Why Do I Get Headaches with Fibromyalgia? Understanding the Connection and Finding Relief

If you’re living with fibromyalgia and dealing with frequent headaches, you’re definitely not alone in feeling frustrated by this combination. Many people with fibromyalgia find themselves asking the same question: “Why do I seem to get headaches so much more often now?”

The truth is, headaches are incredibly common for people with fibromyalgia—and there’s a real neurological reason why these two conditions often go hand in hand. Understanding this connection can help you feel less alone in your experience and work more effectively with your healthcare team to find approaches that help.

You deserve answers about what’s happening in your body, with care that takes both your fibromyalgia and headaches seriously. Let’s explore why this combination occurs and what options you have for managing both.

You’re Not Imagining It: The Fibromyalgia-Headache Connection Is Real

If you have fibromyalgia, you’re much more likely to experience headaches than someone without the condition. Research published in Clinical Rheumatology in 2005 shows that about 3 out of 4 people with fibromyalgia deal with chronic headaches¹. When researchers looked more closely at the types of headaches, they found that nearly 2 out of 3 of these actually meet the criteria for migraines¹.

This isn’t a coincidence, and it’s not “all in your head.” There’s a real, measurable connection between fibromyalgia and headaches that doctors and researchers understand much better now than they did even a few years ago.

You might have noticed that your headaches:

• Feel more intense than headaches you remember having before fibromyalgia
• Seem to happen more often during fibromyalgia flare-ups
• Come with extra sensitivity to light, sound, or even gentle touch
• Occur alongside increased tension in your neck and shoulders

The timing and intensity of headaches can vary significantly from person to person. Some people experience them more consistently, while others mainly notice them during symptom flares. 

Why Your Brain Processes Pain Differently

Here’s what’s actually happening in your body to help explain this connection: both fibromyalgia and many types of chronic headaches involve something called central sensitization. Think of this as your nervous system’s volume dial being turned up too high, making you more sensitive to signals that might not bother other people.

Rather than fibromyalgia directly causing headaches, both conditions seem to derive from the same process: your central nervous system becoming hypersensitive to pain and other sensory input. Research describes this as a shared neurological process rather than one condition causing the other².

This process helps explain why fibromyalgia involves not just widespread pain, but also:

• Sleep problems that don’t improve with rest
• Cognitive difficulties (that “fibro fog” feeling)
• Sensitivity to light, sound, and touch
• Frequent headaches or migraines

Research published in neuroimaging studies suggests that people with fibromyalgia may show different patterns of brain activity in pain-processing areas when experiencing pain stimuli³. These studies indicate that those pain-related regions (such as the posterior insula and secondary somatosensory cortices) often demonstrate heightened activation compared to individuals without fibromyalgia experiencing the same sensations.

Interestingly, similar central nervous system patterns have been observed in headache disorders and other chronic overlapping pain conditions³. This shared neurological processing may help explain why many people with fibromyalgia also experience chronic headaches. However, it’s important to note that individual experiences vary significantly, and not everyone with fibromyalgia will have headaches.

Many people notice clear connections between their headaches and other fibromyalgia symptoms. You might find that poor sleep makes both your fibromyalgia pain and headaches worse, or that stress affects both conditions in similar ways. These connections make sense when you understand that both involve your nervous system’s heightened sensitivity to various triggers.

What Treatment Options Can Help

Managing both fibromyalgia and chronic headaches often works best with approaches that address the underlying central sensitization process. The good news is that several treatment strategies show promise for helping with both conditions.

Behavioral Treatments Show Strong Promise

Behavioral therapy approaches demonstrate some of the strongest evidence for fibromyalgia management,⁹ and many people find these approaches helpful for headache symptoms as well. These treatments work by helping retrain how your nervous system processes pain signals.

You might find cognitive behavioral therapy, mindfulness-based approaches, or stress management techniques particularly helpful in tuning down the brain’s sensitivity to pain, since stress often affects both fibromyalgia pain and headache frequency. Many people begin to notice improvements within 6 to 8 weeks of starting a behavioral therapy program, though individual responses vary significantly.

Movement Therapy Can Make a Difference

Regular, gentle movement adapted to your individual capacity can be effective for many people with both fibromyalgia and headaches. This might include walking, swimming, gentle yoga, or other physical activities for fibromyalgia.

Starting slowly and gradually increasing activity often works best. Some people notice improvements within a few weeks, while others take longer to see benefits. The key is finding movement that feels manageable for you rather than pushing through increased pain.

Medication Approaches

If you’re dealing with both fibromyalgia and frequent headaches, you might wonder whether the medications that help your fibromyalgia could also provide relief for your head pain. The encouraging news is that some people do find their headaches improve when they’re taking certain fibromyalgia medications.

