Fibromyalgia Among Patients With Chronic Migraine and Chronic Tension-Type Headache: A Multicenter Prospective Cross-Sectional Study

Headache. 2017 Nov;57(10):1583-1592. doi: 10.1111/head.13191. Epub 2017 Sep 22.


Objectives: To investigate the frequency and impact of fibromyalgia among patients with chronic migraine (CM) and chronic tension-type headache (CTTH).

Background: Fibromyalgia (FM) is a common comorbidity in patients with chronic headaches. CM and CTTH are the two common types of chronic headaches.

Methods: We conducted a cross-sectional study in neurology outpatient clinics of four university hospitals and selected first-visit 136 patients with CM and 35 patients with CTTH. FM was assessed based on the 2010 American College of Rheumatology diagnostic criteria.

Results: The frequency of FM was significantly higher among patients with CM when compared to those with CTTH (91/136 [66.9%] vs 9/35 [25.7%], P < .001). Logistic regression analyses revealed an increased odds ratio (OR) for FM for patients with CM when compared to those with CTTH after adjustment for age, sex, anxiety, depression, and insomnia (OR = 3.6, 95% confidence interval = 1.1-11.4). Furthermore, CM patients with FM had higher scores in FM Impact Questionnaire compared to CTTH patients with FM (51.5 ± 16.3 vs 43.7 ± 18.7, P = .015). Comorbidity of FM was associated with increased frequency of photophobia, phonophobia, anxiety, depression, and insomnia among patients with CM. Such association was not noted among patients with CTTH.

Conclusion: FM based on 2010 American College of Rheumatology diagnostic criteria was more prevalent among patients with CM than those with CTTH. Some clinical features and comorbidities of CM varied with the presence of FM.

Keywords: anxiety; chronic headache; depression; fibromyalgia; insomnia; migraine.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Fibromyalgia / complications*
  • Fibromyalgia / epidemiology*
  • Fibromyalgia / psychology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Migraine Disorders / complications*
  • Migraine Disorders / epidemiology*
  • Migraine Disorders / psychology
  • Odds Ratio
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Tension-Type Headache / complications*
  • Tension-Type Headache / epidemiology*
  • Tension-Type Headache / psychology