Breaking the Link: Effective Strategies for Managing Fibromyalgia & Migraines

It might be difficult to distinguish between the symptoms of fibromyalgia and migraines. In this article, we will explore the connection between the two, explain what it feels like to have a migraine in addition to fibromyalgia, and equip you with the knowledge to manage this kind of headache pain.

We will also talk about the relationship with chronic fatigue syndrome and the advantages of cognitive behavioral therapy (CBT) for treating migraine headaches.

What does a migraine feel like with fibromyalgia?

The symptoms of fibromyalgia and migraines can be remarkably similar, and both share the following symptoms:

• pain, particularly a pulsating or throbbing severe headache that comes and goes in strength
• debilitating fatigue
• digestive issues, such as nausea
• sensitivity to light, sound, and smell, which might include temporary visual disturbances
• difficulty sleeping
• difficulty concentrating and brain fog
• mood challenges
• muscle tension and stiffness.

Anecdotally, people have described it as a combination of a sinus infection and a hangover, with sharp pains on the sides of the head and extra sensitivity on their scalp. Some have also reported that the headache came with widespread pain as well. For people with fibro, these occurrences don’t just involve a typical migraine headache, they frequently entail widespread pain throughout the body.

What is the link between fibromyalgia & migraines?

Because the symptoms of migraines and fibromyalgia can be difficult to distinguish, it can be a challenge to diagnose and treat. In addition, a large epidemiological study found that 55.8% of people with fibromyalgia also suffer from migraines, and that migraines for these individuals tend to be more frequent and severe than they do for other people¹.

Both conditions share a common process called central sensitization. This means your nervous system is more sensitive and can amplify stimuli, which makes you feel pain. Also, levels of certain neurotransmitters that help control pain, like serotonin and norepinephrine, can be off balance².

Chronic widespread pain

A distinguishing symptom of fibromyalgia is chronic widespread pain. This can be experienced in a variety of ways, including sharp pains or a constant, all-encompassing ache across the multiple parts of the body. This discomfort can vary in intensity, and it is frequently made worse by increased sensitivity at certain tender sites.

Such widespread pain can lead to tension headaches, which typically feel like a tight sensation across the forehead or encircling the back of the head and neck. This rigidity and soreness in regions such as the neck and shoulders can trigger migraines. Stress or holding your body in an awkward posture can also bring on tension headaches.

These links can create a feedback loop where each condition worsens the other, making chronic widespread pain a connecting element as well as a compounding factor for both fibromyalgia and migraines.

Migraines can amplify the symptoms of fibromyalgia

Experiencing migraines can intensify fibromyalgia symptoms. The heightened pain sensitivity that characterizes fibromyalgia has been shown to trigger fibromyalgia flare-ups within a day of a migraine episode³.

There seems to be a link between how often migraines occur and how intense the pain is at fibromyalgia's tender points. This suggests that migraines don't just happen alongside fibromyalgia, but actually make the fibromyalgia symptoms worse. This two-way street leads to:

• more severe migraine episodes
• an increased occurrence of migraine attacks
• more intense fibromyalgia pain episodes
• a greater frequency of fibromyalgia pain events.

Does fibromyalgia cause migraine? Or does migraine cause fibromyalgia?

The issue of what leads to what continues to be unclear – whether fibromyalgia induces the beginning of migraines or vice versa. Interestingly, research indicates that there may be a bidirectional relationship. That means that it's possible for fibromyalgia to trigger migraines and for migraines to also provoke fibromyalgia⁴.

What is the relationship between fibromyalgia migraines & CFS?

Studies have shown that 82% of migraine sufferers also experience symptoms of chronic fatigue syndrome (CFS) and irritable bowel syndrome (IBS)⁵.

This suggests that these conditions may not be isolated issues but rather interconnected elements of central sensitization.

