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Fibromyalgia

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Comorbidities in Headache Disorders

Part of the book series: Headache ((HEAD))

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Abstract

Fibromyalgia (FM) is a common and disabling syndrome, characterized by widespread pain, fatigue, sleep disorders, and other associated symptoms such as cognitive dysfunction, irritable bowel, and headache.

FM is highly prevalent both in migraineurs and in patients with tension-type headache. The mean prevalence of FM in migraine patients is 19.4 %.

This comorbidity characterizes prevalently patients with chronic tension-type headache and chronic migraine. Frequency of headache, anxiety, pericranial tenderness, sleep disorders, and low physical quality of life were indicated as the main symptoms predisposing to FM comorbidity.

The common mechanism concurring in migraine, tension-type headache, and fibromyalgia is a dysfunction of pain modulation with enhanced expression of central sensitization symptoms.

Little evidence is available about the therapeutic approach to this comorbidity, amitriptyline being the sole drug indicated in FM, migraine, and tension-type headache. Duloxetine and pregabalin, used for FM, have limited evidence of efficacy in migraine and tension-type headache, as well as topiramate, flunarizine, sodium valproate, and beta-blockers in FM.

Non-pharmacological treatment, provided by transcranial magnetic and electrical stimulation, as well as other approaches, such as physical exercise and cognitive-behavioral therapy, should be the best choices to be tested in such critical patients.

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Conflict of Interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Neurophysiopathology of Pain SMBNOS Department, Bari Aldo Moro University, Policlinico General Hospital, Giovanni XXIII Building, Via Amendola 207 A, Bari, Italy

    Marina de Tommaso

  2. Department of Neurology, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil

    Luiz Paulo Queiroz

Authors
  1. Marina de Tommaso
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  2. Luiz Paulo Queiroz
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Corresponding author

Correspondence to Marina de Tommaso .

Editor information

Editors and Affiliations

  1. University "Gabriele D'Annunzio", Chieti, Italy

    Maria Adele Giamberardino

  2. Clinical and Molecular Medicine Dept, University of Rome La Sapienza, Rome, Italy

    Paolo Martelletti

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de Tommaso, M., Queiroz, L.P. (2017). Fibromyalgia. In: Giamberardino, M., Martelletti, P. (eds) Comorbidities in Headache Disorders. Headache. Springer, Cham. https://doi.org/10.1007/978-3-319-41454-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-41454-6_5

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