MS vs Fibromyalgia: What are the Key Differences?

Do you suffer from widespread pain? Do your muscles ache or spasm? Is fatigue a very real problem that affects both your body and your brain?

Symptoms like these can feel overwhelming. Getting answers from your doctor can be difficult. So, you might do what many people do… Turn to Dr Google. But searching the internet for answers can be a tricky business. Certain symptoms — like those above — can be present in a range of conditions.

You might come across posts that hint at fibromyalgia, while others suggest multiple sclerosis (MS). When you’re not medically trained, the differences between fibro and MS can be a little difficult to see. This can create worry and confusion.

So, in this article, we’ll discuss multiple sclerosis vs fibromyalgia. Why might these two conditions be confused? What are the similarities? What are the differences? How can you get a correct diagnosis? What treatments are available?

Table of Contents

Similarities & Difference Between Fibro and MS

Why are these two conditions sometimes compared or confused? And how are they different?

Let’s take a look…

Fibromyalgia — commonly referred to as “fibro” — and MS have a number of similarities. Both present with vague symptoms like brain fog, depression, fatigue, and trouble concentrating. Both conditions more commonly affect women. Both are ongoing, or chronic, ailments. So, when we turn to the search engines for advice, the results may appear unclear.

But, we must remember… Online articles are written by humans, including many who are not medically trained. On top of this, diagnosis is a complex business. One that requires years of training and a high level of skill and interpretation. This can lead to incorrect conclusions and confusion.

So, while on the surface MS and fibro might seem similar, they are distinctly different conditions.

Diagnosis: MS vs Fibromyalgia

Diagnosis is the process of identifying and confirming an illness. This is done through history, symptoms, tests, and scans. The differences between fibro and MS, their symptoms, and their progression form an important part in reaching a correct diagnosis.

Diagnosis of Multiple Sclerosis

As an article published on StatPearls said, MS is “an autoimmune disease of the central nervous system (CNS) characterized by chronic inflammation, demyelination, gliosis, and neuronal loss.”

In MS, the body’s immune system attacks its own nervous system. This creates inflammation, strips the protective covering from the brain and spinal cord, causes the brain’s glial cells to react, and promotes the death of nerve cells. It’s a nasty combination that often leads to greater disability.

To diagnose this illness, a health professional considers someone’s history, their physical signs, and the results of MRI scans and other tests. They will make sure to exclude any other causes that could explain someone’s symptoms.

Importantly, a diagnosis is supported when two or more relapses have been proven to have occurred… We’ll talk about this more shortly.

Diagnosis of Fibromyalgia

Sadly, identifying fibromyalgia is often a slow process. Research shows that it takes an average of 2.3 years from first presentation — and almost four different physicians — to receive a diagnosis. That’s horribly sluggish when you’re suffering from the symptoms of fibro. To help shortcut this journey, it’s important to become your own advocate. This begins with understanding how fibromyalgia is diagnosed.

An article published in the journal, Rheumatology, said that:

From a clinical point of view, we must rely on diffuse chronic musculoskeletal pain with the inclusion at least of sleep and fatigue as representative of the constellation of the multi-symptom aspects of this syndrome…

In short, widespread body pain, fatigue, and sleep problems are considered diagnostic. Assuming there is no other cause for these symptoms.

Symptoms: MS vs Fibromyalgia

man with vision issues holding glasses representing symptoms of multiple sclerosis

While MS and fibromyalgia do have overlapping symptoms like depression, pain, and brain fog, the larger symptomatic picture provides important clues to the correct diagnosis. So, disparate signs matter. What are the symptom differences between fibro and MS?

Symptoms of Multiple Sclerosis

The symptoms of MS depend on where the lesions occur, how many there are, and the amount of tissue that has been injured. With this in mind, common symptoms include:

— Visual issues like loss of sight in one or both eyes, double vision, or symptoms of inflammation of the optic nerve (called optic neuritis) like pain, flashing lights, or a dulling of color
— Vestibular symptoms: The vestibular system is the balance system so symptoms might include vertigo (a sensation of dizziness and spinning) and problems with walking
— Bulbar dysfunction: This may present as trouble speaking (dysarthria) and trouble swallowing (dysphagia)
— Motor changes: This affects movement so symptoms may include abnormal muscle tightness (called spasticity), fatigue, shaking, and weakness
— Sensory changes: This affects sensation, and can be experienced in three ways; numbness; pins and needles or a prickly feeling (paresthesias); or abnormal sensations like burning, coldness, crawling, itchiness, or pain (dysesthesias)

— Bowel and urinary symptoms: Incontinence, retention (an inability to completely empty the bowel or the bladder), urgency (a need to go to the toilet immediately), constipation, diarrhea, or heartburn
— Cognitive symptoms: Problems with concentration and memory, and well as issues with executive function (controlling and coordinating thought and appropriate behavior can become difficult)

— Mental illness, including anxiety and depression


As you can see, the symptoms of MS are tied to the central nervous system. Each is related to the part of the brain or spinal cord that is damaged. Because of this, the symptoms above usually match the signs found on testing.

