Headaches and migraines are common in people with fibromyalgia 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 other times they are considered a comorbid condition.

How they are connected

Fibromyalgia and ME / CFS belong to a group of diseases that have been labeled with several different general terms, including functional somatic syndromes and somatic diseases.

Another term that has gained more importance in recent years is central sensitivity syndromes. These syndromes are defined as diseases with physical symptoms that cannot be fully explained or diagnosed as an established medical condition.

Migraine has long been associated with functional somatic syndromes, including ME / CFS and fibromyalgia; which means that the conditions often occur together. Although it is not yet clear why this happens, researchers are studying the possibility that one of the underlying mechanisms that the three conditions may share is central sensitization.

Central sensitization is associated with a number of diseases, including mental health disorders, and occurs after repeated exposure to certain stimuli such as touch, noise, light, temperature, fragrance, and chemicals.

Gradually, the central nervous system becomes abnormally hypersensitive to a stimulus or stimulus (the factors responsible can vary from person to person), intensifying pain.

Scientists are still trying to understand exactly what causes central sensitization, but it appears to have both a biological and a psychosocial basis. So far, the assumptions include:

  • Inflammation
  • Deregulation in the central nervous system pathways
  • A dysfunctional stress response system, particularly on the hypothalamic-pituitary-adrenal axis (HPA).
  • Deregulation of the autonomic nervous system, which controls automatic functions such as breathing, heart rate, and digestion.
  • Changes in the way the brain stem processes stimuli

A manifestation of central sensitization is called allodynia, a type of pain that occurs in response to a stimulus that would not normally cause pain, usually by touch. Allodynia is associated with migraine, fibromyalgia, and sometimes ME / CFS.

It will be interesting to see what future research reveals about the relationship between migraine, fibromyalgia, and chronic fatigue syndrome, particularly as it relates to central sensitization.

Treatment for headaches and migraines

Because treating fibromyalgia and ME / CFS involves managing your symptoms, it’s crucial to stay on top of your headache. The types of headaches that may be present in fibromyalgia and ME / CFS include tension headaches and migraines. Fortunately, there is a wide range of options when it comes to treatment.

How to prevent headaches and migraines

More important than treating headaches when you have them is preventing them from happening in the first place, especially since minimizing headaches can help lessen fibromyalgia and ME / CFS symptoms as well.


Medications that the doctor may prescribe to help reduce the frequency of your migraines include:

  • Biologicals, such as Aimovig (erenumab) and Ajovy (fremanezumab-vfrm)
  • Beta-blockers like Inderal (propranolol), Toprol (metoprolol) and timolol
  • Antidepressants, such as amitriptyline
  • Anticonvulsants like Neurontin (gabapentin), Depakote (divalproex), and Topamax (topiramate)

Some of the medications are also used to treat the symptoms of fibromyalgia and chronic fatigue syndrome, so a single treatment could help multiple conditions. That said, it is important to remember that there is no single treatment that can alleviate all symptoms when it comes to treating more than one condition.

Non-pharmacological measures

Beyond preventive medication, some other measures that can help prevent headaches and migraines include:

  • Acupuncture
  • Chiropractic
  • Biofeedback
  • Hypnotherapy
  • Physiotherapy
  • Transcranial magnetic stimulation

As with medications, some of these treatments can also help with fibromyalgia and ME / CFS symptoms.

Changes in lifestyle

Lifestyle changes can play a role in the treatment of migraine-fibromyalgia-ME / CFS as well, including:

Diet changes: You may find that certain foods or drinks trigger your headaches, making avoiding them important for how you feel.

Exercise: Although exercise helps some people, it is difficult when you have fibromyalgia or especially ME / CFS. Make sure you are not getting worse by overdoing it.

Stress reduction: Learning to control and reduce stress can also help, especially since stress is a major trigger for headaches and migraines.

Managing a condition tends to be difficult, and having more of them can complicate matters. Actively working to treat and manage all your conditions, and generally leading a healthy lifestyle, can make a noticeable difference in your quality of life. Fortunately, in the case of migraine, fibromyalgia, and ME / CFS, you may be able to get double shifts with various treatments and preventive measures.

If you have problems with headaches or migraines, talk to your doctor so he can get a diagnosis and start looking for effective treatments.