Is Migraine a “Symptom” of Fibromyalgia?

I was recently doing some reading on fibromyalgia, and noticed something interesting.  Once in a while migraine is listed as a symptom of fibromyalgia.

Fibromyalgia and Migraine

For example, the National Fibromyalgia Association (USA) (a website which I respect, by the way) says:  Additional symptoms [of fibromyalgia] may include: … headaches and migraines …

Now, to be fair, this statement is under the heading of "Other symptoms/overlapping conditions".  Still, they revert to using just the term symptoms when they actually describe the relationship between migraine (attacks) and fibromyalgia.

Another site writes:  Headaches are an extremely common symptom of fibromyalgia. In fact, more than 50% of people with fibromyalgia suffer from constant headaches or migraines.

However, this site goes on to explain that there may be a common cause or dysfunction for both migraine and fibromyalgia.  Unfortunately, the information on migraine on this site is very out of date.

Two things having a common cause – one thing being a symptom of the other – those are two very different scenarios.  But does it really matter?  After all, if two things have a common cause, isn’t it likely that treating one may treat the other as well, even if one isn’t technically a symptom of the other?

Yes, it’s true that treating one may help with the other.  But I’m afraid simply calling migraine a "symptom" of fibromyalgia may oversimplify the matter.

Here’s what we do know:

  • People with fibromyalgia are much more likely to suffer from migraine attacks.  (Some say "migraine-like" headaches, but I’m not sure that’s a useful distinction)
  • There are many treatments that are common to both
  • There are common co-morbid conditions (conditions that tend to go along with migraine or fibromyalgia), such as irritable bowel syndrome and allodynia
  • Researchers have noticed similar dysfunctions in migraine and fibromyalgia patients (for example, in the serotonergic (serotonin) and adrenergic systems.
  • Not everyone with migraine has fibromyalgia, and not everyone with fibromyalgia has migraine

Although we know there are many commonalities between migraine and fibromyalgia, we don’t know the cause of either, and we don’t know for sure why many people tend to have both.  Could it be that they both are manifestations of the same disease?  Or could it be that there are mechanisms in one that tend to trigger the symptoms of the other?  Though we’ve learned a lot about both in the past few years, we still can’t answer these questions with certainty.

Because of this uncertainty, I think it’s better to call migraine a co-morbid condition, or an overlapping condition.  Treating fibromyalgia alone may or may not take care of your migraine attacks.  We need to be honest about this.  (I’m not suggesting the sites above are intentionally dishonest – I’m just saying that terminology is important in this case.)

That being said, here’s what we should continue doing in relation to the migraine fibromyalgia connection:

  • Continue to research the connection, the related mechanisms of the two.
  • Don’t just treat one or the other – investigate treatments for both.
  • Consider treatments that may be able to treat both.  Be sure your doctor is aware that you’re dealing with both conditions (if you are).
  • Although we still don’t understand the connection, recognize that one could actually lead to the other.  If this is the case, it’s another reason not to put off proper treatment of either migraine or fibromyalgia.

To learn more about fibromyalgia, visit the National Fibromyalgia Association website.

What do you think?  Is this an important distinction?  Does it matter if migraine is a symptom or a co-morbid condition?

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10 comments… add one
  • Kara Apr 20, 2011

    I have suffered from migraines since I was in the 5th grade. I had no head trauma and didn’t know why, and I still don’t know why. Recently about a year ago my doctor diagnosed me with Fibromyalgia. I continue getting migraines, yet the severity and frequency of them has gone up.

  • Christine Apr 21, 2011

    GOOD article. I have suffered from migraines for over 20 years now, since middle school. Almost 2 years ago I was diagnosed with fibromyalgia. I treat them as 2 separate entities, but like you wrote, they have many overlapping qualities, and often I feel that when I am treating one it is also helping symptoms of the other indirectly. It’s interesting, it’s confusing, but I hope doctors can make some more headway and figure things out! I def feel like both have made me realize that my body is highly sensitive — to weather changes, certain foods or food combinations, chemical in foods and beauty products, cleaning products etc.! The more I discover about fibro research the more I feel that it falls into the Neurological field, and my awesome Migraine/Neuro doctor is experienced in treating fibro too, so I feel very lucky that he is my go to for both.

  • Candace Apr 23, 2011

    Therre is strong evidence that fibromyalgia is caused by hypothyroidism. Unfortunately, doctors today ignore blatant hypo symptoms if the TSH and T4 or T3 are “within range”. For more information, google “Dr John Lowe fibromyalgia”. There are many people with both migraine and fibro, but this does not necessarily mean they are connected.

  • Sile Apr 29, 2011

    I think the term misery loves company applies to the pain in migraine and fibromyalgia. I agree that neither causes the other but that if you understand how to get rid of pain, then other conditions such as IBS will also disappear.

  • Nanci Apr 30, 2011

    I just want to say that I have suffered from Migraines for over 20 years. Then I was diagnosed with rheumatoid arthritis, then fibromyalgia, then hypothyroidism. There has to be a definite connection with these auto immune conditions. This is a very difficuly way to live with all these ailments. The social security disibility board should be aware of the struggles of anyone that has these diseases.

  • Christine Apr 30, 2011

    Good one Sile, misery def seems t enjoy company! I agree, I practice treating my overall/whole body and getting it to a healthy state, and along the way a lot of my co-morbid conditions have gone away as a nice, unexpected result!

  • Celeste Cooper May 12, 2011

    Great article and I couldn’t agree more. Migraine is a comorbid condition, meaning that it occurs more in this population of patients than others.

    I am the author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain (co-author, Jeff Miller, PhD), and am well read on this subject as a patient and an advocate.

    Presently, I am in communication with one of the Rheumatologists that is authoring the Preliminary Proposed Diagnostic Criteria for FM. I have discussed with him my continued concern regarding symptoms of conditions (which also includes other comorbid IBS, IC, Raynauds, hypothyroidism, RLS etc) as what they are and not symptoms of FM. We have all fallen prey to ACR criteria, but it needs to be changed.

    The treatments for these other comorbid conditions, including the presence of myofascial trigger points, which has been completely omitted from the new criteria (yet myofascial pain is the PRIMARY symptom of FM, and can play a huge role in migraine), are not treated the same. Certainly, drugs that work on the CNS, might affect comorbid conditions that are also centrally mediated, but they will not treat such things as hypothyroidism.

    It is important that headache, which could be listed as a symptom of FM, I suppose, should not be used synonymously with FM. That is the key.

  • JANET FERN Oct 18, 2011

    i had migraines (as a teenager) and now I have FM(diagnosed), I believe my mum had the same(undiagnosed). My brother has thyroid problems and my two daughters each have severe migraines. Could all these conditions have the same root cause? My GP has me on fluoxitine plus pain killers. If my daughters have Hemiplegic migraine then I am concerned that they may not be on the correct medication. Help, I am going round in circles!!
    J.

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