Fibromyalgia Community

A keen eye might be able to feel the difference, but I doubt it. I am so sorry you carry so many things.

FM gives neuropathy type pain when the nerves get entrapped in muscles that are dysfunctional. The crazy mixed up sense of pain for us changes all pain we perceive, so it is a mixed bag.

For me, when I have a new pain, I have to think alot about it, where is it, what did I do? What could it be from and treat it as such. I don't have miltiple issues though.

RA pain needs inflammatory help, FM needs warmth and pain management as well as movement and stretch. RA needs rest and helping the inflammatory process. So they really are different roads to fix each.

I would ask that rheumy you see...."How will I know?".
I would say RA would have swelling and warmth to the area and motion issues, a sharper pain then FM. (Remember I don't have this to feel your world, I am just looking at the physiology).

Delay in RA treatment will hurt the joints more, a delay in FM treatment does nothing but the pain remains....so I would treat the worst case senario first, no change then it is FM. See if the doc agrees?

Neuropathy therapy should just continue all the time, those meds are classic and protecting your feet and hands are very important. Maintaining a better blood sugar is also part of that avenue.

I again am sorry you have more on your plate to sift through.

I have just recently been quite ill, and the doc had a hard time that I had didn't feel it coming on**, well we live in a "flu" world, so I didn't feel it coming...it was my normal creepy self, until 102* sat me on my butt! A NEW PAIN in the bones arrived and the light went on that I was in trouble!

Listen to your body closely, you may in time be able to see and feel the changes for each issue. But being attentive and alert is the only way.

Good luck, Nancy B

Hello Nana B....I do hope you are feeling better today...

I know that I, too, have a hard time trying to figure out IF I am sick.....it is hard when we have the *normal everyday aches and pains anyway*....I knew this time since I have been really sick to my stomach....and I have had a lower left side back ache...I have been really sick today again...and am about to take my last pill...so I guess I will have to go back to the doctor on Tuesday....I hope they can figure this out...I think it might be kidney stones again along with the UTI...not fun at all.

Take care and good luck...I hope you will soon feel back to normal again...


MiMi

Those are some serious illnesses you have to deal with every day! Good question - how do we know the different types of pains to keep track of how well we are managing each illness we might have?

I'm no expert, but here's what I've learned so far about RA and FM pain: the rheumatologist will treat the RA and keep track of blood test and imaging results to determine if the medicines are working against the disease. Then, if successful, the leftover pain is due to FM, not RA.

In your case, there is also neuropathy pain. Triple whammy.

Have you tried heat/cold therapy? Also, it may help to apply products like rubs and patches on painful areas. Sometimes they work the best, when the pills just aren't cutting it. (Be careful with patches, having diabetes though.) I know a hot shower or bath helps me for a while. Also sitting in a soft place surrounded by various pillows and wraps is wonderful. It helps to keep pressure off the painful area. If I could afford it, I would buy myself a recliner!

Dear An_245587, So glad you have asked this question because it can be difficult when so many different sensations are vying for your attention! Your fellow pain experts have given some great advice and suggestions. It might help to consider the problem from multiple perspectives. Let's start from the underlying disease process.

As Booch007 has implied rheumatoid arthritis is an autoimmune disease where inflammation in the joint causes the classic symptoms of heat, swelling and pain. The disease modifying drugs can be used to halt the inflammation and anti-inflammatory agents are used for pain control.

Nerve damage pain typically of the feet and hands can be felt as prickly, tingling, burning sensations. Medications to control or reduce these sensations are available. When the nerve damage pain is associated with diabetes it is important to bring your blood sugars into good control because high blood sugars can increase the nerve damage.

Fibromyalgia is the development of total body pain not usually in the joints but associated with moving. It is a disease of pain processing pathways in the central nervous system. Movement is helpful and a regular routine with pacing of activities is beneficial. There are medications that may help with tuning down the volume of the pain messages being generated but pain management tools trump all.

(continue next response)

(Dr Margaret's reply continued)

When it seems that you cannot distinguish the different causes of your pain or judge which pain is most in need of addressing it can be very helpful to keep track using a pain diary. This can be done for various sites or a generalized score. Do it three times a day; the same time everyday. Make the distinction between your pain sensation (aching, sharp, burning) and pain distress (frustration, fear, anger, sadness) associated with the pain. After a week you will begin to get an idea of which site hurts most, what kind of pain and distress you are experiencing and what seems to make it better or worse. This information is critical to gain control over your pain and to understand how you might help yourself and how you might ask for help from your doctors and those around you.

Keeping a pain diary can also help when new treatments are started and when a new pain joins the ranks. It's a challenge, but it is possible to live a quality life in spite of the pains, but it may be different life than what you had in mind so being flexible is also an asset. Best wishes, Dr. Margaret

Thanks for the advice about the pain journal 3-4x a day! I am in the process with the doctor of figuring out if I have RA or Fibro. I am waiting for some bloodwork results now and will be seeing a Rheumatologist July 26th. I hope my journal and pain descriptions will help in a diagnosis.