A link appears to exist between fibromyalgia and migraines, research using data on a large of people with both these conditions suggests.
Its results also point to fibromyalgia as having a “stronger predictive power for the onset of migraine than did migraine for the onset” of fibromyalgia, although the link between the two appeared to work both ways.
The study, “Bidirectional association between migraine and fibromyalgia: retrospective cohort analyses of two populations,” was published in the journal BMJ Open.
One of the common symptoms of fibromyalgia is headaches. Migraines — a particularly acute type of headache — have some of the same symptoms as fibromyalgia. The two conditions can both occur in the same person; however, it isn’t totally clear whether a person with fibromyalgia is significantly more likely to develop migraines, or the other way around.
To try to untangle this connection, researchers analyzed data from the Longitudinal Health Insurance Database that stores data from the National Health Insurance of Taiwan, which insures 99% of the Taiwanese population.
They identified patients for two cohorts (groups): The fibromyalgia cohort included 33,216 patients without a history of migraine who were diagnosed with fibromyalgia between 2000 and 2010. The migraine cohort included 17,420 patients with a history of migraine but not fibromyalgia, diagnosed in the same time period.
For each group, the researchers matched patients with a control cohort without the respective disease but similar in terms of age, sex, etc., and followed from the same time-point. Each control group included four matched controls per patient in each disease group.
Then, the investigators analyzed the data to see whether fibromyalgia patients were more likely than controls to develop migraines, and vice versa.
In the fibromyalgia cohort, the incidence of migraine was 4.39 per 1,000 person-years; in the matched control cohort, the incidence of migraine was significantly lower: 2.07 per 1,000 person-years.
Similarly, the incidence of fibromyalgia in the migraine cohort was significantly higher than that in the control cohort: 7.01 vs 4.49 per 1000 person-years.
The investigators concluded that there is a bidirectional — two-way — relationship between fibromyalgia and migraine, with each increasing the likelihood that the other will develop.
This relationship remained constant even after adjusting for other factors known to influence these conditions – for example, males in both the fibromyalgia and the associated control cohort were two time more likely to develop migraines.
Of course, this data is purely a correlation; there isn’t evidence to suggest that either fibromyalgia or migraines can ’cause’ each other. Indeed, the relationship between the two is probably quite complex. For example, people with hyperlipidemia – high levels of fat in the blood – are more likely to develop fibromyalgia. Exercise can decrease blood fat levels – but exercise can also trigger migraines, which may cause people to avoid it.
The researchers write that these analyses “have the potential to guide diagnosis and treatment.” For example, they speculate that people with migraines may be more likely to be additionally diagnosed with fibromyalgia if symptoms like fatigue aren’t effectively treated.
“Therefore, clinical trials of patients with migraine in the future have the potential to evaluate the effects of FM on health outcomes and the efficacy of FM treatment,” the researchers concluded.