Medical

Have Medical Questions? Ask a Doctor Online!

Ask a Doctor,
Get an Answer ASAP!

Medical
This answer was rated:

What is the difference between polymyositis and fibromyalgia

(which I have to say...
What is the difference between polymyositis and fibromyalgia (which I have to say, I barely even believe in - it sounds like "I-don't-like-to-work-itis" to me)? After several weeks of increasing pains and some weakness, my primary doc sent me to a rheumatologist. The only blood work that was out of normal limits was my CK at 1411, my ANA which was "mildly positive" (but I don't remember the number), and several positive results on Epstein Barre, but the doctor said those only showed an "old" EB infection. She put me on methylprednisone 12mg daily and methotrexate 15 mg a week. For me, the fatigue is really not so bad, but the pain is just miserable. I feel like it's hard to talk to the specialist about the pain. She seems surprised that I find it so bad, and she seems to think I want narcotics so she barely addresses my questions. She did prescribe tramadol which made me itch and turn red but did nothing for my pain. I talked a local walk in clinic into giving me an IV dose of (Toradol) ketoralac 60 mg which was heaven. No pain hardly at all for almost 8 hours. (I know I can't keep on taking that.)
SO my question is, is the pain unusual with polymyositis or could I have fibromyalgia? In either case, is there some non-narcotic, non-steroidal help for the pain? I tried po ibuprofen, but the doctor said I shouldn't take that with the steroids.
Show More
Show Less
Ask Your Own Medical Question
Answered in 19 minutes by:
2/9/2011
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,130
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Verified

The key difference between polymyositis and fibromyalgia is that the polymyositis has true inflammation in the muscles, whereas in fibromyalgia, there is no inflammation. Both affect the muscles and cause pain that is felt in the muscles. The polymyositis usually causes weakness more than does the fibromyalgia. The fibromyalgia can develop in someone with another inflammatory condition, but there is no inflammation present from the fibromyalgia, which is why the old term for the condition, fibrositis, is not typically used.

The inflammation of the polymyositis is what causes the elevated CPK, which is typically normal in persons with fibromyalgia. Although it is theoretically possible that the fibromyalgia could develop in someone with polymyositis, it would be impossible to make the diagnosis, as the hallmark of fibromyalgia (tender points in muscles) can occur with the polymyositis. If the treatment for polymyositis leads to improvement in other measures of disease, such as the elevated CPK, but the muscle tenderness persists, then there may need to be consideration of whether fibromyalgia also is present.

The usual first-line treatment for polymyositis is steroids, such as the methylprednisolone. The methotrexate is the usual second medicine to be used. It is true that adding a non-steroidal anti-inflammatory medicine to a steroid is generally unwise, because of possible side effects. Using Tylenol is OK, as it works by a different mechanism. Tramadol is also OK, although you had a reaction to it. If the Tylenol is not effective, then the usual approach would be to use a pain medicine, such as codeine or hydrocodone.

Ask Your Own Medical Question
Customer reply replied 6 years ago
I am allergic to codeines and synthetic codeines and back when they used to use demerol, it took an AWFUL lot of it to work on me after an open abd surgery in the 70's.. In addition I come from a long line of addicts, so I am loathe to try opioids for a longterm condition. (I don't even drink, although my adult children have an occasional beer or wine without any problems.) So nothing like the nerve meds or anything is likely to help then? I really don't know much about them or their interactions, but I've heard of gabapentin, lyrica and amitryptiline (sp?).

These medicines have been studied in a wide variety of chronic pain syndromes, and appear to help with chronic pain by decreasing the firing of the nerves carrying the pain message. These medicines are not typically used for polymyositis, because the other interventions are usually fairly good are controlling the condition, so managing chronic pain is usually not much of an issue. However, if you are allergic to opiates, then it would be appropriate to consider using one of these agents.

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,130
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Verified
Dr. D. Love and 87 other Medical Specialists are ready to help you
Ask your own question now
Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,130
19,130 Satisfied Customers
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.

Dr. D. Love is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me.

Susan O.USA

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

< Previous | Next >

Meet the Experts:

Family Physician

Family Physician

Doctor

2,592 satisfied customers

Emergency Medicine and Family Practice for over 26 years

Dr. Ketch

Dr. Ketch

Board Certified Physician

76 satisfied customers

Medical Degree, Former Assistant Professor at School of Medicine at Yale University

DrRussMD

DrRussMD

Board Certified Physician

51,780 satisfied customers

Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.

Dr Basu

Dr Basu

Experienced Specialist

20,746 satisfied customers

MD

Dr. David

Dr. David

Board Certified Physician

224 satisfied customers

Treat children/young adults, former chief resident, multiple publications

Dr. D. Love

Dr. D. Love

Doctor

19,130 satisfied customers

Family Physician for 10 years; Hospital Medical Director for 10 years.

Dr Chip (M.D.)

Dr Chip (M.D.)

Doctor

14,592 satisfied customers

20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.

