I've been seeing the doctor lately to try to get a diagnosis finally for problems I've been having for over five years...everything from muscle tensing and spasming to shooting pain and sensitive skin.
I had a blood test today that will determine if it might be Lupus, and I have an MRI coming up soon that will determine if it might be MS. The doctor says that fibromyalgia is a 'rule-it-out' diagnosis, that if nothing else fits, it's fibro.
What are the differences between these three disorders in symptoms, effects on daily life (I already know that whatever I have it effects me a LOT, making it difficult for me to do anything on some days but take some Vicodin and lay in bed), and treatment plans...also, what are the long-term prognosises for these disorders? Do any of them have a cure, or a management plan that relieves all symptoms?
I am happy that I am finally getting all the testing done to get a diagnosis finally so we can begin treating the problems, but I am concerned...I have heard a lot about fibro (my sister-in-law has fibro, and my father had fibro), and a little about MS...neither seems good at all, and I don't think either have a cure or total management of symptoms? I don't know anything about Lupus, however.
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Hi – the three conditions are quite different in their underlying disease processes, but do produce some overlapping symptoms.
Multiple Sclerosis (MS) is an auto-immune disease of the central nervous system (CNS). In Multiple Sclerosis, inflammation of nervous tissue causes the loss of myelin, a fatty material which acts as a sort of protective insulation for the nerve fibers in the brain and spinal cord. There are 5 basic types of MS and some of the more common symptoms include: fatigue, heat sensitivity, pain, spasticity (muscle cramps and spasms), cognitive problems, depression, balance and coordination problems and bowel & bladder symptoms. Symptoms will vary depending on the course of the illness, and according to the type of MS the individual has.
Like MS, Lupus is also considered to be an autoimmune disease. For reasons that are not yet clear, in autoimmune diseases the immune system loses its ability to tell the difference between foreign substances (antigens) and its own cells and tissues. The immune system then makes antibodies directed against the "self." These antibodies, called "auto-antibodies," react with the "self" antigens to form immune complexes. The immune complexes build up in the tissues and can cause inflammation, injury to tissues, and pain. In contrast to some other autoimmune diseases, lupus can affect many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Although people with the disease may have many different symptoms, some of the most common ones include extreme fatigue, painful or swollen joints (arthritis), unexplained fever, skin rashes, and kidney problems. For some people, lupus is a mild disease affecting only a few organs. For others, it may cause serious and even life-threatening problems.
Fibromyalgia Syndrome (FMS; FM) is a common and chronic disorder characterized by widespread muscle pain, fatigue, and multiple tender points. Current thinking is that FMS probably begins with a genetic predisposition, and is triggered by exposure to a number of possible stressors – including physical injury or emotional trauma, childbirth, medical operations, viruses, bacteria such as mycoplasma, chronic allergies or chemical toxins. Pain is the most common Fibromyalgia symptom and is necessary for an official diagnosis. According to the American College of Rheumatology diagnostic guidelines, Fibromyalgia is characterized by widespread pain of three months duration or more and pain in 11 of 18 “tender points”. A tender point is a pressure point that, when pressed, feels sore. There are 18 defined tender, or pressure, points on various parts of the body, from the elbows down to the knees.
As your doctor has explained, there are lab tests for MS and Lupus, but not for FMS. But a tender point exam with a doctor who is knowledgeable about FMS, along with your medical history of fatigue and pain, could quickly determine if FMS is what you are experiencing.
Treatments for the 3 conditions are very different. The gold-standard treatments for MS are the 3 interferon meds, Copaxone and now a new med called Tysabri. Lupus has had fewer treatment innovations it seems – and Prednisone (a steroid), Plaquenil (an anti-malarial med), and some chemotherapy meds are the ones most commonly prescribed. FMS now has a couple of FDA approved meds – Cymbalta (Duloxetine), and antidepressant which helps with pain and fatigue, and Lyrica (Pregabalin), an anticonvulsant which helps with both symptoms too.
Good luck in the diagnostic process – this can be so frustrating!
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