaud’s syndrome or phenomenon.13 It occurs because the blood vessels in your fingers (and sometimes toes) are unusually sensitive. When they’re exposed to cold or stress, the most common triggers, the blood vessels narrow or spasm, which reduces blood flow to your fingers. You may also feel a tingling sensation along with color changes. As your fingers return to normal, they may also turn bright red as the blood flow suddenly returns.
Endometriosis is a condition that causes tissue similar to endometrium in the uterus to grow outside the uterus, typically on other pelvic organs or tissues.24 This can lead to significant chronic pain, especially when you have your period. You might also experience pain in your lower back, legs and shoulders, after sexual intercourse, or when urinating.6
Endometriosis in later stages (stage III or IV) or following surgery may cause painful adhesions, bands of scar tissue that may attach to your ovaries or the side of your pelvic wall, for example. Adhesions can cause a different type of pain, sometimes described as a “stabbing” or “sickening” pain. You may also experience diarrhea, constipation, bloating, irregular or heavy periods and fatigue as a result of the condition.6 Endometriosis can also lead to difficulty getting pregnant.
Currently, the best way to make an accurate endometriosis diagnosis is through laparoscopic surgery.24 Excision surgery of the invasive tissue is the most effective treatment, though surgery may not eliminate all of your symptoms and there is a risk of recurrence or adhesions.
Mental Health Conditions
Like many other chronic illnesses, it’s not uncommon you might have both fibromyalgia and a separate mental health condition. While you could have any mental health condition, such as post-traumatic stress disorder (PTSD) or bipolar disorder, an estimated 20 percent of people who live with fibro also have either an anxiety or depressive disorder, the most common among fibromyalgia patients.7
Anxiety can be both a symptom of fibromyalgia and a condition you might have along with fibro. Because fibromyalgia turns your fight-or-flight reaction in the nervous system into overdrive, there’s a lot of overlap between how fibro and anxiety might affect your nervous system so a connection between these two conditions might make sense.
There are a variety of anxiety-based conditions. You might have generalized anxiety disorder (GAD) if you find you worry a lot and can’t tune out the worry no matter what you do. Like fibromyalgia, GAD is twice as common if you’re female.10 Other common anxiety disorders include panic disorder, where you experience panic attacks without an apparent trigger, obsessive-compulsive disorder (OCD) or social anxiety disorder.
Depression symptoms, like a lack of interest in things you usually love, loss of energy, sleep issues and feelings of worthlessness or hopelessness, could be a sign of fibromyalgia or could indicate you also have major depressive disorder (generally just referred to as depression though there are other depressive diagnoses). You’re three times as likely to experience depression if you have fibromyalgia.8
Just like with anxiety, the reason you’re more at risk for having both fibromyalgia and depression could be connected to your nervous system and how fibro affects it.2 For example, having lower levels of serotonin or norepinephrine, mood-regulating neurotransmitters, have been linked with depression. The involvement of these same neurotransmitters has also been linked to fibromyalgia.
If you are struggling with your mental health, know you are not alone. If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or reach the Crisis Text Line by texting “START” to 741741.
About Mitochondrial Disease – Mito FAQ. (n.d.). http://www.mitoaction.org/mito-faq
Arnold, L. M. (2018, December 11). Antidepressants for fibromyalgia: Latest word on the link to depression and anxiety. Retrieved from https://www.mdedge.com/psychiatry/article/66131/depression/antidepressants-fibromyalgia-latest-word-link-depression-and
Chang, L. (n.d.). Irritable Bowel Syndrome (IBS). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome
Diagnosis of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC. (2018). Retrieved from https://www.cdc.gov/me-cfs/symptoms-diagnosis/diagnosis.html
Duarte-Garcia, MD Ali Duarte-Garcia, A. (2019, March). Rheumatoid Arthritis. Retrieved from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis
Endometriosis.org. (2011). Symptoms « Endometriosis.org. Retrieved from http://endometriosis.org/endometriosis/symptoms/
Fibromyalgia. (n.d.). Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia
Fibromyalgia | Arthritis | CDC. (2017, October 11). Retrieved from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
Gastroesophageal Reflux Disease (GERD). (n.d.). Retrieved from https://www.gastro.org/practice-guidance/gi-patient-center/topic/gastroesophageal-reflux-disease-gerd
Generalized Anxiety Disorder (GAD). (n.d.). Retrieved from https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
Hypothyroidism. (n.d.). Retrieved from https://www.thyroid.org/hypothyroidism/
Lyme Disease | Lyme Disease | CDC. (2018, December 21). Retrieved from https://www.cdc.gov/lyme/index.html
Mecoli, C. (2018, April). Raynaud’s Phenomenon. Retrieved from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Raynauds-Phenomenon
Myofascial Pain Syndrome. (n.d.). Retrieved from https://www.fmcpaware.org/m-n/myofascial-pain-syndrome
Rothrock, J. F. (n.d.). What is Migraine? Retrieved from https://americanmigrainefoundation.org/resource-library/what-is-migraine/
TMJ and Facial Pain | AAOMS. (n.d.). Retrieved from https://myoms.org/procedures/tmj
TMJ Treatments. (2016, December 14). Retrieved from https://www.ata.org/managing-your-tinnitus/treatment-options/tmj-treatments
Udell, J. (2017, March). Sjögren’s Syndrome. Retrieved from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Sjogrens-Syndrome
Understanding Migraine with Aura. (n.d.). Retrieved from https://americanmigrainefoundation.org/resource-library/understanding-migraine-aura/
What are the Ehlers-Danlos Syndromes? (n.d.). Retrieved from https://www.ehlers-danlos.com/what-is-eds/
What is Crohn’s Disease? (n.d.). Retrieved from https://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-crohns-disease/
What is lupus? (2013, July 31). Retrieved from https://www.lupus.org/resources/what-is-lupus
What is Ulcerative Colitis? (n.d.). Retrieved from https://www.crohnscolitisfoundation.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/
Zondervan, K. T., Becker, C. M., Koga, K., Missmer, S. A., Taylor, R. N., & Viganò, P. (2018). Endometriosis. Nature Reviews Disease Primers,4(9), 1-25. doi:10.1038/ s41572-018-0008-5