< Previous | Next >

Related Medical Questions
How can one 10 mg Norco or hydrocodone be detected in a
How long can one 10 mg Norco or hydrocodone be detected in a saliva laboratory test with a gas chromatograph, if the person is on oxy 60 mgs & methadone 40 and celexa 40mgs per day?… read more
Dr. Muneeb Ali
Dr. Muneeb Ali
Senior Registrar Critical Care Medicine
Doctoral Degree
7,294 satisfied customers
Do hydrocodone and oxycodone look the same on a urine test?
Second opinion] Do hydrocodone and oxycodone look the same on a urine test?… read more
Dr. Scott
Dr. Scott
Doctor
1,030 satisfied customers
Do hydrocodone and oxycodone look the same on a urine test?
Do hydrocodone and oxycodone look the same on a urine test? … read more
Dr Uzair
Dr Uzair
FCPS (R) General Surgery
M.B.,B.S. FCPS
3,696 satisfied customers
Is it safe to take hydrocodone and Ativan together? A doctor
Is it safe to take hydrocodone and Ativan together? A doctor in the ER recently prescribed me Hydrocodone after I broke my wrist. I take Ativan nightly (2 MG) The doctor said that it was safe to take … read more
Dr Chip (M.D.)
Dr Chip (M.D.)
Doctor
M.D.
14,592 satisfied customers
My husband has a valid Rx for hydrocodone. His company
My husband has a valid Rx for hydrocodone. His company recently started testing for it. His Dr said not to worry about it because he will show the rx is valid but my husband is afraid it will open a c… read more
Dr. D. Love
Dr. D. Love
Doctor
19,130 satisfied customers
I'm taking hydrocodone. my urine test showed positive for
i'm taking hydrocodone. my urine test showed positive for hydrocodone and oxycodone. i have never taken oxycodone … read more
Richard Han
Richard Han
Pediatrician
Post-Doctoral Degree
540 satisfied customers
I take hydrocodone for rheumatoid arthritis and was
I take hydrocodone for rheumatoid arthritis and was requested to do a urine test. It came back positive for alcohol and I do not drink. I do take an over the counter sleep aid which contains polyethyl… read more
Dr. Mo
Dr. Mo
Board Certified Physician
MD
1,781 satisfied customers
Will a neurosurgeon conduct aneurysm intervention for three
Will a neurosurgeon conduct aneurysm intervention for three aneurysms, 3.5mm outpouching from left at A1 A2 junction of anterior cerebral artery projecting medial and inferior, 3mm outpouching from su… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,678 satisfied customers
I have issues with fatigue and a confusing history of
I have issues with fatigue and a confusing history of mononucleosis. I was wondering if you could help. … read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,095 satisfied customers
How will hydrocodone stay detectable for a urine sample drug
How long will hydrocodone stay detectable for a urine sample drug test? … read more
Dr Josh
Dr Josh
Doctor
B.A.M.S.
6,477 satisfied customers
How does a person go through opioid withdrraw? Throwing up
How long does a person go through opioid withdrraw? … read more
Dr. Ravoof
Dr. Ravoof
Doctoral Degree
1,923 satisfied customers
Do opioids really cause people to have a bowel movement once
Do opioids really cause people to have a bowel movement once every 2 or 3 weeks? On Saturday, my doctor prescribed me Tramadol/Aceitometaphine 37.5/325 mg, but it neither took away my back and herniat… read more
Dr Chip (M.D.)
Dr Chip (M.D.)
Doctor
M.D.
14,592 satisfied customers
In the blog it says you can take morphine and hydrocodone
In the blog it says you can take morphine and hydrocodone together. Can you take them at the same time or is there a specific time period required between each?… read more
Dr Josh
Dr Josh
Doctor
B.A.M.S.
6,477 satisfied customers
2000 herniated disc. prescribed hydrocodone. 2001 I no
2000 herniated disc. prescribed hydrocodone. 2001 I no longer wanted to take it...so I enrollled in 21 day rehab and did not take it again. I am an RN and was around many opioids and never had a cravi… read more
DrRussMD
DrRussMD
Board Certified Physician
51,780 satisfied customers
Is there any reason why a pain med hydrocodon-acetaminice
Is there any reason why a pain med hydrocodon-acetaminice 10-325 would quit working? … read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,678 satisfied customers
My adult son suffered a TMI as a result of opioid overdose.
Hello, my adult son suffered a TMI as a result of opioid overdose. He has permanent short term memory loss. There are 5 days in which he cannot account for after the OD and before he was found, where … read more
Dr. Mo
Dr. Mo
Board Certified Physician
MD
1,781 satisfied customers
I tested positive for hydrocodone 4months ago. I just had
i just had another test on the 7th and tested + again. I have never. Been prescribed this drug according to the pharmacy which goes back five years. Talked to my general practitioner and reumatalogist who know what I take only drug is Tylenol w/coding #3 which drug testing lab says no … read more
Dr.Saleem
Dr.Saleem
Consultant Cardiologist
Doctoral Degree
764 satisfied customers
I having been using for the last 13 years 10-325 hydrocodone
I having been using for the last 13 years 10-325 hydrocodone -acetaminophen. from being in constant pain from having my ribs and vertebrae fractured being hit by a car while riding my mountain bike, I… read more
Dr. Muneeb Ali
Dr. Muneeb Ali
Senior Registrar Critical Care Medicine
Doctoral Degree
7,294 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x