Fibromyalgia - Conditions with Similar Symptoms

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Click the icon to see an image of Hashimoto's thyroiditis.

• Systemic lupus erythematosus resembles fibromyalgia, although most patients with lupus also have a rash. Doctors can diagnose lupus with a blood test.

Click the icon to see an image of systemic lupus erythematosus.

• Multiple sclerosis (MS) has symptoms similar to those of fibromyalgia. There is no definitive test for diagnosing it. Magnetic resonance imaging (MRI) scans, however, detect patches of injured tissue in the brain. These lesions suggest MS.

Click the icon to see an image of multiple sclerosis.

• Sjogrens syndrome, a condition characterized by dry eyes and mouth, is sometimes mistaken for fibromyalgia.

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Autoimmune diseases generally develop slowly. Even if a doctor determines that a patient is most likely to have fibromyalgia, the doctor should keep track of any changes in symptoms over time in case one of these other illnesses is actually present.

Lyme Disease. Lyme disease is a bacterial disease transmitted by ticks. Health care providers can usually diagnose early Lyme disease correctly, but a delayed response or recurrence of this disorder may be mistaken for fibromyalgia. Some experts believe that between 15 - 50% of patients referred to clinics for Lyme disease actually have fibromyalgia. Late Lyme disease can usually (but not always) be ruled out using blood tests that identify the organism that causes this disease. If fibromyalgia patients are incorrectly diagnosed and treated for Lyme disease with prolonged courses of antibiotics, the drugs may have serious side effects.

Drugs and Alcohol. Fatigue is a side effect of many prescription and over-the-counter medications, such as antihistamines. In addition, dependency on or abuse of alcohol or illegal drugs may show as constant fatigue. Medications should be considered as a possible cause of fatigue if an individual has recently started, stopped, or changed medications. Withdrawal from caffeine can produce depression, fatigue, and headache.

Polymyalgia Rheumatica. Polymyalgia rheumatica is a condition that causes pain and stiffness, and generally occurs in older women. Tender points are also present with this disorder, although they almost always occur in the hip and shoulder area. Morning stiffness is common, and patients may also experience fever, weight loss, and fatigue. A higher than normal value of erythrocyte sedimentation rate (ESR) can suggest polymyalgia rheumatica. Elevated ESR, however, also occurs with other conditions. Polymyalgia rheumatica often resolves in about a year, but there is a risk of persistent disease. Worse, it is sometimes associated with a rare condition called temporal arteritis, which may cause blindness if not treated, so an accurate diagnosis of polymyalgia rheumatica is important.

Other Diseases That May Rule Out Fibromyalgia.

• Hepatitis -- Hepatitis C may prove to be a cause of some cases of fibromyalgia.
• Anemia
• Diabetes
• Infections -- For example, infectious mononucleosis is marked by fatigue and swollen glands. It primarily affects adolescents and young adults. Some patients may have lingering fatigue that lasts for many months.
• Cancer
• Neuromuscular diseases such as myasthenia gravis

Review Date: 12/15/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital