Fibromyalgia and Headaches

Headaches are common in the overall population. Most people have one at some point, and – from the simplest standpoint – the name describes it well: a headache causes your head to ache.

Beyond that, though, it gets more complicated. What kind of headache is it? What caused it? What will treat it?

Headaches can make fibromyalgia even harder to deal with – they can contribute to the pain you are already suffering from as well as to the sleep disturbances, nausea, and fatigue that characterize the disease. If you find that you are suffering from headaches or migraines with your fibromyalgia, you are not alone.

Types of headaches that may be present in FMS and ME/CFS include tension headaches and migraines. The underlying mechanisms of headaches are still being researched, but researchers have some idea what causes them.

How common are headaches in fibromyalgia?

Recurrent migraine or tension-type headaches are seen in about 70% of fibromyalgia patients and can pose a major problem in coping for this group. A 2004 study found that 76% of treatment-seeking fibromyalgia patients reported chronic headaches, and of fibromyalgia patients with headaches, 63% had migraines. For some people, aggressive treatment of the migraines also provides tremendous relief of the overall pain of fibromyalgia. Myofascial trigger points, or those knots in your neck and shoulder muscles, are the primary cause of your headaches and they can be treated.

Why are they linked?

Research has uncovered some similar mechanisms that seem to unite these three conditions, as well as several others. They represent a “family” of illnesses that has been labeled with several different umbrella terms, including “functional somatic syndromes” and “somatic illnesses.” A term gaining prominence in recent years is “central sensitivity syndromes.”

In central sensitivity syndromes, your central nervous system is highly responsive to certain kinds of input. That can include pain, noise, light, temperature, fragrance and chemicals, and more. Some of these stimuli may trigger or worsen headaches or migraines in some people.

Evidence of a Link Between Fibromyalgia and Migraine?

Dawn Marcus, MD, a professor at the University of Pittsburgh Medical Center specializing in fibromyalgia and migraines, conducted a study that shows strong evidence of a link between the two maladies. Published in the journal Clinical Rheumatology in 2005, the study examined 100 treatment-seeking fibromyalgia patients at the university’s Pain Evaluation and Treatment Institute.

The results were stark: Only 24 percent of the patients evaluated said they did not have troublesome headaches. Among 100 transformed migraine patients evaluated, 36 percent had fibromyalgia. Of 70 migraineurs tested, about 40 percent of those reported a significant number of the physical tender points consistent with that of fibromyalgia. “It was really surprising that most of them did have headaches. Most of those were migraines,” Dr. Marcus says. “There really seemed to be a link between a migraine and fibromyalgia.”

Numerous studies have indicated that fibromyalgia patients have an elevated level of what is known as “substance P,” a neuropeptide thought to be a major player in pain transmission. It has also been studied as a possible source of pain associated with migraines.

Fibromyalgia, migraines, depression, anxiety and other conditions have been linked to low levels of serotonin, a neurotransmitter often associated with mood regulation. Yet Dr. Walitt cautions against pinning the cause on one thing—substance P, serotonin or other deficiencies—in patients with fibromyalgia as well as migraines, as the root causes are more complex than one trigger. “I would shy away from over-emphasizing those types of results,” he says. In other words, substance P and serotonin theories are inconclusive, and pinning the conditions on one or the other could be shortsighted.

While Dr. Walitt says he did not know of a universally accepted study on a possible connection, he contends that the headaches fibromyalgia patients experience tend to be worse than the headaches among those without fibromyalgia. “The way they talk about their headaches, it seems to be more distressing,” he says.

Headache Triggers

No one is exactly sure of the triggers that cause severe headaches in people with fibromyalgia. Sleeping problems and fatigue are probably related to the increased number of headaches suffered during the illness. Muscle spasms and pain caused by fibromyalgia may also increase the frequency of headaches. Migraine headache triggers include light, sound, and weather. Stress often triggers frequent tension headaches.

Some research shows that headaches may be more common in those with FMS who also have depression, anxiety, sleep disturbance, and tenderness (allodynia) around the outside of the head.

What about you?

Do you suffer from headaches? Do you feel it is related to your fibro? How do you treat your headaches?

Sources: www.fmnetnews.com/fibro-basics/fibromyalgia-faqs#14, www.health.com/health/gallery/0,,20352419_5,00.html, chronicfatigue.about.com/od/whyfmscfsarelinked/a/Headaches-and-Migraines-In-Fibromyalgia-and-Chronic-Fatigue-Syndrome.htm, www.fibromyalgia-symptoms.org/fibromyalgia_chronic_headaches.html, www.headachemag.org/Articles/Lifestyle/Fibromyalgia-and-Migraine-Comorbidity/