Treating Fibromyalgia migraines

treating fibromyalgia migraines
Image thanks to to Nik Shuliahin

What is a migraine?
(scientifically speaking)

Migraine is a genetically determined recurrent pain syndrome accompanied by neurological and gastrointestinal features, involving interaction of external triggers and internal pathophysiology. Migraine is currently considered a complex interplay of different processes such as an alteration of pain and sensory input, increased sensitivity of the cortex leading to aura phenomena, central pain facilitation, neurogenic inflammation and brainstem nociceptor sensitisation. ~ Menken M, Munsat TL, Toole JF.

Migraine affects mainly the brainstem and diencephalon4 and is considered an abnormal amplification and sensitisation of pain pathways in these areas of the brain.

Fibromyalgia and migraines (the statistics)

Migaines are common in people with fibromyalgia. The frequency of migraine in patients with FM ranges from 45% to 80%. However, no explanations have been provided for the rate of co-occurrence.

According to the Rheumatology Network the frequency of fibromyalgia is significantly higher among patients who have chronic migraine headaches than in patients who have chronic tension-type headaches.  Also patients with chronic migraines experience more severe symptoms of fibromyalgia.

What fibro migraineurs want? 

People living with both fibromyalgia and migraines are living with severe and chronic pain. They do not particularly want explanations of migraines, or more research into the connection, or a bunch of statistics, unless it brings solutions to the problems they are living with. 

As a person living with these conditions, somedays I can barely take in any information let alone complex scientific diagrams and information. 

Processing is a part of the problem of FMS and having a migraine, however low grade makes it even more difficult. 

So what do I, and countless others want? We want simple easy to understand information told to us by someone we trust... someone who has done the research and found out what can help relieve our migraines symptoms. we want this information told to us by a person because this is the best way we can process information... hearing it from the lips of another person. 

If that cannot happen then we would like it written in simple to understand language, preferably in large font. That's why I am so pleased to present the information from The Migraine Trust. 

For over 50 years The Migraine Trust has been championing migraine research and supporting everyone affected by the condition. 

They have wonderful, helpful and thorough resources including:

  • Seeking medical adviceFrom diagnosis, to follow-up GP appointments and being referred to a specialist
  • Treatments: There are numerous migraine treatment options available from conventional medicines to supplements, herbs and other options.
  • Coping and managing: Information on coping and managing with migraine.
Best of all you can listen to expert doctors telling you ways to manage your migraines here 

I hope you find their site and their videos as helpful as I have. 

Fibromyalgia and migraines


Menken M, Munsat TL, Toole JF. The global burden of disease study: implications for neurology. Arch Neurol 2000;57:418–20.

Jacques Joubert MRCP, MD, FRACP, consultant neurologist, Epworth and Royal Melbourne Hospitals, Victoria, Australia. Migraine Diagnosis and treatment. PDF 

Penn I-W, Chuang E, Chuang T-Y, Lin CL, Kao CH. Bidirectional association between migraine and fibromyalgia: retrospective cohort analyses of two populations [published online April 8, 2019]. BMJ Open. doi: 10.1136/bmjopen-2018-026581.


What is the Fibromyalgia Impact Questionnaire (FIQ)

The Fibromyalgia Impact Questionnaire is something that I encounter a lot when reviewing research into fibromyalgia as it is often used in studies to see how something affects a person's fibromyalgia symptoms.


The Fibromyalgia Impact Questionnaire (FIQ) is an assessment and evaluation tool developed to measure fibromyalgia (FM) patient status, progress and outcomes. It has been designed to measure the areas of health that are believed to be most affected by FM. It is in the form of a two page questionaire with a further two pages of description and scoring. It is designed for the FM patient to fill out themself.


The FIQ was developed for adults with fibromyalgia. Doctors used patient reports, functional status instruments, and clinical observations to create it. 

The original Fibromyalgia Impact Questionnaire was developed in the late 1980s by Drs. Carol Burckhardt, Sharon Clark and Robert Bennett at Oregon Health & Science University in Portland, Oregon USA. At that time the clinical features of fibromyalgia were just being described, and the FIQ was an attempt to capture the total spectrum of problems related to fibromyalgia and the responses to therapy. The FIQ was first published in 1991 and since that time has been extensively used as an index of disease activity and therapeutic efficacy. Its development is described in separate reviews by Dr. Burckhardt and Dr. Bennett. Several issues regarding ethocultural usage, symptom relevance and arcane scoring became apparent and these issues have been addressed in the revised version FIQR. American College of Rheumatology


It measures physical functioning, work difficulty, including housework, morning tiredness, pain, stiffness, fatigue, and well-being including depression and anxiety, over the past week.


There are 20 questions in total. The first 11 relate to physical functioning and are rated on a 4 point scale. Most of the other questions use a horizontal linear scales marked in 10 increments on which the patient rates how they felt overall.

