What is the difference between fibromyalgia and lupus?

These conditions are quite different. Fibromyalgia is a condition of unknown cause in which widespread body pain, fatigue and cognitive problems are the most common symptoms. Fibromyalgia is not considered an inflammatory condition and there is no evidence of autoimmunity; that is, fibromyalgia is not known to be due the immune system’s attack on the body. Physical examination is generally normal (except for areas of soreness called ‘tender points’) and blood tests are typically normal as well.

 

Systemic lupus erythematosus (or, just “lupus”), on the other hand, is an autoimmune disease in which there is inflammation throughout the body. Typical features include rashes, joint pain, chest pain and kidney disease, all due to inflammation. Physical examination may reveal a rash on the face and extremities, swollen joints, and an abnormal lung exam (due to inflammation around the lining of the lung). Blood tests may reveal low blood counts while urine testing often reveals red blood cells and protein due to kidney inflammation. Autoantibody testing may demonstrate an array of abnormal results including anti-nuclear antibodies (ANAs), antibodies to red blood cells, and autoantibodies associated with abnormal blood clotting (called anti-phospholipid antibodies). Of note, people with lupus (or any other autoimmune disease) may also have fibromyalgia.

Treatment also differs. For people with fibromyalgia, treatment is directed at reducing pain, improving sleep and increasing exercise. With lupus, anti-inflammatory and immune suppressing medications are most important.

Finally, in some cases lupus may be life-threatening. While fibromyalgia causes significant suffering, it does not lead to organ damage or premature death.