For most people with MS, the disease follows what’s called a relapsing, remitting course. An attack occurs, with new or exacerbated symptoms. Then follows a partial or complete recovery. This cycle repeats itself.

On the other hand…

Symptoms of Fibromyalgia

Fibro is not CNS-related, and it is not an autoimmune condition. Its symptoms can appear to be vague. This is one reason why diagnosis can take so long.

Common fibro symptoms include:

— Pain that is felt at, or elicited by direct pressure applied to, certain points around the body
— Chronic widespread pain
— Depression
— Fatigue
— Headache
— Unrefreshing sleep, where one sleeps lightly and wakes feeling unrested
— Cognitive manifestations, including the common experience of brain fog (slow, fuzzy thinking)
— Tummy troubles (including irritable bowel syndrome, or IBS)

The symptoms of fibromyalgia are chronic, or long-term.

If you’d like to learn more about fibro, our in-depth article, Fibromyalgia in Females is the perfect read.

Treatment: MS vs Fibromyalgia

treating ms vs fibromyalgia therapy

Once you have received an accurate diagnosis, this will guide treatment. There are options that are specific to each condition; when the difference between fibro and MS matters to the care you receive. There are also options that can be of benefit, regardless of the diagnosis.

Disease-modifying therapies are the mainstay for the mainstream treatment of multiple sclerosis. This consists of medications that aim to reduce the number and extent of CNS lesions and, hopefully, prevent progression. Other pharmaceutical drugs are used to calm inflammation, or to treat specific symptoms like depression or incontinence.

Treatment for fibromyalgia is more varied as a specific cause remains elusive. This is likely because fibro is multifaceted, with a number of potential contributors. An overly sensitive nervous system, trauma, genetics, hormones, and yet to be determined factors appear to be involved.

Recommended treatments include education; fitness, medication, and psychotherapy.

Living with Fibro & MS

Living with a chronic illness can be stressful and tiring. Fatigue, for example, is common in both conditions. The difference between fibro and MS, when it comes to general impacts, dissolves. That’s why treatments that relieve stress and promote general health are often beneficial regardless of the illness.

Lifestyle choices like a nourishing diet, gentle exercise, mind-body approaches including mindfulness and meditation, and stress reduction may offer respite for both Multiple Sclerosis and fibromyalgia.

How XRHealth Can Help Treat Fibromyalgia & MS

At XR.Health, our approach is kind, evidence-based, tailored to your condition, and do-able. If you have difficulty traveling, our digital approach is ideal. Exercises and treatments can be performed in the comfort of your home under the guidance and support of a licensed, degree-qualified therapist. You benefit from cutting edge technology that is not yet available freely.

Our science-backed approaches include:

— Cognitive-behavioral therapy (CBT)
Acceptance and Commitment Therapy (ACT)
Psychodynamic therapies
Online Physical therapy
— Live appointments

Depending on your condition, you will be allocated a licensed, dedicated therapist. You’ll receive 1:1 consultations with a neurology treatment licensed therapist, or experienced fibromyalgia therapist.

To maximize your results (and fun!), we incorporate:

Virtual reality technology
Video calls and in-app messaging
A carefully monitored, personalized care plan that is updated as you progress


That’s why our MS and fibro patients love their care!
At XR.Health, we deliver tailored care, teach stress management techniques that calm, work together to improve your physical and psychological function, and help you to experience greater control.

If you suffer from MS, begin your MS treatment journey with us through our neurological physical therapy.

If you suffer from fibro, begin your fibromyalgia treatment journey with us through our condition-specific program.

We look forward to helping you to step back into a life you love!

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Education: Doctor of Physical Therapy from University of Michigan-Flint

Years in Practice: 10

Education: Bachelor’s in Psychology and a Masters in Social Work from Grand Valley State University

Years in Practice: 14

Education: Master of Science in Occupational Therapy from Eastern Michigan University 

Years in Practice: 19