If you’re exhausted all the time and have achy joints, it could be a lupus flare — but these are also signs of fibromyalgia. About 22 percent of people with lupus also have fibromyalgia, and lupus is a risk factor for developing fibromyalgia. Both conditions share some overlapping symptoms, but they’re diagnosed and treated in different ways.

Below, we’ll touch on the differences and similarities between lupus and fibromyalgia. A healthcare provider can diagnose you and help you find some relief.

Similarities Between Fibromyalgia and Lupus

Fibromyalgia and lupus share some risk factors, symptoms, diagnostic methods, and treatments.

Shared Risk Factors Include Gender, Family History

Women are more likely to experience both lupus and fibromyalgia. Ninety percent of people diagnosed with lupus are women, and women are twice as likely as men to receive a fibromyalgia diagnosis.

Both conditions also have a genetic component. If you’re related to someone who has lupus, you have a 5 percent to 13 percent chance of developing lupus too. If your parents or siblings have fibromyalgia, your risk of developing it is eight times higher than someone with no family history.

In addition, infections (especially from the Epstein-Barr virus) and stress are known to trigger the development of both lupus and fibromyalgia.

Pain and Fatigue Are Common Overlapping Symptoms

Fibromyalgia and lupus may be mistaken for each other because they can cause similar symptoms, including:

• Muscle pain
• Joint pain
• Stiffness
• Fatigue
• Headaches
• Depression
• Dizziness
• Brain fog, confusion, or memory problems
• Sleep disorders like insomnia

In both conditions, symptoms may come and go. Fibromyalgia flare-ups may be caused by stress, hormone changes, weather changes, poor sleep, new medications, or a poor diet. Lupus flare-ups can also be caused by stress and poor sleep, as well as illness, injury, or prolonged sun exposure.

A Similar Diagnostic Procedure Checks for Both Conditions

Since lupus can be a risk factor for fibromyalgia, healthcare providers may run some tests to check for both conditions and to rule out other painful conditions like rheumatoid arthritis. Your primary care provider may refer you to a rheumatologist (someone who specializes in muscle and joint disorders) for a specialist’s opinion.

To start, your healthcare provider will ask what symptoms you’ve noticed and how long they’ve been bothering you. To be diagnosed with fibromyalgia, you must experience widespread pain for at least three months that feels like a sting and can be present during effort but also during rest time. Your doctor may also palpate your muscles or joints. If you’re in the middle of a fibromyalgia flare-up, slight pressure will feel painful on certain parts of the body called tender points. If you feel pain in other spots and not in the tender points, it doesn’t mean you don’t have fibromyalgia.

Then, your healthcare provider will likely conduct blood tests to make sure your extreme fatigue isn’t caused by diabetes, anemia, thyroid disorder, or another underlying condition. Your doctor may also run an antinuclear antibody (ANA) test to see if your immune system has been overactive. This could be a sign of lupus but is typically absent in people with fibromyalgia.

Urine samples, X-rays, and other scans may also be needed to help your doctor confirm a diagnosis.

Pain Relief Strategies May Help With Both

Your doctor can help you manage pain no matter the cause. They may suggest over-the-counter or prescription medications like nonsteroidal anti-inflammatory drugs (NSAIDs), refer you to a physical therapist to learn gentle stretches and exercises, and recommend sticking to a healthy diet, exercising regularly, and prioritizing sleep.

Tracking your habits can also help you figure out what causes flare-ups. For example, if you notice a surge in symptoms every time a big project is due at work, stress could be one of your triggers. Your doctor may recommend talking to a counselor to learn stress-reduction strategies or joining a support group like MyLupusTeam.

Fibromyalgia and Lupus Are Lifelong Conditions

There’s no cure for fibromyalgia or lupus. They’re both considered chronic conditions that need to be managed for life. Symptoms may ebb and flow, so you may go through periods with relatively little pain or periods where you need extra support.

Differences Between Lupus and Fibromyalgia

Despite their similarities, there are key differences between these two conditions.

Different Body Systems Govern Each Condition

Lupus is an autoimmune disorder, which means the body mistakenly attacks its own tissue.

Currently, it’s unknown whether fibromyalgia is related to the immune system. Experts say it’s a pain processing disorder that may be linked to an abnormality in how pain signals are transmitted up and down the spinal column.

Lupus Usually Strikes Before Middle Age

Both conditions can affect people of any age, but fibromyalgia is more likely to occur in people older than 40, whereas lupus is more likely to be diagnosed before the age of 44.

Lupus Causes More Distinct Symptoms

Lupus and fibromyalgia are also characterized by distinct symptoms that help healthcare providers tell them apart. For example, symptoms of fibromyalgia may include digestive and bladder problems, head pain, dizziness, tiredness, and insomnia. People with fibromyalgia also may feel pain from a light touch due to the way their central nervous system overreacts to pain signals.

In contrast, symptoms of lupus tend to affect the organs, bones, skin, and hair. They include:

• Skin rashes, including a “butterfly rash” across the face
• Photosensitivity (sometimes called a sun allergy)
• Swollen joints, glands, feet, hands, arms, legs, or face
• Chest pain when taking a deep breath
• Kidney disease or heart disease
• Blue or white fingers and toes (Raynaud’s disease)
• Mouth and nose sores
• Low-grade fever
• Osteoporosis
• Hair loss
• Seizures

That said, lupus and fibromyalgia won’t cause the same symptoms in every single person. For example, it’s possible to have lupus without having a butterfly rash across your cheeks. Without the presence of distinct symptoms, diagnosing lupus versus fibromyalgia can be tricky.

Lupus May Require More Medication

The pain relievers used to soothe fibromyalgia discomfort may also work for lupus, but sometimes a different approach is needed. For example, people with lupus may benefit from immunosuppressants to stop the body from attacking itself, or from corticosteroids to reduce inflammation.

Your doctor may also suggest vitamin D supplements if you need to avoid being out in the sun due to photosensitivity.

Some People Have Both Conditions

Lupus and fibromyalgia can be very similar, and it’s possible to have both conditions at once. Unfortunately, their similarity can make diagnosis difficult.

Members of MyLupusTeam who have lupus and fibromyalgia shared their experiences: “I just recently found out my first positive ANA test was back in 1997, and no one looked into lupus. All those years they said it was just fibromyalgia with depression and anxiety. If only I knew sooner and started treatments sooner, I possibly wouldn’t have suffered so long.”

Another said, “I was diagnosed with fibromyalgia first, but after I had my son, the lupus symptoms were more pronounced, even though I had rashes and joint pain and had been hospitalized many times after spending summers outside at camp.”

A correct diagnosis is important to make sure you get effective treatment. If you’re being treated for fibromyalgia but still don’t feel well, talk to your doctor about getting screened for lupus. They should be able to look for signs of an overactive immune system, or hidden symptoms like kidney damage and osteoporosis.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you have lupus and fibromyalgia? How were you diagnosed? Share your experience in the comments below, or start a conversation by posting on your Activities page.