What are the differences between fibromyalgia and PMR ?
Thanks....
Not a medical professional but my understand is that Fibro is
nerve related and Poly is muscle related. That's the simple
explanation maybe someone can give you more info....
The fundamental difference is the reason for the pain.
Fibromyalgia is now thought to be a neurological problem in the processing of pain signals by the brain:
"Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain's pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals."
There is now evidence that there are "real" reasons for the pain in fibro - it has been put down to all sorts of things in the past, not least hysteria, but it now seems to be a mechanical problem in some ways.
PMR is almost certainly an autoimmune condition: something (or a series of somethings) upsets the immune system so that it no longer recognises your body as self and it turns on your own tissues and attacks them in the same way as it would an invading viral or bacterial infection. This damages the tissues and results in inflammation which, in turn, leads to swelling and pain. There are a whole load of autoimmune disorders, damaging various tissues and leading to varying symptoms and different names depending on what happens.
Since they don't know the mechanism that causes the symptoms in either case it makes it difficult to treat - all they can really do is find ways to manage the symptoms. In PMR pred reduces the inflammation and manages most of the symptoms until the underlying autoimmune disorder burns out and goes into remission. There are a few drugs that are claimed to help in fibromyalgia.
The similarity is in the symptoms - both cause muscle pain, fatigue and stiffness. Fibromyalgia is said to have pain in 18 specified trigger points and if you have pain in 11 (or something like that) it is fibro - but PMR can cause pain in some of those trigger points too.
The difference is in the response to a moderate dose of pred. In PMR a dose of 15-20mg of pred should achieve a 70% global improvement in symptoms within a few days. Pred rarely improves symptoms due to fibro.
And the real pain? It is possible to have both.
As Eileen says, it is a real pain to have both - and I do. But to me the pain of the conditions is very different.
PMR is a deeper muscle pain while the Fibro is a touch sensitive pain - as if all the nerve endings in the skin are screaming at something which just brushes them or touches them and a heavier touch can be enough for me to shout/scream/yell.
Both pain conditions can be 'managed' and I am currently using this forum as a distraction technique. If I stop and think about it, I realise that I hurt all over - so I do something else as a distraction; it mostly works!
If you palpate certain areas of the body ie upper back, shoulders, hips it will be tender/ painful but wth PMR palpation does not cause tenderness or pain .... yes?
another question... every so often my left eye becomes bloodshot... thoughts?
I have very tender muscles, especially the shoulders (trapesius) - and I don't have fibro. You can also have very tender muscles due to myofascial pain syndrome - and it frequently appears with PMR. It is due to the same cytokines except they are concentrated in trigger points not systemically.
Bloodshot eyes - people develop them when on pred. I never have. OTOH - my husband has them every so often - and he's NOT on pred.
I'm sure I don't have fibro - but I get tender skin. The same sort of feeling you get with flu - brush your fingers (or anything) over your skin and it shrieks. Not necessarily all over, just areas of it...
Yes, you are right again on all accounts Eileen!. I have had ME/Fibro since 1989, but 3 years ago, I knew there was a difference in pain stiffness etc....my doctor recognised it also. I can only say that fibro pain is more nerve /burning pain, and the PMR well, we all know what that is like....the both together...no words can I print here!! My Rheumy said the difference was, one comes from the brain, the other from the spine? ........don`t care where it comes from, pain is pain. Needless to say, I was overjoyed at first to actually be able to be treated!.....now struggling ( with strict Rheumy) to come down on Pred.....I always say to people, pain can mostly be eased with meds, but fatigue...it`s bonecrushing...nothing for it....
