Is There a Link Between Fibromyalgia and Headaches?

The Skinny on Two Painful Disorders

Just like headaches, fibromyalgia hurts too.. Patrik Giardino/The Image Bank/Getty Images

Having a primary headache disorder – like migraine or tension-type headache – is burdensome enough. Unfortunately, many headache sufferers also endure other medical illnesses. One medical condition characterized by pain and fatigue – called fibromyalgia – sometimes coexists with headache disorders.  Understanding this connection may impact how you manage your symptoms, and how your doctor treats you.

What is Fibromyalgia?

Fibromyalgia (FM) is a medical condition that causes diffuse, generalized musculoskeletal pain and significant fatigue. Sufferers of fibromyalgia commonly state that they feel like they have the flu or that they "hurt all over."

How is Fibromyalgia Diagnosed?

According to the 2010 American College of Rheumatology or ACR criteria, fibromyalgia is a chronic pain condition of unknown cause characterized by the following:

  • Widespread Pain Index (WPI) ≥ 7 AND Symptom Severity (SS) scale score ≥ 5 OR WPI 3-6 AND SS scale score ≥ 9.
  • Symptoms not explained by another medical condition.

Widespread pain index (WPI) is documented by a doctor and ranges in score from 0-19, based on the number of sites that a patient reports pain over the past week (e.g. left shoulder girdle, right shoulder girdle, left hip, right hip). The Symptom Severity (SS) scale score is a number between 0-12 that includes the sum of the severity of 3 symptoms (fatigue, waking up unrefreshed in the morning, cognitive symptoms), plus the extent of somatic or "body" symptoms.

Of course, your doctor will rule out other medical conditions that can similarly cause widespread muscle pain like: thyroid disease, rheumatoid arthritis, depression, or inflammatory myopathies.

On physical exam, patients may have several sites of muscle tenderness, but typically a normal neurological and joint examination.

Laboratory tests ordered by your doctor will usually be normal and not suggestive of a medical disorder that can mimic fibromyalgia. Besides muscle pain and fatigue, other common symptoms of fibromyalgia include:

  • Psychological disturbances, especially depression and anxiety
  • Sleeping difficulties (e.g. "I feel exhausted even after a full night's sleep.")
  • Memory Loss
  •  Tension-Type Headaches

Some individuals with fibromyalgia also suffer from other pain-related medical conditions like:

  • Irritable bowel syndrome
  • Chronic pelvic pain
  • A painful bladder syndrome known as interstitial cystitis

Is There a Link Between Fibromyalgia and Headaches?

Yes. In one study in the Journal of Headache and Pain, of the 889 subjects with headaches, 20% also had fibromyalgia – including 35% with tension-type headaches and 44% with chronic tension-type headaches.

Finally, in another study in Neurology, targeting the migraine population, 35.6% of the patients with transformed migraine had fibromyalgia and 22% with episodic migraine had fibromyalgia.

These results are indicative of a positive link or association between headaches and fibromyalgia. That being said, remember an association does not mean that one medical condition causes the other. Both headaches and fibromyalgia are complex diseases – so the exact nature of the connection between them is largely unclear at this time.

Who is More Likely to Suffer from A Headache Disorder in Addition to Fibromyalgia?

The presence of a headache disorder in someone with fibromyalgia is more likely if an individual has  a large number of of headaches and has muscle tenderness around the scalp. Anxiety and sleep problems may also predispose people with fibromyalgia to develop headaches.

The Big Picture

It is not rare for people who suffer from fibromyalgia to also have a headache disorder and vice versa. If you have both, your doctor may tailor your treatment plan to effectively treat both medical conditions. Remain proactive in your healthcare.


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    DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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