Migraine and fibromyalgia do have several common factors: They both are much more likely to occur in women, and they have some common symptoms, including headaches, sensitivity to loud noises or bright lights, and gastrointestinal issues, according to the U.S. Office on Women’s Health. Symptoms of depression are more likely to occur in people who have both migraine and fibromyalgia, according to a study published in July 2018 in the Journal of Headache Pain. Learn more about how these two conditions are related, as well as what treatment options exist for the headache pain that can occur in both migraine and fibromyalgia.
1. Does Fibromyalgia Cause Migraine? Or Does Migraine Cause Fibromyalgia?
“There is definitely a correlation, because it seems that patients with migraine have higher prevalence of fibromyalgia and vice versa,” says Roderick Spears, MD, a clinical associate professor of neurology and a neurologist and headache specialist at Penn Medicine in Philadelphia. A correlation means if you have one disorder, you’re more likely to have the other, says Spears. Over 30 percent of people with migraine also have fibromyalgia, according to a study published in Clinical Rheumatology, and the frequency of migraine in people with fibromyalgia is 55.8 percent, according to a paper published in Headache in June 2015. “It isn’t clear why having migraine makes fibromyalgia more likely or vice versa,” he says. Another way diseases or disorders can have a relationship is if they’re related to the same physiological system, or if the systems overlap in some way, says Dr. Spears. “For example, take the relationship between depression and chronic migraine. Depression is psychiatric, and chronic migraine is neurological, but serotonin is involved in both disorders,” says Spears. Currently there is no clear evidence of that type of relationship between migraine and fibromyalgia, but there is potentially some neurological and musculoskeletal overlap as far as what’s happening in the body in both these conditions, he says. “Right now we aren’t certain about what is happening in the body or brain that would make a person more likely to have both fibromyalgia and migraine,” says Spears.
2. Can a Headache Be a Symptom of Fibromyalgia?
“Headache can absolutely be a symptom of fibromyalgia; it’s one of the most common symptoms. The headaches are typically tension-type headaches or migraine,” says Spears. Other symptoms of fibromyalgia include chronic pain and stiffness, fatigue, sleep issues, and problems with thinking, memory, and concentration, according to the Centers for Disease Control and Prevention (CDC). A tension-type headache is the most common type of primary headache, according to StatPearls. A primary headache is a headache that isn’t caused by another condition or illness. Tension headaches can last from 30 minutes to seven days; migraine attacks tend to last anywhere from four hours to three days. Tension headaches typically have pain on both sides of the head (migraine headaches are usually on one side) and they don’t get worse with activity. Migraine headaches are often more intense than tension headaches and worsen with activity — that’s why many people retreat to a dark room to rest during an attack. Nausea and visual disturbances such as flashing lights or spots can also be part of migraine, according to the American Migraine Foundation.
3. Does Having Fibromyalgia Affect How Migraine Is Managed?
Typically, having fibromyalgia makes migraine more severe, says Spears. “When deciding on a medication or therapy, we try to choose one that will address both disorders,” he adds. There’s evidence that the class of antidepressants known as SNRIs (serotonin and norepinephrine reuptake inhibitors), which includes Cymbalta (duloxetine) and Effexor (venlafaxine), can address fibromyalgia and be effective as a preventive medication for migraine, says Spears. “Antiseizure medications such as Lyrica (pregabalin) and Neurontin (gabapentin) can help with fibromyalgia pain and have beneficial effects for headache as well,” he says.
4. How Do I Get Rid of a Fibromyalgia Headache?
The best treatment depends on the type of headache, says Spears. “If it’s a tension-type headache, you would probably treat with a nonsteroidal anti-inflammatory (NSAID) such as naproxen or ibuprofen,” he says. “If it is a migraine-type headache, we would want to treat with a migraine-specific therapy, which would include the triptans or the new class, called gepants, that includes Ubrelvy (ubrogepant) and Nurtec ODT (rimegepant),” says Spears. Gepants are antagonists of the calcitonin gene-related peptide (CGRP) receptor, meaning they block the ability of CGRP — a pain-related neuropeptide that is elevated in migraine — to bind to the CGRP “docking station,” thereby potentially preventing or shortening a migraine attack, according to a paper published in April 2020 in Headache.
5. Can Behavioral Therapies Help With Fibromyalgia and Migraine Headaches?
An estimated 4 out 5 people cite stress as a trigger for headaches, according to a study published in July 2017 in the Journal of Headache Pain. Managing stress through behavioral therapies such as mindfulness-based meditation, cognitive behavioral therapy, biofeedback, and acceptance and commitment therapy can benefit some people with migraine and headaches, according to the American Migraine Foundation. The effectiveness of these therapies is based on the premise that by changing the way they deal with stress, people may experience fewer migraine attacks or less severe attacks, says Rebecca Wells, MD, MPH, an associate professor of neurology at Wake Forest Baptist Health in Winston-Salem, North Carolina, the director of the comprehensive headache program, and an associate director of clinical research at its center for integrative medicine. “We’re trying to understand if practicing mindfulness can decrease the likelihood that you’re going to experience an event as stressful, or when a stressful event does happen, you’re able to better respond to it,” says Dr. Wells. A review published in Current Rheumatological Reports in July 2017 found that mindfulness meditation may be an effective complementary treatment approach for people with fibromyalgia, especially when combined with exercise and cognitive behavioral therapy. Cognitive behavioral therapy aims to change the way people think about difficult or stressful situations so that they may respond to these challenges in a more positive and productive way. RELATED: How Psychotherapy Can Help With Migraine
6. What Types of Lifestyle Interventions May Improve Migraine and Fibromyalgia?
“There are a few lifestyle habits that may help with both migraine and fibromyalgia,” says Spears.
Get enough sleep. Sleep deprivation has been shown to increase the risk of migraine attacks, as well as the frequency and severity, according to a study published in Pain. Research published in April 2015 in Nature Reviews Rheumatology found that lack of sleep is associated with increased symptoms of fibromyalgia as well. “Regulating sleep is important in managing both conditions,” says Spears.Follow a wholesome diet. “I recommend that people with these conditions avoid artificial sweeteners and limit processed foods,” he says.Stay hydrated. Spears suggests trying to drink at least 64 ounces (about two liters) of water a day.Exercise if at all possible. “Some people with fibromyalgia can’t exercise because of physical pain, and some people with migraine can’t exercise because it triggers more migraine headache. However, I do think activity can benefit those individuals who can tolerate it,” says Spears.
