Navigating the Pain: How Opioids for Fibromyalgia Can Trigger Migraine
Fibromyalgia is an ongoing (chronic) and complicated condition. Those living with it experience “widespread pain, primarily affecting the muscles, bones, and joints” and a “hypersensitivity to both painful and non-painful stimuli.”1
Fibromyalgia is a painful condition to live within itself. But some people live with both fibromyalgia and migraine.
While it “is unclear if migraine triggers fibromyalgia or fibromyalgia triggers migraine,” the “underlying pathophysiology may be similar among those with migraine and fibromyalgia.” This means that some of the treatment options for fibromyalgia can also be used to treat migraine. There are various methods to manage fibromyalgia. But some people end up needing opioids to manage their chronic pain.1
What does living with fibromyalgia look like?
Fibromyalgia is described as “a chronic (long-lasting) disorder that causes pain and tenderness throughout the body, as well as fatigue and trouble sleeping.” Living with fibromyalgia is difficult. It is impossible to plan ahead because you do not know how you will feel until you wake up in the morning.2
Some of my struggles with fibromyalgia include:
- Muscle pain and spasms
- Joint pain
- Numbness
- Hypersensitivity (in my case, high sensitivity to physical touch, lights, smells, and sounds)
What treatments do I use?
There is no cure for fibromyalgia, but doctors can help you manage the symptoms with a “combination of exercise or other movement therapies, psychological and behavioral therapy, and medications.” I have tried physical therapy and aqua therapy to get me moving more, but the pain persisted.2
Before I take my opioid prescription on bad days, I try a variety of other ways to manage my fibromyalgia pain. These include:
- A hot shower/bath
- Heating pads
- Gentle stretches
- Lidocaine patches
- Muscle relaxers
I spend the time trying these methods because they are better for my body than taking the opioid prescription. Plus, these ways of managing my fibromyalgia will not trigger a migraine attack.
Why have I used opioids to treat my fibromyalgia?
Opioids are not the first choice for treating fibromyalgia. There are a variety of treatments that should be used before opioids. Unfortunately, I have tried all the various treatments without much success. I still take gabapentin because it is the only thing that helps a bit with the numbness and tingling in my arms and legs.
With that in mind, my doctor and I decided that an opioid could possibly help with my pain. The drug I am prescribed is called Nucynta®. We chose this medicine because I cannot take some of the other options, such as tramadol and codeine medicines.
I have had my prescription for Nucynta for many years. But I do not use the full amount I am prescribed every month. Despite my high pain levels, I use my Nucynta sparingly for fibromyalgia pain. I also avoid taking it sometimes because I am concerned about the effects it will have on my head. But there are days that I simply cannot avoid taking it.
How have opioids impacted my migraine?
There is a lot of information available about migraine issues from opioid overuse. But there is not as much about the occasional use of opioids triggering a migraine episode. For me, a single dose of an opioid can result in a migraine. These migraine attacks feel similar to a naturally occurring migraine. The difference is, the abortive drug I take does not help ease the pain of an opioid-induced migraine.
In conclusion, though opioids can help with fibromyalgia pain, their use can also trigger migraine attacks in some people. Due to this, you and your doctor should explore other options before resorting to opioids. This is especially true if you are prone to migraine. There are a variety of drug and nondrug options for managing the symptoms of fibromyalgia.
Do you have experience with opioids, fibromyalgia, and migraine?
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