Quick answer: arthritis is inflammation or damage in the joints, with swelling, warmth and stiffness, and it can show up on blood tests and imaging. Fibromyalgia causes widespread pain, deep fatigue and unrefreshing sleep without joint swelling or joint damage, and standard tests are usually normal. You can have both.
Side-by-side comparison
| Feature | Fibromyalgia | Arthritis (osteoarthritis or rheumatoid) |
|---|---|---|
| Where the pain is | Widespread, in muscles and soft tissue, often shifting | In and around specific joints |
| Joint swelling and warmth | No visible swelling | Often present, especially in rheumatoid arthritis |
| Stiffness | Can occur, often all over | Morning stiffness in joints; longer than an hour suggests inflammatory arthritis |
| Fatigue | Prominent, often severe | Common in rheumatoid arthritis |
| Sleep | Unrefreshing, even after a full night | Pain may disturb sleep |
| Thinking problems (“fibro fog”) | Common | Less common |
| Blood tests (ESR, CRP, RF, anti-CCP) | Usually normal | Often abnormal in rheumatoid arthritis |
| Joint damage on X-ray | No | Yes, over time |
| Tender points or widespread tenderness | Yes | Tender joints |
What fibromyalgia feels like
People often describe aching, burning or deep soreness in many areas of the body for at least three months. It frequently comes with:
- Deep tiredness
- Sleep that does not refresh
- Trouble concentrating or remembering
- Headaches
- Irritable bowel symptoms
- Sensitivity to touch, noise or light
- Low mood or anxiety
Doctors diagnose it from your history and examination, using criteria that look at how widespread the pain is and how severe your other symptoms are. There is no single blood test.
What arthritis feels like
Osteoarthritis is wear and tear. Pain is usually in the knees, hips, hands or spine, gets worse with use and eases with rest, and stiffness after rest is short (under 30 minutes).
Rheumatoid arthritis is an autoimmune disease. It causes warm, swollen, painful joints on both sides of the body, often the small joints of the hands and feet, with morning stiffness lasting an hour or more. Blood tests such as rheumatoid factor, anti-CCP, ESR and CRP can help, and X-rays or ultrasound can show damage.
How doctors tell them apart
1. Examination: swollen, warm joints point to arthritis. Widespread tenderness with normal-looking joints points to fibromyalgia. 2. Blood tests: ESR, CRP, rheumatoid factor and anti-CCP. Normal results make rheumatoid arthritis less likely but don’t rule out osteoarthritis. 3. Imaging: X-ray or ultrasound looks for joint damage. 4. Ruling out look-alikes: an underactive thyroid, vitamin D or B12 deficiency, sleep apnea, anemia and some medicines can cause similar aches and tiredness. See our guide on the causes of chronic fatigue.
Can you have both?
Yes. Fibromyalgia is more common in people with rheumatoid arthritis and other inflammatory conditions. When pain persists despite good control of joint inflammation, doctors often look for fibromyalgia alongside it.
Treatment differs
Fibromyalgia:
- Regular, gradual aerobic exercise (walking, swimming, cycling), the best-studied treatment
- Sleep routines, and treatment of any sleep apnea
- Cognitive behavioral therapy and stress management
- Medicines such as duloxetine, pregabalin or milnacipran for some people, prescribed by a doctor
- Pacing your activity so good days don’t lead to crashes
Arthritis:
- Osteoarthritis: exercise, weight management, pain relief, physical therapy, injections or surgery in some cases
- Rheumatoid arthritis: disease-modifying medicines to control inflammation and protect joints, started early
For practical help with joint pain, see our guide on how to manage arthritis flare-ups.
When to see a doctor
Make an appointment if you have joint swelling, morning stiffness lasting more than an hour, or pain and tiredness that lasts more than a few weeks. Early treatment of inflammatory arthritis prevents permanent damage. Get urgent care for a single hot, swollen joint with fever.
Frequently asked questions
Is fibromyalgia a type of arthritis?
No. It affects how the body processes pain, not the joints themselves, and it does not cause joint damage.
Can fibromyalgia turn into arthritis?
It doesn’t turn into arthritis, but the two can occur together.
Does fibromyalgia show up on an X-ray or MRI?
No. Imaging is usually normal, which is why diagnosis relies on symptoms and examination.
What kind of doctor treats these conditions?
A rheumatologist is the specialist for both, though your regular doctor can often start the assessment.
Cura Editorial Team
Contributor at Cura Health Journal.