Women with migraine are at a higher risk of widespread chronic pain

Women who suffer from both episodic and chronic migraines are more likely to have widespread chronic pain, which is often diagnosed as fibromyalgia. Brazilian researchers evaluated 179 women with episodic and chronic migraine. They discovered that the more frequent were their migraine attacks, the more likely they were to have widespread chronic pain. A likely explanation of this association is the phenomenon of allodynia. Allodynia is an increased sensitivity of the skin during and after a migraine attack, which affects many migraine sufferers. Patients often report not being able to brush their hair or wear glasses because the skin becomes very sensitive. This skin sensitivity can spread from the face and scalp to involve the upper body. It is logical to assume that with frequent migraine attacks this sensitivity spreads and can involve the entire body. This sensitivity is is a reflection of increased excitability of brain cells, which has been documented to be present in migraine sufferers. If migraines are frequent and are left untreated, this increased excitability can become persistent and may predispose to other chronic pain conditions. The obvious important lesson of this study is that migraine headaches need to be treated aggressively in order to avoid the development of additional pain syndromes and impaired quality of life. This treatment should utilize all available approaches – abortive drugs such as triptans (as well as Migralex and NSAIDs), and prophylactic therapies, including aerobic exercise, biofeedback, magnesium, CoQ10, Botox injections and prophylactic drugs.

  1. Susan says: 09/13/20127:10 am

    I have had hormonal migraines for sevearal years, I am currently on topamax and that seemed to help some, however that has stopped working, I am currently on day 7 with no relief, I am taking medrol dose steroid pack that my neurologist prescribed, I am on day 3 with no relief, I have also taken imitrex with no relief. My gynecologist told me he could remove my ovaries and that could help, but I am wondering if that would make the migraines stop completely? I never heard of this and can’t seem to find a definative answer. Hoping maybe you could help or direct me to where I can find more information. I am 37, and am done having children. Thank you.

  2. Dr. Mauskop says: 04/17/201210:49 pm

    Yes, it is true that 2 out of 3 women stop having migraines after menopause, although during the transition migraines can temporarily get worse. The average age of menopause is 52, but it can occur much earlier or later.

  3. Kathy says: 04/17/201210:42 pm

    I have been a migraine suffering female since age 8. This increased during my Adolescent years. I have been through so many prevention as well as relief medications to numerous to count. For all of my adult years, I have suffered with migraines at least 20 if not more days out of the month. I had heard many years ago that after menopause a high percentage of these women had their migraines go away. Is this TRUE? I have been praying since age 23 that this indeed was a true fact and waiting for menopause for myself. I am now 48 years old and would be grateful to learn the TRUTH of no migraines after menopause. With sincerest gratitude, as well as thanking in advance for a respone.

  4. Dr. Mauskop says: 04/12/20125:45 pm

    Fibromyalgia is not necessarily a permanent condition and does go away in many people. Intensive physical therapy is the most proven treatment for this condition. Antidepressants, such as Savella and Cymbalta also help, but they are often difficult to stop because of withdrawal symptoms. They can be stopped, but often it has to be done very slowly. Acupuncture, cognitive-behavioral therapy, magnesium, CoQ10 are worth trying, since they can help without causing side effects. All these treatments also help migraines.
    Migralex is often gentler on the stomach than many other anti-inflammatory drugs because it contains magnesium which acts as a buffer.

  5. Debbie says: 04/12/20124:57 pm

    I never made this connection but I have had chronic pain in my back and neck over the past 9 months. My migraines have been very frequent and debilitating during this period and i tested negatively for lupus and nothing showed on spinal MRIs of the back. My neurologist just added Neurontin to my preventives and I noticed after I left the office that my receipt included “fibromyalgia” as a diagnosis in addition to migraine! My question is this: Is this reversible? If I can get to the point where my migraines are less frequent, will this other pain subside if it is, indeed, related to chronic migraine?
    Related to the above post, is Migralex gentler on the stomach than anti-inflammatories like Indocin and Naproxen?
    Thank you!

