Fybromyalgia and Headaches?

It is decidedly unfair that such a burdensome and painful condition as fibromyalgia should often occur concurrently with migraine headaches, but that is the nature of FM. Although the exact number is unclear, it has been estimated that up to 76 percent of all fibromyalgia sufferers also experience chronic headaches including migraines.

Unfortunately, there appears to be a deleterious synergy between fibromyalgia and migraine conditions. Both conditions tend to appear with sensory sensitivities which in turn lowers the pain threshold. In other words, having fibromyalgia or chronic migraines tends to intensify the other condition. That is why almost 84 percent of people with both conditions admit that their quality of life has significantly fallen.

The Nature of Fibromyalgia and Chronic Migraines

Fibromyalgia is one of the most common chronic pain conditions, affecting almost 4 million U.S. adults. This arthritic condition is characterized by

  • Widespread pain
  • Fatigue
  • Sleep issues
  • Tender points
  • Anxiety
  • Depression
  • Cognitive issues including difficulty concentrating or remembering

Although the cause of fibromyalgia is unknown, it is believed that there is a neurological dysfunction in which sensitivity to pain is abnormally high.

The risk factors for fibromyalgia include

  • Middle age is the most common age group for diagnosis
  • Lupus or rheumatoid arthritis sufferers are more likely to develop fibromyalgia
  • Women are two times more likely to have fibromyalgia than men
  • Traumatic events may trigger the onset of fibromyalgia
  • Having a family member with FM raises the risk
  • Obesity

Almost 12 percent of people suffer from chronic migraine headaches, and it is the 6th leading cause of disability in the world. Chronic migraines are defined as 15 or more migraine days a month, for more than three months. In many patients, the frequency of migraines may increase over time, eventually becoming a chronic condition.

Unlike severe headaches, migraines present with some distinguishing symptoms.

  • Intense throbbing pain on one or both sides of the head
  • Nausea
  • Dizziness
  • Vomiting
  • Tingling in the face, hands or feet
  • Auras, including lines, colors or flashing lights
  • Sensitivity to bright lights, sounds, textures or smells

The cause of migraines is unknown, but there is evidence that the neurotransmitter serotonin plays a key role. Serotonin helps regulate blood vessels, and narrowed or dilated blood vessels appear to be a factor in the onset of migraines. Risk factors for experiencing chronic migraines include

  • If one of your parents has chronic migraines, you have a 50 percent chance of acquiring this condition; if both of your parents have this condition, then your risk rises to 75 percent.
  • Women are much more likely to suffer from chronic migraines than men.
  • Most migraine sufferers experience their first episode during adolescence, and they almost always start before age 40.

Devastating Combination

The statistics alone suggest there is a strong link between fibromyalgia and chronic headaches, but the exact nature of this overlap is a mystery because of the uncertainty regarding the causes of both conditions. However, study after study shows that there is some kind of relationship between FM and chronic headaches.

One study that examined 100 patients with frequent migraine headaches found that 36 percent also suffered from fibromyalgia. Another survey compared 70 fibromyalgia patients to 70 patients with chronic headaches; it found that 35 percent of fibromyalgia patients also had migraines or tension headaches, while 42 percent of the headache sufferers experienced tender points, a common symptom of fibromyalgia.

Many of the risk factors for fibromyalgia and chronic headaches are the same, so it may be that these populations merely overlap. Both conditions are common among women of childbearing age, and both patient populations are more likely to suffer from pain sensitivity and depression.  Without definitive evidence of the causes of fibromyalgia and chronic headaches, it is difficult to distinguish between symptoms and causative factors.

There is mounting evidence that both conditions may be related to increased excitation of the nervous system. Just as migraine sufferers tend to have abnormal levels of serotonin, fibromyalgia patients have an imbalance of another neurotransmitter known as Substance P. Both of these chemicals may play a related role in stress responses

Treatment Options for Fibromyalgia and Chronic Headaches

In general, you probably want to treat your fibromyalgia and chronic headaches as independent conditions. Although you may treat overlapping symptoms like pain and sleep issues with one therapy, you will probably need an array of treatments to manage both conditions.

These may include one or more of the following therapies:

  • Over-the-counter pain relievers—most physicians will initially recommend that you try OTC non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen or aspirin. For many patients, these commonly used pain relievers are as effective as prescription pain medications.
  • Prescription drugs—for migraine sufferers who can’t manage episodes with OTC medications, there are prescription pain relievers like Imitrex, Zomig, Maxalt and Cambia. Fibromyalgia patients may be prescribed Lyrica to help with pain, fatigue and sleep problems.
  • Tricyclic antidepressants—although tricyclic antidepressants may help with anxiety and depression that is common to both fibromyalgia and chronic headaches, they may also help prevent episodes by stabilizing levels of key brain chemicals like serotonin.
  • Muscle relaxants—although it isn’t understood why, many fibromyalgia patients respond positively to muscle relaxants like Flexeril and Zanaflex. These drugs can ease pain, fatigue and tenderness.

For many patients with fibromyalgia and chronic headaches, it is important to adopt a holistic approach that includes lifestyle changes.

  • Stress management—stress is often a trigger for fibromyalgia and chronic headaches episodes, so minimizing stressors in your life is often essential. This may require modifying professional and personal responsibilities as well as taking proactive steps like mindful meditation or cognitive retraining.
  • Exercise—although regular physical activity like yoga or tai chi can help lower stress and boost mood, too much can sometimes trigger episodes. You should discuss your exercise routine with your physician so that you are properly monitored.
  • Diet—you should maintain a healthy diet in general, but you should pay special attention to what foods may trigger an attack of fibromyalgia or chronic headaches.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.