Types of headaches
There are three types of headache that have been linked to fibromyalgia : migraines, cluster headaches, and tension headaches.
Migraines last between four and 72 hours and have some of the following features:
Preceded by symptoms (including fatigue, hunger, or anxiety)
or an aura (blurry or distorted vision signalling that a headache is about to begin)
Throbbing on one or both sides of the head
Accompanied by sensitivity to light or sound
Accompanied by nausea, vomiting, or loss of appetite
Followed by residual pain and discomfort
Some people find that a long nap following a migraine helps relieve some residual symptoms.
Cluster headaches begin as a severe burning sensation on one side of the nose or deep in one eye. They can last only 15 minutes or as long as three hours.
the pain feels like:
Feels like electric shocks or “explosions” in or behind the eye
Occurs only on one side of the face
Comes on without warning (unlike many migraines)
Tends to recur at the same time every day (often soon after falling asleep), usually for a period of several weeks
Can cause eyes to water, nose to run, or eyelids to droop
Completely resolves (until the next cluster headache)
Tension headaches are the most common type of headache in the general population. Their duration can be 30 minutes to all day (or even up to one week).
Tension headaches also:
Rarely cause severe pain; it's most often moderate or mild
Feel like a constant, band-like aching or squeezing sensation that is either right over the eyebrows or encircling the head
Come on gradually
Can happen during any part of the day, but typically occur in the latter part of the day
Migraine headaches can be incredibly painful, and the accompanying light and sound sensitivity can lead to people withdrawing to a quiet, dark space for hours at a time.
includes fatigue, irritability, problems concentrating, and dizziness.
Cluster headaches are often described by people as the worst pain they could ever imagine, like a burning ice pick being plunged into their eye. The pain from cluster headaches causes many people to fall on the floor, pull at their hair, rock back and forth, scream, and weep.
Although the pain from cluster headaches resolves and has no lingering effect like with migraines, people often feel completely exhausted after each headache.
Just as disabling as the headaches are the fear and dread that people feel knowing there is a good chance that another one is coming within hours or the next day. This anxiety can interfere with daily activities or social contact, as well as lead to insomnia.
When to See Your Doctor
You should see your doctor for any type of an unusual headache, a headache that keeps recurring, or one that lasts for a long time.
It is a good idea for Fibromyalgia to make a diary of when you are experiencing the pain, we often forget by the time we walk into the Doctors office.
write down, times, the type of headache, how long they lasted etc.
When evaluating your headache, your doctor will first likely ask you several specific questions about your headache in order to narrow down the diagnosis. These questions include:
Location: Where is the pain located?
Character: How would you describe your headache? (e.g. throbbing, aching, burning, or sharp)
Severity: What is your pain on a scale of 1 to 10, with 10 being the worst pain of your life? Would you describe your headache as mild, moderate, or severe? Is this the worst headache of your life?
Exacerbating or alleviating factors: What makes the pain better or worse?
Radiation: Does the pain radiate?
Onset: Was the onset of your head pain rapid or gradual?
Duration: How long has the pain been going on for? Is the pain constant or intermittent?
In the case of an extremely severe headache that comes on suddenly and has not occurred previously, brain imaging tests may be done to rule out a tumour or stroke.
Headache Evaluation and Diagnosis
Doctors treat headaches based on the cause. If the headache is the result of a medication side effect, you doctor may be able to substitute the offending drug or change the dosage. At other times, painkillers may be prescribed to help alleviate the symptoms.
Commonly prescribed medications include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen and Advil or ibuprofen, are usually the first-line defence in treating tension headaches and migraines.
Antidepressants known as serotonin norepinephrine reuptake inhibitors (SNRI), including venlafaxine.
Antidepressants used to treat symptoms of depression common in people with Fibromyalgia, may also help treat migraines. Since both depression and migraines are linked to low serotonin levels, restoration of those levels may improve both symptoms over time.
Triptans are a class of drug used specifically to treat migraines and cluster headaches. They bind serotonin receptors in the brain, blocking certain pain pathways and narrowing blood vessels.