The FIQ is scored in such a way that a higher score indicates a greater impact of the syndrome on the person. Each of the 10 items has a maximum possible score of 10. Thus the maximum possible score is 100. The average FM patient scores about 50, severely afflicted patients are usually 70 plus.

Get the Fibromyalgia Impact Questionnaire (FIQ) pdf.

The FIQ is a useful measure of disease impact in patients with fibromyalgia. It has shown good responsiveness to change in clinical studies. 

It is a useful instrument for measuring the changes in groups of patients in treatment programs and clinical trials.  Whether it is beneficial for helping individuals and their health care providers plot changes as a result of individual treatment has not been formally tested but many clinicians use it for that purpose. ~ Dr. Carol Burckhardt.

Fibromyalgia Impact Questionnaire


Can fibromyalgia affect your hand skills?

Many people mention that they have reduced hand skills and more hand pain when they have fibromyalgia. This includes skills such as handwriting, chopping vegetables, opening cans and using keys to open the door.  It includes pain in the joints, nerves and muscles of the hand and wrist.

fibromyalgia and hand skills

Fibromyalgia can affect your hand skills due to reduced fine motor and gross motor control, increased levels of pain and peripheral neuropathy. Fibromyalgia hand pain can arise from hand use or even when not using the hands. 

Here I have summarised the results of some research done into the hand function of 40 patients with fibromyalgia. 

The authors of this 2018 research acknowledged that fibromyalgia is a potentially debilitating chronic pain syndrome. 

They aimed to compare the hand function of fibromyalgia (FM) patients and healthy individuals and to demonstrate the relationship between hand disability and FM. 

Patients and methods 

The study included 40 female patients with FM and 30 healthy people who did not have FM (control group). 

  • All participants were evaluated for pain threshold measurements, handgrip strength, and pinch strength. 
  • Functional states, hand disability, hand skills and coordination were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) form, the Disability of Arm–Shoulder–Hand (DASH) questionnaire and the Purdue Pegboard Test, respectively.
fibromyalgia and hand skills

  • Handgrip strength values, DASH score, lateral pinch strength test, Pegboard placement time, and Pegboard collection time of the patient group were significantly lower than those of the control group. 
  • A negative correlation was found between FIQ score and handgrip strength, two-point pinch strength test, three-point pinch strength test, and lateral pinch strength test in patients with moderate FM.
  • A correlation was observed between DASH score and handgrip strength, lateral pinch strength test, Purdue Pegboard placement time, and Purdue Pegboard collection time in patients with moderate FM. 

The results show that hand function was decreased in patients with FM compared to the control group. Decreasing hand function was influenced by the FIQ score. 

"As a result, the evaluation of hand function should be taken into consideration in the management of FM."

Research: Assessment of hand function and disability in fibromyalgia

  • October 2018 
  • Zeitschrift für Rheumatologie 78(43)
  • Sunday

    Does CBD help fibromyalgia?

    Here I have summarised the results from a large survey of cannabidiol (CBD) use among 2701 participants with fibromyalgia.

    CBD and fibromyalgia

    CBD, or cannabidiol, has been shown to reduce fibromyalgia symptoms by 30 to 40 percent in this 2020 University of Michigan survey of over 2,700 people with the condition.  


    • Around 32% of participants currently used CBD, mostly for pain, anxiety, and sleep.
    • Around 30 to 40% reported relief across symptom domains:
    30.5% for pain. 
    40.1% for insomnia/sleep problems. 
    40.0% for anxiety. 
    20.0% for fatigue. 
    32.3% for depression.
    21.9% for memory/mental clarity. 
    43.2% for other symptoms.
    • Participants typically tried CBD due to inadequate relief from other medications.
    • Two-thirds of participants disclosed CBD use to their doctor.
    • Only 33% asked for doctor advice on using CBD.
    • Around half of participants reported side effects, which were typically minor.
    This article indicates that CBD use is common among people with fibromyalgia.

    The results suggest that many people with fibromyalgia get benefits from using CBD across multiple symptoms domains. 

    The survey researchers recommend that doctors should discuss CBD use with their fibromyalgia patients.

    SOURCE: Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey


    Tinnitus and fibromyalgia

    Tinnitus, or ringing in the ears, is something I have lived with for over 20 years but never realized it was connected to fibromyalgia.  In this post I share how tinnitus feels to me and what I have discovered about tinnitus in fibromyalgia. 

    are fibromyalgia and tinnitus connected?

    What is Tinnitus?


    The reality of fibromyalgia and other chronic pain conditions

    The reality of fibromyalgia

    Sometimes my body tells me not to do something, so I listen. But sometimes this is difficult... like when I am at the beach, with my grandsons, and the pain just hits me and I know I will be overdoing it just to drive home.


