What to Know about Fibromyalgia and Migraine

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June 13, 2022
June 13, 2022
3
minutes
What to Know about Fibromyalgia and Migraine


Fibromyalgia is a musculoskeletal condition characterized by muscle pain and tenderness in addition to changes in mood and fatigue. The American College of Rheumatology defines fibromyalgia as the following: Pain and symptoms lasting over three months, including fatigue, waking unrefreshed, and cognitive problems. Because several medical issues can mimic these symptoms, the American College of Rheumatology also states that the diagnosis can only be made if there is no other health problem that would explain the pain and other symptoms.

The causes of fibromyalgia are not completely known but are stipulated to be related to abnormal pain signaling in the brain and spinal cord. A significant amount of research has gone into finding the root cause of migraine, and we do know that it is familial, it is due to the production of inflammatory neurotransmitters throughout the sensory system of the head, and that specific triggers cause the production of these neurotransmitters. Although fibromyalgia and migraine do not appear to be linked, there are some important connections between the two.

Who gets fibromyalgia and migraine?

Both fibromyalgia and migraine are most common in women, and specifically women in working-age groups. It is not completely understood why fibromyalgia affects women more than men, however, migraine is thought to be more common in women due to fluctuations in estrogen and other hormones. There is a significant overlap between who gets these two disorders.

Genetics

Although a genetic basis for fibromyalgia has been investigated, specific genes for fibromyalgia have not yet been identified. Migraine, however, has 28 genes now identified as causing migraine, with more being investigated. In 2019, researchers began characterizing some of these genes to see if any patterns emerged. What they saw was that some people with migraine had vascular issues together with their migraine (heart conditions, stroke, blood clots, etc.), some had mood problems (anxiety, depression), and some had musculoskeletal conditions, including fibromyalgia. There currently is no genetic test that can determine whether you have any of these genes, but this research highlights the connection between migraine and fibromyalgia.

Treatments

A number of the same medications that prevent migraine also help fibromyalgia. These are primarily the antidepressants Effexor and Cymbalta, as well as amitriptyline and nortriptyline. Some muscle relaxants can be helpful for both as well, and some rheumatologists recommend trigger point injections for fibromyalgia - this can also improve neck and shoulder pain associated with migraine.

Many of the behavioral modifications we classically think about for migraine can help control fibromyalgia. Regular exercise is one of the best ways to prevent migraine and can help fibromyalgia as well. Fatigue is a hallmark of fibromyalgia, and regular sleep patterns can help both fibromyalgia and migraine. Yoga and meditation can help both, and cognitive behavioral therapy can help with anxiety and depression that can be associated with migraine and fibromyalgia.

Looking for help with headache or migraine? Try Neura Health to schedule a visit with a headache specialist within just a few days! 


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Thomas Berk, MD
Thomas Berk is Medical Director at Neura Health, where he treats Neura patients via video visit. He is a former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine.
About the Author
Thomas Berk, MD is Medical Director of Neura Health and a neurologist and headache specialist based in New York City. A former Clinical Assistant Professor at the Department of Neurology at NYU Grossman School of Medicine, he has over 12 years of clinical experience. He graduated from the NYU Grossman School of Medicine and completed his neurology residency at NYU as well. He completed a headache fellowship at the Jefferson Headache Center in Philadelphia. He is an emerging leader of the American Headache Society and has been on the Super Doctors list of rising stars for the past five years.

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