Multiple sclerosis (MS) and fibromyalgia both involve the nervous system and cause chronic symptoms, such as pain and fatigue. However, there are key differences.

MS is a neurological condition. It causes the immune system to attack the central nervous system (CNS) and damage the nerves’ protective coating, which is called myelin.

Fibromyalgia is a complex condition that affects many of the body’s functions. The most telltale symptom is widespread pain and tenderness in the muscles and joints. Unlike MS, fibromyalgia is not an autoimmune disease.

Currently, the medical community does not fully understand what causes fibromyalgia, but it appears to involve changes in the CNS.

In this article, learn about the differences between MS and fibromyalgia and how doctors diagnose and treat these conditions.

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Fibromyalgia and MS share some symptoms, such as muscle weakness and pain. However, there are key differences concerning the types of pain and accompanying issues. We explore these below.

Fibromyalgia pain

Fibromyalgia pain is typically widespread and lasts a long time. The skin may always feel tender, and some areas may be more sensitive than others.

People with fibromyalgia say that the pain ranges from a dull ache to a burning or shooting pain. There may be tender spots in muscles and tendons from which pain radiates.

For a diagnosis of fibromyalgia, the pain must have lasted for at least 3 months.

Other fibromyalgia symptoms

Below, learn about other symptoms of this condition and their broader effects:

  • Chronic fatigue may cause people to take long breaks between activities or need extra sleep.
  • Restlessness or restless legs syndrome can make it hard to get comfortable and relax and may lead to sleep disturbances, such as insomnia.
  • “Fibro fog” refers to a sense of confusion or difficulty focusing. Some research suggests that it results from the brain trying to tune out pain, which makes thinking more difficult.

How do people recognize a fibromyalgia flare?

MS affects nerves throughout the body. Damaged nerves may fire without cause, leading to pain and other sensations in one or multiple areas.

The pain affects people differently, but it can involve:

The severity can vary, depending on how far MS has progressed. Some people only experience tingling, while others experience widespread, debilitating pain.

Other MS symptoms

Other symptoms of MS include:

Changes in speech

As the immune system damages the nerves, it can take more time for the nerves’ signals to reach the brain. This can make speech slow or difficult.

Vision changes

Nerve damage can also affect the eyes, leading to blurred or double vision. Some people experience extensive or complete vision loss.

How does MS affect the eyes and vision?

Difficulty moving or walking

Nerve damage can lead to muscle weakness in the arms or legs, which can affect the way a person walks. Their gait may become disrupted or unsteady.


Damage to the nerves can also inhibit a person’s coordination, causing them to feel off-balance or dizzy.

Bladder and bowel changes

People with MS may need to urinate or have bowel movements more frequently, for example.

Learn about the early signs of MS.

Diagnosing either condition can be challenging, and it may involve a process of elimination.

MS diagnosis

To help them diagnose MS, a doctor:

  • asks about the person’s symptoms and medical history
  • does a physical and neurological examination
  • may suggest an MRI scan to check for damage to the brain and spinal cord
  • may do a lumbar puncture to remove some cerebral spinal fluid for testing in a laboratory
  • may do some blood tests to rule out other conditions

Fibromyalgia diagnosis

There is no single test for fibromyalgia. A doctor instead asks questions about:

  • specific symptoms of widespread pain
  • presence of tender points
  • changes in thinking
  • fatigue
  • feeling unrefreshed after sleep or waking up tired despite spending adequate time in bed resting

They may perform an MRI or blood tests to rule out other conditions.

MS and fibromyalgia are long-term conditions. Symptoms of fibromyalgia can be persistent, but the condition is not life threatening. The symptoms of MS can progress and become debilitating.

The National Multiple Sclerosis Society reports that MS may reduce a person’s lifespan by 7 years and that severe and rapidly progressing forms can be fatal.

However, the National Institute of Neurological Diseases and Stroke states that a person with MS has the same life expectancy as a person without the disease.

As there is no cure for either condition, treatments involve managing and reducing symptoms to improve the quality of life.

MS treatment

Having a thorough treatment plan can help relieve symptoms, prevent flare-ups, and slow the progression of the condition.

An emerging class of drugs called disease-modifying therapies can help reduce the number of flares and may also slow progression.

Other treatments, such as corticosteroids, can help manage flares and the symptoms that can arise.

Some over-the-counter medications can provide temporary relief from symptoms such as pain. Options include:

A doctor may prescribe the following for pain and itching:

Alternative therapies that may also help include:

However, there is not enough evidence to confirm that all of these are useful for people with MS.

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Fibromyalgia treatment

The American College of Rheumatology reports that the following can help people manage the condition:

  • Medicinal therapy: Some prescription drugs can reduce pain and other symptoms. Options that may help manage pain include antidepressants, such as duloxetine (Cymbalta), Milnacipran (Savella), and pregabalin (Lyrica).
  • Physical exercise: People should use this alongside drug therapy. Examples include aerobic exercise and low impact exercises such as yoga and tai chi.
  • Mental health support: Tools such as cognitive behavioral therapy (CBT) or CBT for insomnia may complement treatment. Friends, family members, and various groups can also provide crucial support and enhance overall well-being.
  • Sleep: Some medications that relieve pain may also help improve sleep.
  • Education: Learning more about fibromyalgia can help a person understand what is happening and help them find suitable treatments and more relief.

People use a range of complementary therapies and natural remedies for fibromyalgia, such as:

There is little scientific evidence to confirm that most of these therapies work, but some people may find them helpful.

Some limited research has shown that cannabinoids may help people with sleep issues and pain due to fibromyalgia. However, experts urge caution. More research is needed to confirm the safety and effectiveness of cannabinoids for fibromyalgia. Cannabinoids can also affect people in different ways. Finally, the use of cannabinoids is not legal in all states.

Can CBD help with fibromyalgia?

Fibromyalgia and MS can be challenging to diagnose as their symptoms resemble those of many other conditions, including:

Here are some questions people often ask about fibromyalgia and MS.

How can you tell the difference between fibromyalgia and MS?

MS is an autoimmune disease, when the body’s immune system mistakenly attacks its own cells. Doctors do not know exactly why fibromyalgia occurs, but it appears to result from a change in the way a person perceives pain.

The symptoms can be similar, but people with fibromyalgia are more likely to experience depression, irritable bowel syndrome, and widespread, persistent pain. Symptoms more common with MS include weakness, vision problems, muscle spasms, and bowel or bladder issues.

When should you suspect MS?

Both MS and fibromyalgia can be hard to diagnose, as they involve a range of nonspecific symptoms — such as pain and fatigue — which are common to various conditions.

To confirm a diagnosis of MS, a doctor will likely compare how lesions on MRI results change over time and how widespread they are on the body. A lab test of cerebral spinal fluid may show unusual features, such as high levels of certain proteins.

There is currently no diagnostic test that can confirm the presence of fibromyalgia. However, some research has shown that certain changes may be present in people with this condition.

Tests to rule out other conditions can help identify these conditions.

Can an MRI show fibromyalgia?

A diagnostic MRI test will not show signs of fibromyalgia. However, some researchers have identified unusual features on MRI scans in people with fibromyalgia compared with those who do not have the condition.

MS and fibromyalgia are different conditions that can cause similar symptoms. There is no cure for either, but there are many ways to manage the symptoms.

People should speak with a doctor about any possible symptoms of either health issue. The doctor will help develop a comprehensive treatment strategy.

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