Sharing the Diagnosis of Fibromyalgia vs of Arthritis

Unlike most people with both fibromyalgia and arthritis, my fibromyalgia was diagnosed several years before my arthritis. I was diagnosed with chronic pain due to central sensitization in my hips in 2017, fibromyalgia in 2019, and osteoarthritis in 2024. I have always struggled to tell people I have fibromyalgia, due to its history of being dismissed as a legitimate medical condition.  However, fibromyalgia is now recognized as a very real condition. 

As the American College of Rheumatology describes, the most common symptom is widespread pain. Severe fatigue and sleep problems are also common. Current evidence supports that fibromyalgia is caused by inappropriate pain signalling and modulation, and that the pain is contributed to by “central sensitization” of the nervous system. This can result in hyperalgesia, or increased pain from a typical pain stimulus, and allodynia, or pain due to a stimulus that does not normally provoke pain. The symptoms of fibromyalgia can be very disabling, and as someone with this condition, I can assure you that it is very real. 

Why, then, has it been so hard for me to tell people I have this condition? Well, because fibromyalgia often lacks visible symptoms and has a somewhat unclear etiology, some people, including some healthcare providers, may question the legitimacy of fibromyalgia. This can lead to delays in diagnosis and appropriate treatment. Moreover, it can lead to medical gaslighting, invalidation, stigma, and misguided negative perceptions. On top of already having anxiety disorders contributing to my fears about sharing this diagnosis, the risk of negative social and medical repercussions contributes significantly to whether I share my diagnosis or not. However, to destigmatize this condition, especially with the privilege my voice as a medical student can carry, I have tried to be more open about living with fibromyalgia, and how it disables me. 

I used to wish I could tell people I had arthritis instead of telling them I have fibromyalgia. It seemed less of a risk to share that, as there has historically been less skepticism about arthritis than fibromyalgia. Recently, I found out that I do have arthritis. Specifically, I have osteoarthritis in my sacroiliac joints, pubic symphysis, and femoroacetabular joints, due to some dysplasia, previous injuries and surgeries on my hips. On top of the difficult emotions that you might expect from being diagnosed with a degenerative arthritis at 25, it was also very validating to have structural evidence of my pain. After years of largely invisible pain, suddenly a simple x-ray and CT images prove at least some of my pain. Suddenly, I can tell people that my limitations from pain are due to arthritis, if I don’t want to share the fibromyalgia part. However, I still find I have anxiety about sharing this diagnosis. I fear people will think it can’t be that bad because it’s not rheumatoid arthritis. I fear that people won’t believe me because I am young – most osteoarthritis is diagnosed after age 50. I fear I still don't quite fit into the rheumatic disease community because I don’t have an autoimmune arthritis. 

The fact that I still have anxiety about sharing my diagnosis of arthritis has taught me that there can always be a fear of stigma when sharing a medical diagnosis. All of my medical conditions are equally valid, no matter which ones show up on imaging or not. I also have POTS – but that’s a whole other story. How others react to my disclosure of my condition(s) says more about them than it does about me and my health. So, for anyone out there who feels anxious about sharing a diagnosis, I see you, I understand, and I believe you. You can practice telling me if you want!