Fibromyalgia is defined by widespread body pain, tenderness to palpation
of tender point areas, and constitutional symptoms. The literature reports
headache in about half of fibromyalgia patients. The current epidemiological
study was designed to determine the prevalence and characteristics of
headache in fibromyalgia patients. Treatment-seeking fibromyalgia patients
were evaluated with measures for fibromyalgia, chronic headache, quality
of life, and psychological distress. Multivariate analysis of variance
(MANOVA) and t-tests were used to identify significant differences,
as appropriate. A total of 100 fibromyalgia patients were screened (24
fibromyalgia without headache and 76 fibromyalgia with headache). International
Headache Society diagnoses included: migraine alone (n=15 with aura,
n=17 without aura), tension-type alone (n=18), combined migraine and
tension-type (n=16), post-traumatic (n=4), and probable analgesic overuse
headache (n=6). Fibromyalgia tender point scores and counts and most
measures of pain severity, sleep disruption, or psychological distress
were not significantly different between fibromyalgia patients with
and without headache. As expected, the fibromyalgia patients with headache
scored higher on the Headache Impact Test (HIT-6) (62.1+/-0.9 vs 48.3+/-1.6,
p<0.001). HIT-6 scores were >60 in 80% of fibromyalgia plus headache
patients, representing severe impact from headache, and 56-58 in 4%,
representing substantial impact. In summary, chronic headache was endorsed
by 76% of treatment-seeking fibromyalgia patients, with 84% reporting
substantial or severe impact from their headaches. Migraine was diagnosed
in 63% of fibromyalgia plus headache patients, with probable analgesic
overuse headache in only 8%. General measures of pain, pain-related
disability, sleep quality, and psychological distress were similar in
fibromyalgia patients with and without headache. Therefore, fibromyalgia
patients with headache do not appear to represent a significantly different
subgroup compared to fibromyalgia patients without headache. The high
prevalence and significant impact associated with chronic headache in
fibromyalgia patients, however, warrants inclusion of a headache assessment
as part of the routine evaluation of fibromyalgia patients. Marcus DA,
Bernstein C, Rudy TE. Clin Rheumatol. 2005 May 18.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15902517&query_hl=2
Credit: All abstracts retrieved from PubMed, developed by the National
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Library of Medicine (NLM).
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