Question
Diagnosed 3 yrs ago with mild RA and last yr with Fibromyalgia. I’ve been on Methotrexate only for 6 months with great results, but I now get attacks up to once a week on a random limb joint. It starts to ache until the soreness prevents use and after 2 days disappears without a trace. Only when I’ve had several attacks on one joint does the ache start to dwell there, eg my wrists now need braces regularly and that was where I got my first attacks. The pain seems to be more muscular without any accompanying joint swelling hence the Fibro diagnosis. My question is why do I find that any antiinflammatory type brings a huge improvement within a couple of hours since many people say there is no inflammation associated with Fibro? Second question, I believe joint deformation tends to occur in the early years of diagnosis and that RA disease can sometimes ‘burn out’ after some 10yrs. Does this mean my symptoms have to worsen considerably before I can start counting this time?
Answer
The diagnosis of fibromyalgia (FM) is considered when patients complain of diffuse muscle and soft tissue pain with tender points. Pure or primary FM (not assoicated with any other inflammatory disease) is non-inflammatory beasue of it poor response to anti-inflammatories and the lack of inflamamtory findings on blood work and exam. However patients with inflammatory diseases such as RA can have diffuse musuloskeletal pain that feels like FM but responds to anti-inflammatories and thus likely casued by inflammation.
When or if RA “burns out” is highly variable. Some investigators do not believe it ever “burns out”.
