Headaches & Migraines in Fibromyalgia & Chronic Fatigue Syndrome

A "Family" of Conditions

Migraines with Fibromyalgia
Bruce Laurance Collection/Photographer's Choice RF/Getty Images

Headaches and migraines are common in people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). In fact, headaches of a new type, pattern, or severity" is one of the diagnostic criteria for ME/CFS. Sometimes, headaches are treated as a symptom of these conditions, while sometimes they're considered a comorbid condition.

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.

Learn more about these symptoms:

Headache & Migraine Basics

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?

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.

Tension headaches are sometimes blamed on poor posture or other factors that make the muscles of the head and neck tense.

However, several other factors may be at play. They often feel like you have a tight band around your head.

Migraines involve intense pain, often throbbing pain. Light or sound may cause extreme pain. Some people have strange visual disturbances, including blind spots, blurred vision, flashing lights, and zig-zaging lines. Sometimes, migraines cause nausea and vomiting, as well as other symptoms.

Migraines are believed to be caused by abnormal activation of the central nervous system that leads to narrowing and inflammation of the blood vessels in your head. They can last anywhere from a few hours to about three days.

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.

Learn more about headache symptoms with these articles from the Verywell.com Headaches & Migraines site:

Treating Headaches & Migraines

A wide range of medications are used to treat headaches and migraines. Over-the-counter drugs include antiinflammatories such as Motrin (ibuprofen) Aleve (naproxen,) and pain relievers like Tylenol (acetaminophen.) Of these, Tylenol may be the least effective against severe headaches.

Doctors sometimes prescribe drugs for migraines, especially chronic ones. These drug include:

  • Narcotics, such as Vicodin (hydrocodone acetaminophen) or Percocet (oxycodone acetaminophen)
  • Antidepressants, such as amitriptyline
  • Anti-seizure drugs, such as Neurontin (gabapentin) and Topamax (topiramate)
  • Other drugs such as ergotamine, Imitrex (sumatriptan), or Fioricet (butalbital, acetaminophen, caffeine)

Many of these drugs are also used to treat FMS or ME/CFS, so one treatment might help multiple conditions. (However, it's important to remember that no single treatment is likely to alleviate all of your symptoms.)

When you're taking multiple medications, it's important to talk to your doctor and pharmacist about possible side effects and drug interactions.

While some of these medications are designed to treat pain when you have it, some are aimed at preventing headaches/migraines. Your doctor can help you determine which ones may be right for you.

Preventing Headaches & Migraines

More important than treating headaches when you have them is preventing them from happening in the first place.

Treatments that may help prevent headaches and migraines include:

Again, some of these treatments may also help with symptoms of FMS and ME/CFS.

Lifestyle changes can play a big role as well. You may find that certain foods or drinks trigger your headaches, which makes avoiding them important to how you feel.

Exercise helps some people, but it's tricky when you have FMS or, especially, ME/CFS. Be sure you're not making yourself worse by doing too much! Read Exercising with FMS & ME/CFS.

Learning to manage and reduce your stress can also help.

Living with Multiple Conditions

Managing one condition is hard enough, and having more of them can complicate issues. It can help to actively treat and manage all of your conditions and, in general, live a healthy lifestyle.

Fortunately, in the case of multiple central sensitivity syndromes, you may be able to get double-duty from several treatments.

If you have problems with headaches or migraines, talk to your doctor so you can be diagnosed and start looking for effective treatments.


de Tommaso M. Expert review of neurotherapeutics. Prevalence, clinical features and potential therapies for fibromyalgia in primary headaches.

de Tommaso M, et al. Journal of headache pain. 2011 Dec;12(6):629-38. Clinical features of headache patients with fibromyalgia cormorbidity.

Kucuksen S, et al. Clinical rheumatology. 2013 Feb 27. [Epub ahead of print] The prevalence of fibromyalgia and its relation with headache characteristics in episodic migraine.

Ravindran MK, et al. BMC neurology. 2011 Mar 5;11:30. Migraine headaches in chronic fatigue syndrome (CFS): comparison of two prospective cross-sectional studies.

Smith HS, Harris R, Clauw D. Pain physician. 2011 Mar-Apr;14(2):E217-45. Fibromyalgia: an afferent processing disorder leading to a complex pain generalized syndrome.

Tietjen GE, et al. Headache. 2007 Jun;47(6):857-65. Migraine comorbidity constellations.

Yunus MB. Seminars in arthritis and rheumatism. 2008 Jun;37(6):339-52. Central sensitivity syndrome: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.

Yunus MB. Seminars in arthritis and rheumatism. 2007 Jun;36(6):339-56. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes.

Continue Reading