According to the Arthritis Foundation, more than 3.7 million people in the United States suffer from this condition. It is more common in women. Research has shown a clear link between fibromyalgia and arthritis, especially rheumatoid arthritis. The incidence of fibromyalgia ranges from 15 to 17% in patients with rheumatoid arthritis. People with rheumatoid arthritis have a 30 to 80% greater risk of developing this condition. Thus, it is considered to be an arthritis-related condition.
Fibromyalgia is also observed with other forms of chronic inflammatory arthritis: Psoriatic arthritis and Spondyloarthritis. Inflammatory arthritis is controversially termed as secondary fibromyalgia. This is attributed to the underlying inflammatory process. It is more commonly seen in patients with psoriatic arthritis, a pilot study reveals. Larger studies are, however, required. It has recently been estimated that about one-fifth of people with osteoarthritis also suffer from fibromyalgia. The probable link between the two is poor posture and obesity.
Let’s understand the connection between fibromyalgia and arthritis in detail, and treatment options for those with both these conditions.
Fibromyalgia And Arthritis: What If Somebody Has Both?
The risk of fibromyalgia increases with inflammatory forms of arthritis. This is mostly due to chronic pain itself, which sensitizes the brain not only to things that hurt but also to things that normally aren’t painful. They have pain receptors firing all the time. In fighting the pain, fatigue sets in. People, thus have sleep and cognitive problems.
Patients with both conditions tend to have more severe symptoms, including
- Greater pain
- Joint tenderness
- Decreased physical motion
- Decreased mental function
Overall, they have a lower quality of life. They are in poorer health, and they suffer from a number of conditions such as diabetes, hypertension, and depression. They are also more likely to be disabled and unable to work.
Treatment Options For Fibromyalgia And Arthritis
A common misconception is that there are no effective therapies for fibromyalgia. It requires both pharmacological and non-pharmacological therapies. Pharmacological therapy targets pain. Non-pharmacological therapies aim at the functional consequences of pain. Research shows that regular activity is one of the most effective treatments for pain syndromes. People must start slowly at first, increasing activity gradually once they start feeling better.
Several studies published in the Journal of Pain Research suggest that yoga may help ease symptoms. Women with the disease improved from a 75-minute yoga class twice a week for eight weeks.
Deep, restorative sleep is also essential for reducing chronic pain. For many people with the disease, it’s difficult to maintain sleep. Pain interferes with normal sleep, and a lack of sleep makes pain worse. Conversely, a good night’s rest can significantly improve symptoms.
Certain techniques to improve symptoms of these two conditions include:
- Deep breathing exercises
- Cognitive behavioral therapy
These techniques modify the way your brain functions. They are helpful in improving symptoms, especially pain and fatigue while promoting deep rest and relaxation.
Acupuncture may help in reducing pain and stiffness. This was published in the Cochrane Database of Systematic Reviews. Promising results were also seen with Tai chi over 24 weeks; a study in the New England Journal of Medicine reported this.
Non-pharmacological measures are more important in managing the disease. The three drugs approved to treat the disease — Pregabalin Duloxetine, Milnacipran— are only moderately effective. Majority of clinical trials have involved antidepressants of one class or another. Their effect on serotonin and nor-epinephrine are thought to be responsible for the antidepressant activity of these compounds. These activities also appear to be an important mechanism for pain relief.
Non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are commonly used by a number of fibromyalgia patients. However, a number of studies have failed to confirm their effectiveness in fibromyalgia. There is limited evidence that patients may experience more relief when treated with combinations.
Pregabalin— a drug used in epilepsy showed good effect in improving pain, sleep disturbances, and fatigue in fibromyalgia patients.
Sedative-hypnotics are also used by some patients. Few studies are published on the use of hypnotics, such as zopiclone and zolpidem. These agents can improve sleep and fatigue of these patients, though their effects on pain were not significant.
Finally, a few classes of agents that are not widely used clinically but have shown promise in controlled trials are:
- 5-HT3 antagonists
- NMDA antagonists
- Growth hormones
Natural Supplements For Treating Fibromyalgia And Arthritis
Some studies show that some medicinal herbs and natural supplements may help in treat most symptoms of fibromyalgia and arthritis. If you want to take a natural approach to treating the disease, it is important to learn as much as you can about the therapies you consider.
It’s a natural amino acid. 5-HT helps your body in the production of serotonin, the chemical regulating your mood. Studies suggest its role in relieving pain, morning stiffness and fatigue. More research is needed though.
Melatonin is a natural hormone available as an over-the-counter supplement. It is sometimes used to induce drowsiness and improve sleep patterns. Some studies state that melatonin may be effective in treating pain. Most patients of both these conditions have sleep problems and fatigue, and melatonin may be helpful.
Melatonin is generally as regarded safe, but it has a few side effects. For example, due to the risk of daytime sleepiness, anyone taking melatonin should use caution when driving.
St. John’s Wort
There is no specific evidence that St. John’s wort is helpful in treating these conditions. However, this herb is often used in treating depression. Depression is commonly associated with fibromyalgia. This may be a long-term treatment goal. St John’s wort is usually safe. The most common side effects are stomach upset, skin reactions, and fatigue. St. John’s wort should not be mixed with antidepressants or any other supplement unless your doctor approves. The combinations can cause illness.
There are limited studies on L-carnitine. It is thought to provide some relief from fatigue. Some researchers have also concluded that L-carnitine may provide support for the muscular system. More studies are needed.
If standard drugs aren’t giving you the relief you need, talk to your doctor about complementary therapies. Massage therapy, yoga, meditation, or other options may help you feel better. Your doctor can help you understand the potential benefits and risks of adding them to your treatment plan.