Fibromyalgia and headaches seem to go hand in hand. I have always been one, ever since I was young, to be very prone to headaches. These days if I do not have a migraine, I have a bad headache. A lot of the research focuses on migraine disease and fibromyalgia. Both migraine disease and fibromyalgia syndrome are neurological diseases that cause sensory overload… they feed off each other and over time brain receptors become more sensitive to pain. Pain begets pain.
Although the statistics vary, researchers have suggested that a chronic headache comorbidity may exist in as many as 76% of fibromyalgia patients. Migraine tends to be the most common of these headache disorders, with separate studies showing that more than half had probable migraine.Theraspecs
A lifetime prevalence study showed that current migraine is present in around 45% of patients with fibromyalgia. In addition, a lifetime history of migraine is present in 55% of patients with fibromyalgia. It was seen that the onset of migraine before fibromyalgia was 67%. Migraine was diagnosed in the same year as fibromyalgia in 11% of patients and occurred at least 1 year after onset of fibromyalgia in 22% patientNews Medical
Chronic headaches and Migraine in Fibromyalgia
Migraine can often be underdiagnosed in fibromyalgia due to the fact we get so many severe headaches and not everyone with a migraine disease gets an aura to define it easily by a doctor. Even as is there are quite comorbid conditions.
A study of 100 people with migraine disease indicated fibromyalgia in 36% of the people with migraine disease. Of those with both fibromyalgia and migraine, they experienced greater pain severity and more depression. (Help for Headaches)
There was another study with 70 people with fibromyalgia compared to people with chronic headache types. 35% of people with fibromyalgia in the study reported migraine or tension-type headaches. 42% of the headache patients had painful fibro tender points throughout the body. Those with both headache and fibromyalgia reported more pain, disability, and depression than those with headache diseases and types alone. (Help for Headaches)
These studies suggest that fibromyalgia, like some types of chronic headache, may be associated with increased excitation within the nervous system, which means it over-responds to stimulation that is not normally painful. Similar to migraine, abnormalities in serotonin, a brain chemical involved in fine-tuning painful experiences, may be contributing to the increased excitation in fibromyalgia. Also, levels of substance P, a brain chemical that is involved in pain sensation, are high in patients with fibromyalgia. Finally, patients with fibromyalgia and patients with chronic headaches respond in similar ways to stress, and differently from people who do not have fibromyalgia or frequent headaches.Help for headaches
More fibromyalgia flares?
It seems like headache disorders do not play well with fibromyalgia as we saw with the studies about. More disability, more pain intensity, more depression. Yay. But some research suggests more frequent fibromyalgia flare-ups as well. So not cool. At all.
Unfortunately, there are unique challenges if you have been diagnosed with both fibromyalgia and a primary headache disorder—especially chronic or transformed migraine. Patients may tend to experience a higher number of pain flares (approximately 20 per month) and were recorded as averaging 19 migraine attacks per month. For context, 15 migraine days per month fulfills the diagnostic criteria for chronicity. In addition, chronic migraine appears to have a direct influence on fibromyalgia flares, with 87% occurring within 12 hours of a migraine attack.3 This may mean that migraine acts as an independent ‘trigger’ for fibromyalgia. Although general pain levels are comparable, one small study did show worsening headache severity when both chronic migraine and fibromyalgia were present.4Theraspecs
It seems fibromyalgia does not play well with migraine disease Either. Because in both there is photophobia. 63% of people with fibromyalgia said they had photophobia between migraine attacks and 97% believed light was a trigger itself. (Count me in on both those stats) (Theraspecs)
Depression and anxiety
We saw in the studies mentioned about this is an issue with the migraine and fibromyalgia combo.
With depression and a headache disorder, Depression is seen in 46% and Anxiety in 39%
And this means that treatment is complex. It is not just treating the headache disorder And the fibromyalgia, which is complex enough, it is also managing and treating comorbid mental illness issues. I know I have Major Depressive Disorder and I can say this combination of chronic migraine, fibromyalgia and depression is brutal and difficult to manage and treat. It has to be tackled all at the same time I find, for it to be effective. And for that, I needed to go to the pain clinic where I could see a psychologist, a psychiatrist, their pain specialist and take part in their programs.
Co-morbidity between fibromyalgia and migraine involves heightened somatic hyperalgesia compared to one condition only. Increased migraine frequency – with shift towards chronicity – enhances both hyperalgesia and spontaneous FMS pain, which is reversed by effective migraine prophylaxis. These results suggest different levels of central sensitization in patients with migraine, fibromyalgia or both conditions and a role for migraine as a triggering factor for FMS.Study
Hyperalgesia is an abnormal sensitivity to pain is a key feature of fibromyalgia but this study shows that both conditions’ sensitivity to pain interacts triggering fibromyalgia.
Either way, we can see the similarities between the two conditions such that they feed of each other worsening each other in various ways. This not only increases disability but also complicates treatment. However, some medications used for fibromyalgia are also used for migraine prevention so there can be an overlap in treatment when it comes to medication. Not to mention some de-stressing techniques like meditation and yoga can assist with both.
I found it best to tackle the fibromyalgia, migraine, depression ball of hell in one lump sum of treatment. It took time and therapy and medication but it improved my quality of life and coping skills. However, I have never had much luck with migraine prevention treatment and have been told I am non-responsive to the medication. I wonder how many others with this combo have the same issue. That the complexity of these two conditions feeding off each other and increasing the intensity makes one less responsive to treatment. So I have found more benefit in managing my depression with therapy and medication. Improving my coping skills. Decreasing work… until I became disabled by further health issues. And just trying to manage the pain as best I could since it didn’t seem to be going anywhere.