Managing migraine pain with fibromyalgia

Managing fibromyalgia migraine symptoms requires a tailored multidisciplinary approach. It involves lifestyle changes and stress management, and might also include medication treatments.

Retraining your pain response

Our perception of chronic pain and nerve pain is profoundly influenced by our mental state, especially when such discomfort arises from physical or emotional trauma. This experience of pain is also modulated by the role that pain receptors play in our bodies.

When it comes to retraining your pain response, approaches such as cognitive behavioral therapy and mindfulness meditation are effective tools for recognizing stress triggers and controlling the interplay between stress and pain.

Medication

Medications can be used to both treat and prevent migraines.

OnabotulinumtoxinA, also known as Botox, can be used as a preventative (also known as a migraine prophylaxis). You've probably heard of Botox as a cosmetic compound, used to prevent wrinkles. However, because it works by causing the muscles to relax, it can also treat muscle spasms, muscle tension, and associated challenges such as migraines. Taking magnesium supplements is another way to help prevent these headaches⁶.

As a treatment, while medication can be a part of your comprehensive pain-management plan, it's important not to rely on it as your primary treatment. Medication should be seen as a tool that enables you to engage in other effective pain management strategies to improve your condition. These strategies may include education, lifestyle adjustments, and psychological support.

Common medications prescribed for fibromyalgia include:

• over-the-counter medications such as aspirin and ibuprofen
• antidepressants such as amitriptyline and duloxetine, which can help manage pain and improve mood
• pain and inflammation modulators such as Low Dose Naltrexone (LDN)
• anti-seizure medications such as pregabalin and gabapentin can help regulate the over-sensitized nervous system.

Your doctor is the best person to speak to about which medication or pain relievers may be suitable for your individual situation.

Lifestyle changes

Modifying lifestyle habits plays a pivotal role in managing the symptoms of both fibromyalgia and migraines. These can include:

• Adjusting your diet. Depending on your individual needs, you may need to eat more anti-inflammatory and plant-based foods, reduce your sugar intake, adhere to a low FODMAP diet, or cut out specific foods that trigger your pain^7,8.
• Establishing a regular sleep pattern and a pre-sleep ritual that promotes relaxation – this can greatly influence the quality of your sleep and reduce the sensation of tiredness, which can reduce your headaches.
• Incorporating physical activities of light to moderate intensity, ensuring these activities are performed at a level that does not aggravate any of your symptoms.

Can behavioral therapies help with fibromyalgia & migraine headaches?

According to a 2017 study in the Journal of Headache Pain, 80% of participants identified stress as a headache precipitant⁹. The American Migraine Foundation also acknowledges that behavioral therapy can play a significant role in managing stress-related triggers¹⁰.

Cognitive-behavioral therapy (CBT) is a technique that helps people to reshape their response to persistent pain and address psychological factors that exacerbate chronic pain conditions. Through CBT, you can learn to modify your physiological responses in anticipation of pain, which can lead to a reduction in both the frequency and intensity of pain episodes.

Relaxation techniques such as progressive muscle relaxation, mindfulness-based stress reduction (MBSR), and biofeedback, are also very helpful in managing stress and pain.

When to consult healthcare providers

Navigating the complexities of fibromyalgia, headache disorders, and migraines can be daunting, but you're not alone in this battle. If you're experiencing severe migraine symptoms or if these conditions are disrupting your daily life, it's essential to seek guidance from a healthcare provider.

More information

At MoreGoodDays®, we embrace a multidisciplinary approach tailored to support you in managing fibromyalgia.

We recognize the comprehensive impact fibro has on your life and so we integrate diverse strategies to address your unique needs. Our program provides psychological support – including cognitive behavioral therapy and stress-management tools – educational resources, and other symptom management techniques such as exercise, nutrition, and sleep habits to enhance your overall wellbeing and empower you.

With time, you can retrain your body's pain response. Together, we're committed to helping you lead a healthier, happier life despite the challenges of fibromyalgia.

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