Difference Between Fibromyalgia and Psoriatic Arthritis

Key Difference – Fibromyalgia vs Psoriatic Arthritis
 

Pain is a natural adaptation of the body to get our attention towards a site or an organ that is either injured or malfunctioning. But the task of interpreting pain is indeed a herculean task by every sense of the word. The two conditions that are going to be discussed in this article are also associated with pain. Fibromyalgia (also called the chronic widespread pain) is defined as pain for more than three months both above and below the waist Psoriatic arthritis is the form of arthritis that occurs as a complication of psoriasis. In fibromyalgia, there aren’t any identifiable inflammatory processes whereas in psoriatic arthritis there are several inflammatory reactions going on within the joints. This can be considered as the key difference between fibromyalgia and arthritis.

CONTENTS

1. Overview and Key Difference
2. What is Fibromyalgia 
3. What is Psoriatic Arthritis
4. Similarity Between Fibromyalgia and Psoriatic Arthritis
5. Side by Side Comparison – Fibromyalgia vs Psoriatic Arthritis in Tabular Form
6. Summary

What is Fibromyalgia?

Fibromyalgia (also called chronic widespread pain) is defined as pain for more than three months both above and below the waist.

Clinical Features

• The pain is widespread with unremitting aching discomfort.
• There can be sleep disturbances which give rise to irritability and lapses in concentration
• Other conditions such as irritable bowel syndrome, tension headache and dysmenorrhea can coexist

Treatment

• A supervised and graded aerobic exercise regimen over 3 months is effective
• If depression is diagnosed it should be aptly treated
• Cognitive behavioral therapy can help the person to cope better with this condition
• Analgesics like paracetamol and weak opioids are given to alleviate the pain
• Depression is treated with antidepressants such as fluoxetine
• Low dose amitryptiline can prevent sleep disturbances

What is Psoriatic Arthritis?

Arthritis is the inflammation of joints. Psoriatic arthritis is the form of arthritis that occurs as a complication of psoriasis. About 10% of the psoriatic patients are also suffering from psoriatic arthritis.

Clinical Features

There is a wide range of clinical patterns that can be observed in psoriatic arthritis.

• Mono or oligoarthritis
• Polyarthritis – this can be confused with reactive arthritis
• Ankylosing spondylitis – this pattern is characterized by uni or bi sacroiliitis and early cervical involvement.
• Distal interphalangeal arthritis is the commonest pattern of joint involvement in psoriatic arthritis. Adjacent nail dystrophy can also be seen.
• Arthritis mutilans – this affects about 5% of the patients resulting in periarticular osteolysis and bone shortening.

The erosive effect of psoriatic arthritis can be clearly observed through the radiographs. There is a central erosion giving rise to a “pencil in cup” appearance.

Treatment

• NSAIDS or analgesics can be used to alleviate the pain
• Local synovitis can be controlled by using intra-articular corticosteroids
• The bone damage can be prevented in mild Polyarticular cases by the use of sulfasalazine or methotrexate
• Anti TNF alpha agents have also been proven to be effective in controlling the disease progression.

What is the Similarity Between Fibromyalgia and Psoriatic Arthritis?

• Pain is the major complaint in both these diseases.

What is the Difference Between Fibromyalgia and Psoriatic Arthritis?

Summary – Fibromyalgia vs Psoriatic Arthritis

Fibromyalgia (also called chronic widespread pain) is defined as pain for more than three months both above and below the waist whereas psoriatic arthritis is the form of arthritis that occurs as a complication of psoriasis. Although psoriatic arthritis is characterized by ongoing inflammatory reactions taking place inside the joints, there are no such inflammatory processes in fibromyalgia. This is the major difference between fibromyalgia and psoriatic arthritis.

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References:

1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.

Image Courtesy:

1. “Fibromyalgia” By Hang Pham (CC BY-SA 4.0) via Commons Wikimedia
2. “Psoriatic arthritis fingers ar1934-1” By Fiona McQueen, Marissa Lassere and Mikkel Østergaard. – Magnetic resonance imaging in psoriatic arthritis: a review of the literature. Arthritis Research & Therapy 2006, 8:207. doi:10.1186/ar1934 (CC BY 2.0) via Commons Wikimedia