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Title of Journal: Clin Rheumatol

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Abbravation: Clinical Rheumatology

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Springer-Verlag

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DOI

10.1002/anie.201000387

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1434-9949

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Fibromyalgia and headache an epidemiological stud

Authors: Dawn A Marcus Cheryl Bernstein Thomas E Rudy
Publish Date: 2005/05/18
Volume: 24, Issue: 6, Pages: 595-601
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Abstract

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 Treatmentseeking fibromyalgia patients were evaluated with measures for fibromyalgia chronic headache quality of life and psychological distress Multivariate analysis of variance MANOVA and ttests 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 tensiontype alone n=18 combined migraine and tensiontype n=16 posttraumatic 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 HIT6 621±09 vs 483±16 p0001 HIT6 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 treatmentseeking 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 painrelated 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

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