    Dry skin brushing

    how to dry skin brush

    This article is about the ancient technique of skin brushing, how to do it and one of it's little know benefits


    Fibromyalgia clinical trials


    clinical trials into fibromyalgia

    Fibromyalgia medical research is being actively performed throughout the world. It gives us hope that we see new fibromyalgia clinical trials every few months because they are the first step in getting new evidence based treatments and even a possible understanding of what causes fibromyalgia. 

    This is the current list of clinical trials into fibromyalgia at which is a resource provided by the U.S. National Library of Medicine.

    To add a fibromyalgia clinical trial to this list, please leave a comment below.


    Fibromyalgia humor

    Humor is a great tool for dealing with life's ups and downs. Being able to see the lighter side of things is a great skill for helping us overcome problems and research has shown that it can actually support both emotional and physical health.

    Seeing the humorous side of things can help us overcome many of the stressful situations we may face when we live with chronic illness. When you see or read a joke that relates to what you are experiencing, or have experienced, it makes you feel connected to a wider community as you see that others understand and are going through the same things. That's why I love sharing #FunnyFibro humor on twitter each and every day and often on facebook.

    For those of you who are not on those platforms I am sharing some of the Funny Fibro's I shared on them last month here and hope you enjoy them.
    Fibro humor Funny Fibro

    Fibromyalgia humor

    Fibro humor Funny Fibro

    Fibro humor Funny Fibro

    Fibromyalgia humor

    Fibro humor Funny Fibro

    Fibromyalgia humor

    Fibromyalgia humor

    Fibro humor Funny Fibro

    Fibro humor Funny Fibro

    Fibro humor Funny Fibro

    Fibro humor Funny Fibro

    Fibro humor Funny Fibro

    I also have a Fibromyalgia humor board on PINTEREST


    Relevance of Mitochondrial Dysfunction in the Experimental Fibromyalgia Model.

    Fibromyalgia (FM) is one of the most common musculoskeletal pain conditions. 
    Although the cause of FM is still unknown, mitochondrial dysfunction and the overproduction of reactive oxygen intermediates (ROI) are common characteristics in its development. ROI's play diverse roles in inflammation
    Mitochondria are the “energy factory” of our body. Mitochondrial diseases are long-term, genetic, often inherited disorders that occur when mitochondria fail to produce enough energy for the body to function properly. CLEVELAND CLINIC 
    The reserpine experimental model can induce FM-related symptoms in rodents by depleting biogenic amines. However, it is unclear whether reserpine causes other processes associated with the disease characteristics of FM. 
    So far, no one has investigated the relevance of mitochondrial dysfunction in the reserpine-induced experimental FM model using protection- and insult-based mitochondrial modulators. 

    What are mitochondria?

    Mitochondria are the “energy factory” of our body. Several thousand mitochondria are in nearly every cell in the body. Their job is to process oxygen and convert substances from the foods we eat into energy. Mitochondria produce 90% of the energy our body needs to function.
    What are mitochondria?
    Reserpine (1 mg/kg) was subcutaneously injected once daily for three consecutive days in male Swiss mice. We carried out analyses of reserpine-induced FM-related symptoms, and their modulation by using mitochondrial insult on ATP synthesis (oligomycin; 1 mg/kg, intraperitoneally) or mitochondrial protection (coenzyme Q10; 150 mg/kg/5 days, orally). We also evaluated the effect of reserpine on mitochondrial function using high-resolution respirometry and oxidative status. 
    Reserpine caused:
    •  nociception, 
    • loss in muscle strength, and 
    • anxiety- and depressive-like behaviours 

    These symptoms were consistent with the clinical symptoms of FM. They did not induce body weight and temperature alterations or motor impairment.
    Reserpine-induced FM-related symptoms were increased by oligomycin and reduced by coenzyme Q10 treatment
    Reserpine caused mitochondrial dysfunction by negatively modulating the electron transport system and mitochondrial respiration (ATP synthesis) mainly in oxidative muscles and the spinal cord. 
    These results support the role of mitochondria in mediating oxidative stress and FM symptoms in this model. In this way, reserpine-inducing mitochondrial dysfunction and increased production of ROI contribute to the development and maintenance of nociceptive, fatigue, and depressive-like behaviours.


    FIBRO FILES: Fibro in the media this week.

    Fibromyalgia in the media this week.

    Chronic Pain May Be Effectively Treated Using Placebo Effect: 60 patients with osteoarthritis and 79 patients with fibromyalgia as well as 98 healthy individuals were given an inert cream to be applied on their forehand. Pavankumar Kamat, 
    July 16, 2020, Medscape.

    Cancer and Fibromyalgia: Addressing the Needs of Patients Despite Limited Research. Mary Hanley, LMSW CancerCare, July 15, 2020, Oncology Nurse Advisor. Having either cancer or fibromyalgia is a challenge that millions of Americans face every year. But how do those with comorbid cancer and fibromyalgia fare? Addressing comorbidity between cancer and fibromyalgia is an emerging, but still lacking, area of research. 