Several FDA-approved fibromyalgia medications have been studied for their effects on headache symptoms in people with fibromyalgia: 

Pregabalin (Lyrica) changes how your nerve cells communicate pain signals. While research from The Journal of Rheumatology in 2008 shows it can significantly reduce fibromyalgia pain¹⁰, individual responses vary and side effects may be challenging.⁴

Duloxetine (Cymbalta) and milnacipran (Savella) both work on brain chemicals that regulate pain and mood. Think of them as helping to rebalance your brain’s pain-processing system. Studies in Arthritis and Rheumatology demonstrate that duloxetine can meaningfully reduce pain and improve daily functioning¹¹. Milnacipran, which research in Clinical Therapeutics from 2008 shows reduces both pain and fatigue¹², tends to have a stronger effect on the brain chemical norepinephrine.¹³

For people with fibromyalgia who experience frequent headaches that meet migraine criteria, healthcare providers may consider migraine-specific treatments, though this represents off-label use for fibromyalgia. The shared central sensitization mechanism provides a scientific rationale for this approach.

Response rates vary significantly between different medications and individual patients. What works well for one person may not work for another, even when they have similar symptoms. Factors like your overall health, other medications, and individual brain chemistry can all influence how well different treatments work for you.

Comprehensive Approaches Work Best

Many people find the most success with a combination approach that includes:

• Behavioral therapy or stress management techniques
• Gentle, regular movement adapted to your capacity
• Sleep hygiene improvements (since poor sleep affects both conditions)
• Medication when appropriate and helpful for your situation

What to Expect from Treatment

Individual responses to treatment vary significantly, and finding the right combination often takes time and patience. Some people notice improvements within a few weeks of starting treatment, while others may need several months to see benefits or may need to try different approaches.

Timeline expectations that many people find realistic include:

• Behavioral approaches: Many people begin to notice improvements within 6-8 weeks
• Movement therapy: Benefits often develop gradually over several weeks to months
• Medications: Most fibromyalgia medications require 6-8 weeks to determine effectiveness
• Comprehensive approaches: The full benefits of combined treatments often develop over several months

Remember that your healthcare provider may need to adjust dosing or try different options to find what works best for your individual situation.

When to Seek Professional Help

If you’re experiencing both fibromyalgia and frequent headaches, working with fibromyalgia specialists who understand both conditions can be especially valuable. Consider seeking professional guidance when:

• Headaches significantly impact your quality of life
• You’re unsure about the relationship between your symptoms
• You’d like to explore evidence-based treatment approaches
• Your current treatments aren’t providing adequate relief
• You experience new or worsening headache patterns

A comprehensive evaluation may include reviewing your fibromyalgia symptoms and how headaches fit into your overall symptom pattern. Healthcare providers experienced in both fibromyalgia and headache management can help you develop personalized approaches for addressing both conditions as part of your overall care.

How Swing Care Can Help

At Swing Care, our fibromyalgia specialists understand the complex relationship between fibromyalgia and headaches. We take a comprehensive, evidence-based approach that addresses both conditions as part of your overall fibromyalgia care, recognizing the individual variation in how these conditions affect each person. Get started with our fibromyalgia assessment to explore treatment options that address both pain and headache symptoms.

Key Takeaways

The connection between fibromyalgia and headaches is very real and affects about 3 out of 4 people with fibromyalgia. Rather than one condition causing the other, both involve central sensitization, a shared neurological process where your nervous system becomes more sensitive to pain signals.

Treatment approaches show promise, though individual responses vary significantly. Behavioral therapy approaches demonstrate particularly strong evidence, while movement therapy and certain medications can also be helpful for many people. Working with healthcare providers experienced in both fibromyalgia and headache management can help you develop personalized approaches for addressing both conditions.

With the right combination of treatments and professional support, many people find meaningful improvements in both their fibromyalgia symptoms and headache frequency. Your experience is valid, help is available, and you deserve care that takes both conditions seriously.

For more comprehensive information about managing fibromyalgia symptoms, explore our fibromyalgia treatment options to learn about evidence-based approaches that may help with both fibromyalgia pain and headache management.

This information represents current medical evidence as of January 2025 and is intended for educational purposes only. The relationship between fibromyalgia and headaches involves complex neurological mechanisms that vary significantly between individuals. Treatment decisions should be made collaboratively with qualified healthcare providers who can assess your individual circumstances and medical history. Evidence quality and treatment responses vary significantly between individuals, and ongoing research continues to refine our understanding of these conditions.

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