At 47 I suffered from RSI (writers cramp in hands) and had to take time off work. Six months later my whole health deteriorated and I was diagnosed with Fibromyalgia. I have suffered the pain of both RSI and Fibromyalgia for 18 years.Two months ago life changed dramatically for me in the middle of the night and I have now been diagnosed with Polymyalgia. If I have been diagnosed correctly then I would say that both myalgias started in a similar manner. With Fibro, any muscles I used would not relax and had to be massaged and treated. I had sweats, felt nauseous, lethargy, brain fog, chronic bowel problems, never ending sinus, and all fibro points were tender. This did not really change much in 18 years. It mainly affected my upper body in the beginning, but spread throughout my lower body over the years. I always felt pain when anything touched me. I thought Poly had virtually hit me over night, but in hindsight I had been deteriorating over a few months. My first obvious sign that something was different, was waking in the middle of the night and feeling excruciating pain in my neck/upper shoulders, and in my legs between my hips and knees. Pain was much more excruciating and sharp than Fibro and in just two bands of my body. In previous weeks I had more brain fog etc, sweats, blurry eyes, lethargy, and a frontal headache which I had never suffered from before. I thought I had over done it and I was suffering from a Fibro meltdown, but possibly it was the onset of Poly. Blood tests indicated it was Poly, and I improved incredibly within 24 hrs of taking Prednisone. They started similarly, but I have experienced different kinds of pain. Since taking Predisone, my Fibro points have settled down, and for the 1st time in 18 years I have no RSI pain in my hands. I also do not hurt when someone touches me.(Fibro). Massage, stretches, excercises always helped Fibro stiffness. Nothing helped my Poly stiffness except Prenisone. I think there is still a lot of research to be done to understand both of these problems.
I agree with everything you have written here...I don`t know what dosage of pred you are on, but I started on 15mg 3 years ago, and for the first time in many years, i had energy!! I could walk with my family and go out, when and wherever I wanted....for a while....and I realised what I had been missing all those years....I think you can get so used to a restircted lifestyle, which is sad, but with out choice. I now have the fibro pain, and nerve tenderness, fatigue, foggy head....and so on....and some dull pain in my shoulders/cramp sometimes in feet/hands...but I am lowering pred every 6 weeks only by, .5mg.....be careful, as I have had terrible relapses, and very blurred vision, which has kept me housebound!....Research I think is a long way off, my doctor told me years ago.....you don`t die from it, so they won`t put money into it....and nothing has changed I`m afraid!!..good luck and try to keep well....we have a double battle on our hands!!...
That's interesting - for most of the 5 years before pred I had what was assumed to be RSI in both hands, right was noticeably worse than left but of course when you are typing it is different than when writing. I gave up trying to write any more than a few words, it simply caused too much pain. The pain went from the outside of my elbow diagonally to the inside of my wrist and I had sharp pains in my fingers when I tried to bend them that came and went.
And yes Linda - when my PMR got so much worse 6 years ago I was stopped from driving for another reason (a consultant who didn't listen to me about a historical event that had been clarified) and for nearly 6 months I had no licence because the NHS made something of a mess of an EEG and reporting it as totally normal, taking months not weeks. That was when I realised just how much I had adapted my lifestyle because of the unrecognised and untreated PMR: if I could drive there I could go, if I couldn't I didn't. We moved house at the same time - and I got a kitchen that wasn't PMR-friendly. It was sheer unadulterated hell.
If I hadn't been left for nearly 6 years without any treatment would I have recovered faster? Would I be able to get off pred now?
Research isn't as far off as you think - there are very active groups in several countries and I am involved with one in the UK. A paper was publlished just a few months ago by another UK group comprising interviews with patients about how PMR affected their day to day life - and it has been an absolute revelation to the doctors who did the work. They are beginning to take us seriously - and things will get better as more younger people are diagnosed as having PMR not some other vague problem and as the retirement age rises. Until relatively recently it was perceived as only in ladies over 60 so we were retired and of no financial interest. It will be a different matter when our children have to work to 70.
It`s heartening to know that we are being taken "seriously" by those that matter in research, hope on the horizon
....but how worrying that our grandchildren will be working till 70....why would anyone pay into a pension.....I had for nearly 40 years (ill health forced me to finish at 55) and I loved my job (RSi through typing suspected as well at first)...and will not get the amount next April that others will, who have`nt done the same.......shocking. If I had the energy, I would march on parliament which I think some going to do next year!! oooooh, once I get started......
Is that your state or your company pension? I had to wait over 2 years for my state pension because of the sliding change to 65 for women - but was pleasantly surprised at the amount i got above the "base rate" because of SERPS I didn't know I'd paid! I spent most of my working life moving around or freelance so no comfy company pension of any size for me. Get enough of my piddly private one to say there is some though.
