The symptoms of Lyme disease, rheumatoid arthritis, and fibromyalgia are similar in some ways, but the treatments are much different. Getting the right diagnosis can speed treatment tailored to the individual's needs.

See How to Get a Fibromyalgia Diagnosis

Lyme Disease

People who spend time in wooded areas are more likely to develop Lyme disease, which is spread by deer ticks and western blacklegged ticks. The disease is also called Lyme Borreliosis.

A tick can transmit more than one infection in a single bite, and symptoms of these other infections are not the same as those of Lyme disease.

See Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or an Infection?

The Centers for Disease Control estimates that about 300,000 people in the United States are diagnosed with Lyme disease every year, most often in the upper Midwest and the Northeast United States. 1 Lyme Disease: Frequently Asked Questions (FAQ). www.cdc.gov/lyme/faq/index.html.

The Centers for Disease Control recommends a two-test process to diagnose Lyme disease, but the tests' reliability depends on how long the individual has had the infection and other factors.

Antibiotics are usually effective when given soon after the infection starts. In some cases, however, the person is not aware of the bite, and treatment is delayed. If the diagnosis is delayed or if Lyme disease returns, it may share some symptoms with fibromyalgia.

See Characteristic Symptoms of Fibromyalgia

How it is similar to fibromyalgia: Fatigue, stiffness, arthritis pain, extreme headaches, sleep problems, and difficulty concentrating can develop late in Lyme disease. Symptoms may come and go, sometimes returning years later.

How it is different from fibromyalgia: Stiffness is typically confined to the neck in Lyme disease. Lyme disease often includes a distinctive, ring-shaped rash. Antibiotics effectively treat the Lyme disease infection for most people when administered soon enough; there is no medicine that eliminates fibromyalgia.

See Medications to Ease Fibromyalgia Symptoms

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Rheumatoid Arthritis

When a person has rheumatoid arthritis, the immune system attacks the body, causing inflammation and damage to the joints. In some cases, such as when the condition causes deformities in the fingers, the damage is obvious.

See Rheumatoid Arthritis (RA) Symptoms

Early diagnosis and treatment are important, since the inflammation causes increasing damage to the joints over time. The hands and wrists, as well as the balls of the feet and the knees, are usually affected first.

See Rheumatoid Arthritis (RA) Diagnosis

About 1.5 million American adults have rheumatoid arthritis. 2 Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum. 2010;62(6):1576-82. Symptoms usually appear when a person is between 40 and 60, and rheumatoid arthritis is more common in women.

See Risk Factors for Rheumatoid Arthritis (RA)

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How it is similar to fibromyalgia: Sleep difficulties, joint pain, anxiety, depression, lack of mental sharpness, and body stiffness are common. Periods when symptoms intensify, called flare-ups or flares, are typical.

See Rheumatoid Arthritis (RA) Treatment

How it is different from fibromyalgia: Rheumatoid arthritis is a progressive disease, meaning it gets worse over time. It damages the joints, causing swelling and sometimes deformities. (Joints are not swollen or damaged in fibromyalgia). Also, the pain of fibromyalgia is generally more widespread and longer lasting. Exercise must be approached carefully in fibromyalgia to avoid significant pain the following day, while exercise typically eases pain for people with rheumatoid arthritis. No single lab test or exam can confirm that a person has either condition, but blood tests may show biological markers for rheumatoid arthritis.

See Blood Tests to Help Diagnose Rheumatoid Arthritis (RA)

  • 1 Lyme Disease: Frequently Asked Questions (FAQ). www.cdc.gov/lyme/faq/index.html.
  • 2 Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum. 2010;62(6):1576-82.

Dr. Vijay Vad is a sports medicine specialist at the Hospital for Special Surgery in New York, where he specializes in back pain, knee arthritis, frozen shoulder, and general sports medicine. He previously served as a physician for the professional men’s tennis circuit and on the Westchester Classic of the PGA Tour.

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