Migraine and fibromyalgia: what is the connection?

Studies show a strong association between migraine and fibromyalgia.
“These conditions share overlapping mechanisms that imply the way the brain treats pain,” said Daniel Arkfeld, MD, rheumatologist at Keck School Medicine of USC in Los Angeles. “There is an growing set of research suggesting that the two conditions arise from central awareness – an increased response from the nervous system to pain signals.”
Does one cause the other?
Although there is no final evidence that migraine causes fibromyalgia or vice versa, researchers think that they can share common pathways that increase vulnerability to chronic pain.
“A theory is that repeated migraine attacks could change the way the nervous system reacts to pain over time, which has potentially triggered fibromyalgia in people who are already predisposed,” said Dawn Buse, PhD, clinical professor of neurology at Albert Einstein College of Medicine in New York. “On the other hand, the first symptoms of fibromyalgia – such as pain and stiffness in the neck and shoulders – can activate the nerve roads and contribute to the start of migraine.”
Other studies are necessary to fully understand the bidirectional relationship, but physiological overlap – in particular involving neurotransmitters like serotonin – suggests a shared biological basis.