It is only state pension that will be at 70 or whatever - company/service pension will be available earlier and it is up to them to think about in advance as we did. OH is still totally ignorant of how much he will get - the entire thing for the new pension rules is in such a mess they can't provide forecasts at the moment. He took early retirement on the grounds he'd done well above the 30 years in the UK you needed for full state pension and then they moved the goalposts! More by luck than judgement he does JUST have the 35 years under the new rules - but no add-on bits as he was in the NHS so he is almost certainly one of the people who will lose out through the changes. Nothing new there then! But he will get a smidgeon of Italian pension as well as a bit of German pension - but if you get any German pension at all you are not allowed to continue in employment and can only do what is called a "450 euro job". Fine if you get a full pension as they are very generous but not so fine if it is just a bit. Ah well - it's enough to take us for dinner 
Yes, I was pleasantly surprised what I got.and had to wait like you (I`m 63)..and so was himself....couldn`t understand why I got more than him!, but like you serps...contracted in or out, all beyond me.....have got small private pension.(.UEA) Well, if it`s german/Italian it`s all money in the end...good job it`s not greek! What does annoy me (easily done with this gov) is they say it`s a benefit, it`s a pension.... which we`ve paid in for!..and at least now I don`t have to pay for my Pred....
.
Quite - I wouldn't get owt if I hadn't paid in in the first place. Someone got iffy at me a couple of weeks ago because I said I would probably return to the UK if we ever got ill: "Oh, so you'd come back for MEDICAL CARE?" Well, not by choice because the medical care here is outstanding still. But if you need your offspring to do the needful (one's trained as a nurse and one a paramedic) it's the obvious thing to do isn't it? And I am still paying tax in the UK as well as here...
I started on 20mg a few weeks ago. In the second week I had 3 amazing surreal days of no pain or stiffness - Fibro, Poly or RSI
.After 18 years of pain I had to stifle my emotions - I thought I had died and gone to heaven. As soon as I was dropped to 15mg, fibro pains, Poly headache, sweats and all those you mention returned. I had no idea how bad I had been so you can get used to pain. My favourite part - my head cleared - I could focus. Two weeks later my hand pains have not returned, but now have spasms. What dose are you down to now after 3 years ? What do you do for Fibro pains ?
I was very surprised my initial dose of 20mg gave me relief from Fibro and RSI as well(for 3 days),as I was told it would not help. My Dr now says that the initial dose may have put me in a state of euphoria. Is that possible ? Or have I had inflammation for 18 years ?
I started on 15mg 3 years ago (standard) got down to 7mg, and struggled with symptoms returning.....stayed on that for a while and droppped to about 5mg, about November last year I got real bad blurred vision...I was sent to the emergency eye clinic to check for GCA....it wasn`t that....I was put up again to 15mg anyway....but I am struggling with some stiffness and fatigue....I have been splitting my dose...My Rheumy (not very pleasant) said "you must be down to 10mg when I next see you in August or I will give you medication to get you off pred" that is Methotrexate, which has recently hospitalised my sister after only 2 doses!! I will lie to the Rheumy if I have to in August, I`m doing it my slow way! I am on 12mg at the moment.......I can only tolerate 1 Paracetamol before bed for pain, can`t take anything really because of fibro....makes my vision worse, and balance...just like noise/light is intolerable.....have the burning ankle pain so far this morning...but will try to bear it.....yes, it becomes part of life...and many people over the years have asked me how I put up with it....but what is the choice!! How do you deal with both problems dare I ask?.....
He could be right about the euphoria bit but I think it is more likely that at least some of your "fibro" for the last 18 years has been due to PMR or something similar. I am quite sure that there are many younger PMR patients who are merely dismissed with "imagination", "depression" or "psychosomatic" diagnoses or "fibromyalgia". The RSI I would lay odds is part of the PMR - it was for me, it was tendonitis due to the PMR, that and synovitis are part of PMR. When I got to the end of the initial 6 week course of pred the return of the pain seemed worse than it had been before - I assume because of the contrast of 6 weeks of almost no pain.
I would also suspect that the return of the pains etc was partly due to the 5mg drop in dose - far too big a step for someone with PMR and it would induce steroid withdrawal pain and symptoms which are often almost identical to the problem for which you are taking the pred.