How common is it to get Fibromyalgia if I have been diagnosed with RA?

Bothersome sensations such as widespread pain, fatigue, and non-refreshing sleep are the defining features of fibromyalgia. These are also common complaints in other active rheumatic diseases. In fact, a person with active rheumatoid arthritis with multiple active joints will often meet the American College of Rheumatology criteria (both 1990 and 2010) for fibromyalgia. Adding to the confusion, the development of concomitant fibromyalgia symptoms is greater in people with rheumatic disease than in the general population. The prevalence of concomitant fibromyalgia in rheumatoid arthritis patients has been estimated in several papers to be somewhere around 15%. The most recent paper on the subject in Pain by Wolfe, et al. showed that 7.4% of 9739 rheumatoid arthritis patients met fibromyalgia criteria at their most recent evaluation but 19.8% met fibromyalgia criteria at some point during follow-up. In summary, it is not uncommon to have both problems.

In practice, a person with symptoms of both disorders will typically be treated aggressively for their rheumatoid arthritis by their rheumatologist. This is because there are objective markers that can be measured in rheumatoid arthritis, such as joint swelling, joint tenderness, and inflammatory markers in the blood (such as erythrocyte sedimentation rate and C-reactive protein). If aggressive therapy leads to improvements in the signs of rheumatoid arthritis but do not alleviate diffuse body pain, fatigue, non-refreshing sleep, and other bothersome symptoms, then therapies directed at fibromyalgia symptoms should be considered.