If you constantly feel exhausted and your body aches all over — especially your muscles and joints — it could be a flare-up of fibromyalgia. But keep in mind, these can also be symptoms of other conditions, like lupus. In fact, about 22 percent of people living with systemic lupus erythematosus (SLE) — the most common type of lupus — also have fibromyalgia. Having lupus may increase the risk of developing fibromyalgia.

While the two conditions share several symptoms, such as fatigue and widespread pain, they are diagnosed and managed in different ways. Understanding the differences is key to getting the right treatment and support.

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

How Are Fibromyalgia and Lupus Similar?

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

Women Are More Likely to Have Fibromyalgia and Lupus

Fibromyalgia and lupus both affect women more than men. Women are twice as likely as men to be diagnosed with fibromyalgia, according to Cleveland Clinic. About 1 out of 10 people diagnosed with lupus are male, according to the Lupus Foundation of America.

Both conditions often run in families. If a parent or sibling has fibromyalgia, your risk of developing it is eight times higher than someone with no family history. If someone in your family has lupus, your chance of getting it is between 5 percent and 13 percent.

Infections (especially from the Epstein-Barr virus) and stress can also trigger the development of fibromyalgia or lupus.

Pain, Fatigue, and Headaches Are Common 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. This means you might feel better for a while and then suddenly feel worse again. These are called flare-ups.

Fibromyalgia flare-ups may be caused by things like stress, changes in hormones, changes in weather, poor sleep, new medications, or an unhealthy diet. Lupus flare-ups can also be caused by stress and poor sleep, as well as illness, injury, or sun exposure.

Rheumatologists Diagnose Fibromyalgia and Lupus

A rheumatologist is a doctor who specializes in diseases that affect the muscles, joints, and immune system. They can diagnose fibromyalgia, lupus, and other conditions like rheumatoid arthritis. If you first see a regular doctor (called a primary care provider), they may send you to a rheumatologist for a specialist’s opinion.

Before doing any tests, your healthcare provider will ask what symptoms you’ve noticed and how long you’ve had them. They may also examine your body to look for signs of lupus or fibromyalgia.

To be diagnosed with fibromyalgia, you need to have widespread pain that lasts at least three months. The pain often feels like a sting and can happen during activity but also while resting.

To diagnose lupus, doctors need to see certain symptoms and run requires blood tests. If your doctor suspects lupus or wants to rule it out, they will order an antinuclear antibody (ANA) test. This checks if your immune system has been too active. A positive ANA test could be a sign of lupus, but most people with fibromyalgia do not have this.

Your doctor might also order urine tests, X-rays, or other tests to help make a clear diagnosis.

There Is No Cure for Fibromyalgia or Lupus

Unfortunately, there is no cure for fibromyalgia or lupus. Both are chronic (long-term) conditions that need to be managed for life. Symptoms may come and go, so you may go through periods where the diseases are well-controlled and periods where you have more symptoms.

How Are Fibromyalgia and Lupus Different?

Even though fibromyalgia and lupus have some similar symptoms, they are very different in other ways.

Lupus Is an Autoimmune Disease

Lupus is an autoimmune disorder. This means the immune system, which normally fights off illness, attacks the body’s own healthy tissues by mistake.

We don’t yet know whether fibromyalgia is related to the immune system. Doctors believe it’s a pain-processing disorder. People with fibromyalgia may have extra-sensitive nerves that send too many pain signals up and down the spinal column.

Fibromyalgia Usually Starts at a Later Age

Both conditions can affect people of any age, but fibromyalgia is more common in people over 40, whereas lupus is usually diagnosed under the age of 44.

Lupus Has More Obvious Physical Symptoms

Lupus and fibromyalgia each have specific symptoms that help healthcare providers tell them apart. People with fibromyalgia may feel pain from even a light touch, because of how their central nervous system overreacts to pain signals. They may also have digestive and bladder problems, head pain, dizziness, tiredness, and insomnia.

People with lupus often have symptoms that affect the internal organs, bones, skin, and hair.

Common skin and hair symptoms include:

• Skin rashes, such as a malar rash (“butterfly rash”) on the face
• Photosensitivity (skin that’s sensitive to sunlight)
• Mouth and nose sores
• Hair loss

Common joint and bone symptoms include:

• Osteoporosis (weak or brittle bones)
• Swollen, painful joints

Other lupus symptoms include:

• Pleurisy (chest pain when when taking deep breaths)
• Kidney or heart complications
• Raynaud’s disease (fingers and toes that turn white or blue in response to cold or stress, often followed by tingling or numbness
• Low-grade fever
• Seizures

Not everyone with lupus or fibromyalgia will have the same symptoms. For example, someone with lupus might not develop the hallmark butterfly rash on their face. When these clear signs are missing, it can be hard to tell lupus and fibromyalgia apart.

Fibromyalgia and Lupus Have Different Treatments

Fibromyalgia is treated with a combination of medication, behavioral, and lifestyle interventions. These may include:

• Pain relievers, such as over-the-counter treatments, antidepressants, or anti-seizure medications
• Gentle exercise, such as resistance training, water aerobics, or tai chi
• Talk therapy, such as cognitive behavioral therapy and other therapeutic approaches
• Better sleep habits (called “sleep hygiene”)

Some lupus and fibromyalgia treatments are the same, such as over-the-counter pain relievers. However, lupus is an autoimmune disease, so treatments for the condition focus on controlling inflammation and stopping the immune system from attacking the body. Treatment options include:

• Antimalarial drugs (like hydroxychloroquine)
• Corticosteroids
• Medications that suppress the immune system
• Biologic drugs that target specific parts of the immune system

Healthy lifestyle changes can also help people with lupus manage their symptoms.

It’s Possible To Have Fibromyalgia and Lupus

It’s possible to have both conditions at once. Unfortunately, their similarities can make it difficult to get a diagnosis.

Several members of MyFibroTeam report being diagnosed with lupus, as well as other conditions, alongside fibromyalgia. “I have recently been diagnosed with systemic lupus, RA, and mixed connective tissue disorder 😢,” one member shared. (RA refers to rheumatoid arthritis.)

“I have lupus and thyroid issues as well,” one member said to another. “I hope you start to experience some relief from fibro, hypothyroidism, and lupus. It’s not a good combination, I tell ya 😑😅.”

“My lupus has been in remission for two years now, but I’m left with fibromyalgia,” another member wrote.

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.

Find Your Team

MyFibroTeam is the social network for people with fibromyalgia and their loved ones. On MyFibroTeam, 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.