How to Tell if it’s Fibromyalgia or Multiple Sclerosis

By Tiffany Vance-Huffman,

There is so much mystery in the world of fibromyalgia, in large part because it effects everyone differently. Another reason for the mystery is due to the similarity in fibro symptoms compared to other diseases and syndromes. Fibromyalgia is sometimes misdiagnosed as a different problem and vice versa. This is because the myriad of symptoms associated with fibro are commonly found in other illnesses such as multiple sclerosis, also known as MS. So how can you tell if it’s fibromyalgia or multiple sclerosis?


The National MS Society defines it as follows: “Multiple sclerosis (MS) involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves.” If you or a loved one live with fibromyalgia, you can definitely spot some familiar buzz words and phrases, can’t you? Specifically, “immune system,” “abnormal response,” and “central nervous system.” In fact, the similarities in symptoms become quite striking when you review a side-by-side comparison. Note that most, not all, of the fibromyalgia symptoms overlap with MS symptoms, making it difficult to distinguish whether it’s fibromyalgia or multiple sclerosis:

Numbness or TinglingNumbness &/or Tingling
WeaknessMuscle Weakness
Dizziness & VertigoDizziness
Emotional ChangesAnxiety
Walking (Gait) DifficultiesImpaired Coordination
Spasticity (i.e., muscle stiffness and spasms)Muscular aching, throbbing, & twitching
Vision ProblemsVision Problems
Bladder ProblemsBladder Problems
Bowel ProblemsIrritable Bowel Syndrome
Cognitive ChangesCognitive Problems
TremorRestless Leg Syndrome
Swallowing ProblemsDry Eyes & Mouth
ItchingItching &/or Burning
Sexual ProblemsInsomnia/Poor sleep
Speech ProblemsRinging in the Ears
Breathing ProblemsNeurological Symptoms
SeizuresSkin Sensitivities & Rashes
Hearing Loss

It is plain to see many similarities in symptoms between fibromyalgia and multiple sclerosis, including clear neurological connections associated with pain, numbness, and tingling. However, experts explain that unlike MS, fibromyalgia does not show up as brain lesions on an MRI. Furthermore, while both conditions have no known source, MS is distinctly categorized as an auto-immune disease, but fibromyalgia is not. So that is one way to determine if it’s fibromyalgia or multiple sclerosis.

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A key difference in MS is that the patient actually accrues long-term nerve damage which leads to physical and cognitive impairments. In fact, some types of MS are progressive. Primary Progressive MS (PPMS), for example, “is characterized by worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions.” While fibromyalgia, on the other hand, is often mistakenly considered an arthritic condition, it does not actually cause damage to joints, muscles, or tissues.


Fibromyalgia is primarily characterized by chronic and widespread pain. A close second is the debilitating fatigue. But as you can see from the chart above, the symptoms are quite broad. The problem many patients run into is that fibromyalgia resembles so many other conditions that it’s usually difficult to nail down a diagnosis. However, some physicians are more inclined to spot it than others.


The University of Maryland Medical Center explains that a fibromyalgia diagnosis is comprised of a detailed muscle exam that includes checking for tenderness at specific locations on the body. Rating the severity of specific symptoms is another key part of the exam. The symptoms must be present for at least three months. They add that there are no blood, urine, or laboratory tests which can provide a conclusive fibromyalgia diagnosis. However, fibro diagnosis also means that no other disorder or condition can explain the symptoms.

Diagnosing MS, however, is quite different because it causes several more neurological symptoms than fibromyalgia. Thus, exams tend to focus on brain and nerve function, including a brain MRI and sometimes a spinal tap. Even though MS can also be difficult to diagnose, it is often easier than fibromyalgia. This is because the evaluation requires searching for lesions or damaged areas to the central nervous system.

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It’s true that the similarities between multiple sclerosis and fibromyalgia are striking. But given the neurological damage caused by MS, it is a condition that is slightly easier to target than fibromyalgia. Patients with MS are usually treated by a neurologist. But so are many fibro patients. As such, a neurologist likely has a keen eye in making the distinction between the two. Only tests will be able to tell. Were you misdiagnosed? How did it effect you? Tell us your story, please!


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  • I was diagnosed with fibromyalgia in 1996(age 50), the same year I was diagnosed with diabetes although I had many symptoms of fibromyalgia before that, such as extreme pain all over , terrible menstral periods, long lasting, heavy, painful), cognitive difficulties, memory issues, extreme fatigue, etc.
    On the facebook fibromyalgia facebook family it seems that a good majority of fibro patients also have diabetes(unusual).

    Anyway, my younger brother was diagnosed with MS at age 18(relapsing/remitting), my older sister has RA and fibromyalgia, another younger brother I am sure has fibromyalgia. As I look back, I can think of a couple of aunts and uncles probably could have had fibro.
    In 1991, at the age of 41, my husband was diagnosed with Progressive MS and died at age 56. My daughter, age 38 was diagnosed with fibro but I’m sure has had it for a while. The utmost scariest thing is that my daughter’s daughter(my granddaughter, age 8 is displaying symptoms of fibro already such ad extreme exhaustion, & others I can’t recall at the moment.

    My brother who was diagnosed with MS in college at age 18 & died at age 62, his daughter, my niece, was diagnosed with MS at age 38. She is doing well & I’m praying that she has Relapsing/Remitting.
    Needless to say, my family would be ideal for some enthusiastic clinician andd reseacher to study.
    I worked in Healthcare for over 40 years and I wish I was young enough and had some financial backing to continue what I have been witnessing. I am 73 years old. I was 1 of 5 children and at least 4 of us have MS, Fibro, CFS, RA, Sjogrens, Scalp Psoriasis and only God knows what else. I even think my oldest brother might have fibro.
    If you want to get in touch with me, please do. Maybe we can help future families since younger ones of us continue to suffer.

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