    Development for Bedtime Treatment of Fibromyalgia. Tonix Pharmaceuticals. Tonix is developing TNX-102 SL as a potential treatment for the symptoms of Fibromyalgia. It is currently in Phase 3 clinical development. TNX-102 SL targets mechanisms which are associated with disturbed sleep. It is believed that increasing sleep quality in fibromyalgia may facilitate the body's adaptive ability to modulate the perception of pain.

    Patients with fibromyalgia, OA, RA at increased risk for self-harm: according to findings published in Arthritis Care & Research. Carrie Beach, July 08, 2020, Healio. 

    “Our interest lies in examining and comparing the risk of self-harm in specific rheumatological conditions (ankylosing spondylitis, fibromyalgia, osteoarthritis and rheumatoid arthritis),” James A. Prior, BSc, MSc, PhD, of Keele University, in Staffordshire, UK.


    Basic Body Awareness Therapy for patients with fibromyalgia

    Basic Body Awareness Therapy for fibromyalgia
    The non-pharmacological management of Fibromyalgia (FM) has been the focus in many studies recently and seems to have a stronger impact on symptoms and quality of life than pharmacologic treatment. 

    New psychological support therapy showing promising results in FM includes virtual Basic Body Awareness Therapy (BBAT).
    BBAT is a movement awareness training programme that teaches patients how to correctly move, increasing awareness of body coordination. 
    They are everyday movements such as sitting, standing, walking, and lying down and standing up. The movements are simple, small and soft, and are meant to foster more functional movement quality and habits.
    Basic Body Awareness Therapy
    IMAGE thanks to Amber Life Clinic 

    In a randomised study, 20 FM patients assigned to BBAT and followed-up for 24 weeks showed a significant reduction in pain and anxiety scale scores compared to 21 people in the control group.
    Introduction: The aim of the study was to assess whether Basic Body Awareness Therapy (BBAT) improves musculoskeletal pain, movement quality, psychological function, and quality of life.
    Methods: The effects of BBAT in addition to treatment as usual (TAU) were studied in a randomized controlled trial. 
    Forty-one patients were randomly assigned to a control group (n = 21) and an intervention group (n = 20). 
    Both groups received TAU including pharmacological therapy. 
    The intervention group took part in 10 BBAT sessions. Outcome variables were measured regarding pain, movement quality, psychological function, and quality of life. 
    Outcome measures were assessed before intervention, in post test, and in follow-ups at 12 and 24 weeks. 
    Results: The BBAT group showed significant improvement in 'pain' after the testing and in 'movement quality' from baseline to 24 weeks.  
    Within the group analysis showed significant improvements in the SF-36 body pain subscale at 12 and 24 weeks, Hospital Anxiety Depression scale in anxiety subscale at 12 weeks, State-Trait Anxiety Inventory anxiety questionnaire at 12 and 24 weeks, and STAI state at 12 and 24 weeks
    Conclusion: This study showed that BBAT is an effective intervention in patients suffering from fibromyalgia in relation to pain, movement quality, and anxiety.

    BBAT has also shown significant effects in areas such as: 
    • Stroke (Lindvall, Anderzén, Carlsson, and Forsberg, 2016), 
    • Rheumatic diseases (Olsen and Skjaerven, 2016), 
    • Traumatized refugees (Madsen, Carlsson, Nordbrandt, and Jensen, 2016; Stade, Skammeritz, Hjortkaer, and Carlsson, 2015), 
    • Major depression (Danielsson and Rosberg, 2015), 
    • Chronic whiplash associated disorders (Seferiadis, Ohlin, Billhult, and Gunnarsson, 2016), 
    • Eating disorders (Catalan- Matamoros, 2007; Catalan-Matamoros et al., 2011; Thörnborg and Mattsson, 2010), 
    • Borderline personality disorders (Skatteboe, Friis, Hope, and Vaglum, 1989), 
    • Chronic pelvic pain (Mattsson, Wikman, Dahlgren, and Mattsson, 2000; Mattsson et al., 1997, 1998; Olsen et al., 2017), 
    • Long-lasting chronic pain (Bergström, Ejelöva, Mattsson, and Stålnacke, 2014)
    Basic Body Awareness Therapy for fibromyalgia

    If you are interested in doing BBAT you need to find a physiotherapist who has been trained to teach it.

    Basic Body Awareness Therapy for fibro

    FM RESEARCH SOURCE: BRAVO C, SKJAERVEN LH, ESPART A, GUITARD SEIN-ECHALUCE L, CATALAN-MATAMOROS D: Basic Body Awareness Therapy in patients suffering from fibromyalgia: A randomized clinical trial. Physiotherapy Theory Pract. 2018.