Fibromyalgia

The Link Between Migraine and Fibromyalgia

The Link Between Migraine and Fibromyalgia

Migraine disease and fibromyalgia are both chronic pain disorders. Each condition is quite debilitating on its own. Fibromyalgia is characterized by widespread musculoskeletal pain along with fatigue, sleep, memory and mood issues. Over the last 15 years, researchers have found these diseases have a strong connection to one another, with fibromyalgia patients more likely to develop migraine disease as they age.3 Comorbidities are common among people with migraine, but fibromyalgia seems to have a significant symptomatic link.4 Though, researchers don’t know why these conditions tend to coexist so often.3

How Prevalent is Migraine Disease in Fibromyalgia Patients? 

At least half of people living with fibromyalgia report headache as a symptom.4 A 2005 study of 100 patients found that 63% reported severe headaches4, and a 2015 study found that 55% of fibromyalgia patients met the criteria for migraine headaches.7 Migraine disease and fibromyalgia co-occur so frequently that it suggests they share common mechanisms in pathophysiology. Both conditions involve hyperalgesia (or increased sensitivity to pain and pain response). That is a double-edged sword as hyperalgesia is partly responsible for the frequency of migraine attacks, which triggers fibromyalgia flares.2

People who have these conditions tend to report different pain sensitivity levels than those who live with just one of them.2 The widespread pain, cognitive difficulties, and fatigue involved with fibromyalgia can be amplified by migraine attacks, decreasing quality of life.5

When a 2018 study focused on migraine patients and the incidence of fibromyalgia, they found that 36.2% met the diagnostic criteria for fibromyalgia. Those patients experienced more rates of depression, sleep disruption, anxiety, and overall lower quality of life than those with migraine disease alone.1

Co-Existing Fibromyalgia and Migraine in Women

These medical conditions are more common in women than in men. A 2016 study evaluated female patients with “high frequency” episodic migraine or chronic migraine who were also diagnosed with fibromyalgia. They found that women with migraine disease had more monthly flares of fibromyalgia than those with only one condition. These flares largely came on within 12 hours of migraine onset. The more migraine attacks women with both diseases experienced, the more likely they were to have fibromyalgia pain and increased pain sensitivity. Luckily, the participants who had access to effective preventive treatments for migraine attacks had significant improvement in their flares and pain thresholds.2

Depression and Other Comorbidities

Depression is common with invisible illnesses, as is anxiety and other mood disorders. Mood issues are a hallmark of fibromyalgia, too.5 When researchers evaluated depressive symptoms, headache-related disability, and higher-intensity head pain in those with the two diseases, they found that people with both were more likely to suffer from depression and worse head pain than those living with only fibromyalgia.8 With migraine being the first cause of disability in those under 506, it makes sense that headache-related disability would be similar in those with migraine and those with the two conditions.1

People living with migraine and fibromyalgia are at a higher risk for other coexisting problems. Research of 1,730 patients with fibromyalgia showed that patients with migraine headaches were also more likely to experience these health concerns7 :

  • Hypertension
  • Asthma
  • Irritable Bowel Syndrome
  • Chronic Fatigue Syndrome
  • Depression
  • Anxiety
  • Post-Traumatic Stress Disorder (PTSD)

Improving Care and Treatment for Migraine Disease and Fibromyalgia

There is an increased disease burden in people living with fibromyalgia and migraine disease.7 This group has amplified pain sensitivity and higher fibromyalgia flares, along with more depressive symptoms and mood disorders.8 It’s critical that doctors and other medical professionals who specialize in headache or rheumatology screen for both conditions.

Treating comorbidities can be tricky and having a team of medical professionals improves the chances of finding an effective treatment plan. The link between migraine and fibromyalgia is strong, and the likelihood of developing migraine disease only increases the longer a person lives with fibromyalgia.3 Effective preventive migraine treatments may decrease monthly flares.2

If you have episodic or chronic migraine and struggle with fatigue, sleep disturbances, and overall musculoskeletal pain, it’s worth screening for fibromyalgia at your next doctor’s appointment.5 You are your best advocate when it comes to your health care. Discuss any new or ongoing unexplained symptoms, and if you’re unhappy with your provider, seek out a new specialist in your area.


References: 

  1. Beyazal, M. S., Tufekci, A., Kirbas, S., & Topaloglu, M. S. (2018). The Impact of Fibromyalgia on Disability, Anxiety, Depression, Sleep Disturbance, and Quality of Life in Patients with Migraine [Abstract]. Noro Psikiyatri Arsivi, (55), 2nd ser., 140-145. doi:10.5152/npa.2016.12691
  2. Giamberardino, M. A., Affaitati, G., Martelletti, P., Tana, C., Negro, A., Lapenna, D., . . . Costantini, R. (2016). Impact of migraine on fibromyalgia symptoms [Abstract]. The Journal of Headache and Pain, 17(1). doi:10.1186/s10194-016-0619-8
  3. Inserro, A. (2019, April 16). Study Finds Association Between Migraine, Fibromyalgia Onset. Retrieved November 06, 2020, from https://www.ajmc.com/view/study-finds-association-between-migraine-fibromyalgia-onset
  4. Marcus, D. A., Bernstein, C., & Rudy, T. E. (2005). Fibromyalgia and headache: An epidemiological study supporting migraine as part of the fibromyalgia syndrome [Abstract]. Clinical Rheumatology, 24(6), 595-601. doi:10.1007/s10067-005-1121-x
  5. Mayo Clinic Staff. (2020, October 07). Fibromyalgia. Retrieved November 06, 2020, from https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780
  6. Steiner, T. J., Stovner, L. J., Vos, T., Jensen, R., & Katsarava, Z. (2018). Migraine is first cause of disability in under 50s: Will health politicians now take notice? The Journal of Headache and Pain, 19(1). doi:10.1186/s10194-018-0846-2
  7. Vij, B., Whipple, M., Tepper, S., Mohabbat, A., Stillman, M., & Vincent, A. (2015). (210) Prevalence of migraine headaches in patients with Fibromyalgia [Abstract]. The Journal of Pain, 16(4). doi:10.1016/j.jpain.2015.01.125
  8. Whealy, M., Nanda, S., Vincent, A., Mandrekar, J., & Cutrer, F. M. (2018). Fibromyalgia in migraine: A retrospective cohort study [Abstract]. The Journal of Headache and Pain, 19(1). doi:10.1186/s10194-018-0892-9

MEET THE AUTHOR


Ashley S. Hattle has experienced episodic cluster headaches since 2007 and is a medical writer based in Southwest Michigan. She’s the award-winning author of Cluster Headaches: A Guide to Surviving One of the Most Painful Conditions Known to Man. Hattle is a passionate advocate for those living with cluster headache and other neurological disorders. Her episodic cluster headaches took over her life every six months for up to three months at a time, taking her away from school, work, friends, and family. After years of struggling to live with the condition, Hattle found Clusterbusters, a nonprofit dedicated to helping cluster headache patients, where she met her husband, who has chronic cluster headaches.
Hattle has given presentations at many conferences, including the American Headache Society Symposium, Mississippi Headache Symposium, Association of Migraine Disorders Symposium, and the Headache Cooperative of New England Annual Meeting. She has written for many publications online and in print on various topics, specializing in medical content.

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