Chronic Headaches With Fibromyalgia

Strong headache is very problematic

Image: gpointstudio / Shutterstock

When I was 19 years old, I developed chronic headaches. I simultaneously developed insomnia. I’m not sure which one fueled the other, but it seemed to be a reciprocal relationship wherein one made the other worse. If you have fibromyalgia, then you are likely no stranger to headaches either. You also know that lack of sleep can make them worse. And when you’re experiencing muscle pain during the night, it’s hard to sleep. No sleep = worse pain and headache. Worse pain and headache = no sleep. Right? It’s a vicious cycle and it can be hard to figure out where it stops and starts.

Do people get headaches with fibromyalgia?

Interestingly, the numbers are kind of all over the board on this one. For example, the American Fibromyalgia Syndrome Association, Inc. says that 70% of patients get headaches with fibromyalgia. The National Fibromyalgia Research Association says 60%. The experts at WebMD claim 40% of people get headaches with fibromyaglia. And the American Council for Headache Education (ACHE) notes approximately 35%. But it seems like most of the people I’ve encountered with fibromyalgia have to deal with chronic headaches as well.

Obviously there are some unknowns here. This is likely for two key reasons: 1.) fibromyalgia is undoubtedly a very strange condition with uncertainties at every turn, from understanding what causes it to determining all of its symptoms and much more; and 2.) headaches occur in people without fibromyalgia all the time and the reasons range from stress and bright lights to medical conditions and food intolerances. In short, both headaches and fibromyalgia have such broad associations and variations that headaches are just kind of an add-on. Specifically, the Mayo Clinic lists headaches in the “also common” section of the symptom list, right along with depression, painful menstruation, and irritability.

So, yes, for 35-70% of patients with fibromyalgia, they get headaches with fibromyalgia. It’s a common symptom.

Why do patients get headaches with fibromyalgia?

The ACHE notes various studies that examine this very question or similar trains of thought. The findings are quite noteworthy and include: 1.) patients with fibromyalgia and headaches experienced greater sensitivity to pain, disability and more depression than patients with headache only, 2.) nearly half of headache-only patients experienced painful fibromyalgia tender points throughout their bodies, despite not actually having fibromyalgia.

Ok, so what does that actually mean? “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… 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.”

Does this answer the question as to why people with fibromyalgia often have chronic headaches? Nope. But it does indicate a distinct difference in the way fibro patients experience pain. And when you look at the similarities in fibromyalgia patients and headache-only patients, the lines start to blur when trying to decipher which comes first: the headaches or the fibro? We’re back to our chicken and egg scenario that just keeps popping up over and over with this incredibly frustrating condition. It’s rarely clear which condition comes first and/or if one is a trigger or a consequence of the other.

What can I do about my fibro headaches?

The folks at ACHE are in the business of figuring out just what to do about headaches. They offer some headache therapies that are also good for minimizing some fibromyalgia symptoms:

  • Antidepressants (these also have some pain-relieving effects)
  • Tizanidine (muscle relaxant, pain relieving effects)
  • Psychological pain management skills (stress management, coping skills, relaxation techniques, etc.)
  • Aerobic exercise

Keep in mind that there are different types of headaches. Tension-type headaches are particularly common with fibromyalgia patients. Thus, ibuprofen or acetaminophen may be helpful depending on circumstances and individual. And so can stretching or yogic exercises that specifically target the release of tension. Also, I don’t know about you, but I frequently walk away from aerobic exercise with a headache that did not exist before. It’s probably more appropriate to say that I fall down from aerobic exercise! Nevertheless, certain activities can exacerbate or even trigger headaches. Just be attentive to what brings them on for you.

Lastly, everyone is different. So while aerobic exercise or Advil may be the perfect solution for you, it may not even phase your fibro neighbor. In every case, talk to your health care practitioner to make sure the headaches aren’t related to a different condition. And, of course, ask them about the most effective ways to treat your headaches with your other medications and supplements. Have you found an effective fibro headache treatment? Tell us what works for you!