  6. Dr. Mauskop says: 04/04/20128:40 pm

    Unfortunately, drugs like Nexium and Prilosec (omeprazole) prevent absorption not only of magnesium, but also of vitamins, such as B12, D and other. Besides headaches, these drugs can cause osteoporosis and serious intestinal infections.
    The cheapest magnesium supplement is magnesium oxide and it is often well absorbed. If magnesium oxide causes diarrhea or just is not absorbed, chelated forms of magnesium can be tried. These include magnesium aspartate, gluconate, diglycinare, and other. Magnesium citrate in a powder form (“Natural Calm”) is another good product. If all of these cause diarrhea or do not help, I recommend MagTab SR, a slow release form of magnesium lactate, which is well absorbed, but is more expensive and you need to take at least 6 large tablets daily.
    Glad to hear that Migralex helped; we’d appreciate it if you reviewed it on Amazon.com – http://www.amazon.com/Dr-Mauskops-Migralex-20-caplets/dp/B002WEYAE4

  7. Barb Cortes says: 04/04/20127:20 pm

    My neurologist put me on lyrica when topamax stopped working on my migraines. My blood work was negative for rheumatoid/lupus, and I do have tender points and body aches, fatigue. The 200mg of lyrica has helped stop the migraines and some of the body pain. But I’m wondering if the chronic pain now is related to the migraines and not fibromyagia. My upper endospcopy was normal as well as lower GI, but I still have to take nexium for gastiric reflux which zaps the magnesium levels. I used the Migralex the other day for a break through headache and it was really helpful, advil no longer works with my zomig, thanks! Usually I would have spent the entire day with that headache:( Is there a magnesium supplement that contains a type of free magnesium that can be absorbed by the body?

  8. Dr. Mauskop says: 04/01/201212:06 pm

    Patients suffering from chronic migraines ans who respond to Botox injections appear to benefit from a surgical procedure, which involves cutting muscles in the forehead. I do not recommend this procedure for several reasons. First, migraines tend to go away with age, in women often after menopause, but sometimes even before. All surgical procedures carry a risk of excessive scarring and neuropathic pain, which is rare, but when it happens it can be very difficult to treat. This surgery works only for patients who have pain in the front of the head since you cannot cut all the muscles around the scalp. Because Botox injections are now approved by the FDA for chronic migraines, they are usually covered by most insurance companies, while surgery is not. The study we are conducting with a vagus nerve stimulator is currently limited to patients with episodic and not chronic migraines – migraines occurring on fewer than 15 days each month.

  9. Taryn says: 04/01/201211:10 am

    I have also read about the plastic surgery where the surgeon does something with the forehead. He removes something from there and from what I have read it is helpful and can last for 5 years or longer. I read about it in the UK. I don’t know if they do it here in the US? Would you recommend it? I would be very interested in your study using the thing by the neck. I am running out of options. Do you know if botox is covered by insurance? I know it is FDA approved, but?? Thank you for your time. Taryn

  10. Dr. Mauskop says: 03/31/201211:54 am

    Yes, Botox can help migraines regardless of the type – menstrual migraine, migraine with or without aura, exercise-induced migraine, weather-related migraine, etc. Overall efficacy of Botox is about 70%. Researchers are trying to determine factors which will help us predict who is more likely to respond to Botox. Botox definitely will not help migraine aura which occurs without a headache. However, if the aura is always followed by a headache, with repeated Botox injections not only the headache goes away, but often the aura stops occurring as well.

  11. Taryn says: 03/31/201210:42 am

    Will Botox help menstrual migraines? I am getting a hysterectomy Monday, but will not take out my ovaries because I read migraines can get worse. I have tried everything short of shooting myself, which I did attempt suicide once. They are so painful and I can’t take them anymore. Would appreciate help. Thanks, Taryn

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