Differential Diagnosis for Nighttime Body Pain

Single Most Likely Diagnosis

• Fibromyalgia: A common condition characterized by widespread musculoskeletal pain, fatigue, and tender points, often worsening at night due to decreased activity and increased awareness of pain.

Other Likely Diagnoses

• Osteoarthritis: Nighttime pain can occur due to increased stiffness and decreased movement, leading to pain in the affected joints.
• Rheumatoid Arthritis: Morning stiffness is more common, but nighttime pain can occur, especially if the disease is not well-controlled.
• Chronic Fatigue Syndrome: Characterized by persistent fatigue and muscle pain, which can worsen at night.
• Hypothyroidism: Muscle aches and pains, including nighttime body pain, can be a symptom of an underactive thyroid gland.

Do Not Miss Diagnoses

• Malignancy (e.g., Bone Metastases): Nighttime pain can be a symptom of underlying cancer, especially if it's persistent and worsening over time.
• Infections (e.g., Osteomyelitis, Endocarditis): Certain infections can cause nighttime body pain, and it's crucial to diagnose and treat them promptly to avoid serious complications.
• Multiple Myeloma: A type of blood cancer that can cause bone pain, which may worsen at night.

Rare Diagnoses

• Polymyalgia Rheumatica: An inflammatory condition that causes muscle pain and stiffness, often worse in the morning but can also occur at night.
• Ehlers-Danlos Syndrome: A group of genetic disorders that can cause musculoskeletal pain, including nighttime body pain.
• Sickle Cell Disease: A genetic disorder that can cause episodes of pain, including nighttime body pain, due to sickling of red blood cells.
• Lyme Disease: A bacterial infection that can cause musculoskeletal pain, including nighttime body pain, if left untreated or undertreated.