Do I Have MS Or Fibromyalgia?

Do I Have MS Or Fibromyalgia?

Although, MS and fibromyalgia are both debilitating conditions and their symptoms overlap to a great extent and it is hard to differentiate between the two conditions simply based on symptomatology. They are in fact, two very distinct diseases. Although, etiology of both the diseases is idiopathic, MS is an autoimmune disease whereas fibromyalgia is thought to be an exaggerated pain response of nerves. Where multiple sclerosis is accompanied by progressive damage to nerve sheath fibers that can be noted in MRI, fibromyalgia is not accompanied by any such damage to nerves of muscles, or joints. It is accompanied by tender points on examination.

Relatively it is easy to diagnose multiple sclerosis as the damaged nerve sheaths can be noted in MRI; however, fibromyalgia is hard to diagnose because no damage is noted in scans or images. Therefore, to diagnose fibromyalgia, one must first rule out every other differential diagnosis by performing all the tests. When every other disease is excluded and no known cause is diagnosed, then the diagnosis of fibromyalgia is confirmed.

Although, both the conditions are not fatal, they reduce the quality of life to minimum and have lifelong impact leading to distressing life. Both the diseases have no particular treatment or cure; they can only be managed by multidisciplinary approach. The management approach is to minimize pain symptoms and improve quality of life.

Do I Have MS Or Fibromyalgia?

This can be done with pain medications, stress management, alternative therapy (such as acupuncture, massage, and yoga), and sleep hygiene. MS may require further CBT, and speech therapy.

What Is MS?

MS is the acronym for multiple sclerosis. This condition typically affects the central nervous system, involving the brain, optic nerves and spinal cord. It is chronic disease that progresses with time and ranges from mild to severe. It is considered as an autoimmune disorder in which the auto-antibodies attack the myelin sheath of nerve fibers.

Myelin sheath is the protective covering of the nerves and when this is affected, the nerves, responsible for conduction of stimulus (motor or sensory), stimulus conduction becomes abnormal. These exposed nerves (devoid of myelin sheath) become less capable of conducting stimulus and with time, they altogether stop conducting impulses. This leads to loss of neurologic function in the long run.

What Is Fibromyalgia?

Fibromyalgia as the name dictates is a pain syndrome that is chronic and causes widespread tenderness in the body. It is pain of the muscles, tendons and ligaments; however, in real life the symptoms are not limited to just pain. It is a progressive debilitating disease that, not only affects a person physically, but mentally, emotionally as well as socially too. The pain of fibromyalgia can be termed as centralized pain, meaning pain originating in the central nervous system or amplification of pain. Generally, pain is a universal phenomenon that there is damage, inflammation or insult to a part of body and the insult cannot be tolerated by the body. However, people suffering from fibromyalgia not only feel pain normally felt by a person, the pain felt by them can be heightened by the sensitivity of their nerves and may feel more pain than a normal person in that particular situation would. They are more sensitive to the pain stimuli and response to pain medications, such as opioids would only be limited.

Symptoms Of MS

As the MS affects nerve sheath, which are spread all over the body, the symptoms are widespread. They include muscle fatigue, pain, weakness, tingling, numbness, muscle spasms and tremors, visual disturbances, cognitive impairment along with difficulty with coordination, gait, balance, speech, swallowing problem, memory problems, bladder and bowel problems, dizziness, vertigo, sexual dysfunction, seizures, respiratory and breathing problems, depression, anxiety and headache.

Symptoms Of Fibromyalgia

As there is increased pain sensitivity, the symptoms of fibromyalgia are also widespread. These include fatigue, muscle weakness, numbness, tingling, pain, irritable bowel syndrome, memory issues known as fibro fog, depression, mood swings, sleep disturbance, skin sensitivities and rashes.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026145/

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