Fibromyalgia Comorbidities: What Conditions Overlap With Fibromyalgia?

Fibromyalgia is a chronic health condition that causes pain and other symptoms, such as headaches, fatigue, anxiety, and depression. Experts aren’t sure what causes fibromyalgia, but if you have it, you may be more likely to have some other conditions that share these symptoms as well. If you have these conditions at the same time as fibromyalgia, they're known as comorbidities. 

Migraine can be severe and may make you sensitive to light and sound. Chronic migraine is when a headache occurs on 15 or more days per month. A tension-type headache is different — it feels like there’s a tight band around your head.  In one survey of people with fibromyalgia, more than half had migraine headaches. With both conditions, your central nervous system is hypersensitive to stimuli.  In a study of headache patients, 36% had fibromyalgia. Among the people with fibromyalgia, tension-type headache was the most common type of headache, followed by episodic and chronic migraine. It’s unclear whether fibromyalgia triggers migraine or vice versa, or whether they are caused by something else. Treatments vary, but cognitive behavioral therapy and antidepressants are sometimes used to treat both fibromyalgia and migraine.

Irritable bowel syndrome (IBS) is a gastrointestinal condition with symptoms like abdominal pain, bloating, cramping, diarrhea, and constipation. IBS shares some symptoms with fibromyalgia, including pain and intestinal irritability, as well as anxiety and depression. Both IBS and fibromyalgia are more common in women. The two conditions may be linked by alterations in gut microbiota and the gut-brain axis, which connects your brain and microbiota in your gut through your nervous system. One study suggests that probiotics might be helpful in treating both IBS and fibromyalgia, but more research is needed.

If you have fibromyalgia, symptoms of depression and anxiety are common. One systematic review of studies found that 51% of patients with fibromyalgia had depression and 47% had anxiety. The link between fibromyalgia and these psychological disorders may go both ways: The chronic pain that fibromyalgia causes can lead to anxiety and depression, and chronic stress and pain can lead to or worsen symptoms of depression. But depression and anxiety can also worsen your perception of pain. A holistic treatment approach that includes both physical and mental health may be helpful, so be sure to talk to your doctor if you’re having symptoms of depression or anxiety along with fibromyalgia.

Sleep problems are among the most common symptoms of fibromyalgia. More than half of people with fibromyalgia have chronic insomnia. If you have both conditions, treating your pain may also improve your sleep, but some research shows that treating insomnia might also improve pain. For example, one study of people with fibromyalgia and insomnia compared those who received their usual treatment and those who had that treatment along with cognitive behavioral therapy (CBT). Those who had CBT saw improvements in their insomnia, which in turn improved their pain. Improving your sleep habits may help with your insomnia, but talk with your doctor about your symptoms. 

Postural orthostatic tachycardia syndrome (POTS) is a blood circulation disorder that causes an increased heart rate, dizziness, and other symptoms when you go from lying down to standing up. Some POTS symptoms, including fatigue and headaches, overlap with fibromyalgia symptoms, and POTS is sometimes misdiagnosed as fibromyalgia. Some people have both fibromyalgia and POTS. If you do, your treatment may vary depending on your situation. But in some cases, exercise can help manage POTS, and certain types of exercise can help with fibromyalgia as well. If you have POTS symptoms, talk with your doctor.

Your temporomandibular joint (TMJ) is the joint that connects your jawbone to your skull on each side. TMJ disorders are a type of temporomandibular disorder (TMD), and they can cause pain in and around your jaw. TMJ disorder and fibromyalgia symptoms, such as facial pain and headaches, sometimes overlap. The cause of TMJ disorder may be hard to determine, but fibromyalgia may contribute. And fibromyalgia is considered a risk factor for TMJ disorders. A systematic review found that patients with fibromyalgia were more likely than those without it to have TMD symptoms. Some treatment options, such as pain relievers and antidepressants, may be prescribed for both TMJ disorders and fibromyalgia.

Like fibromyalgia, interstitial cystitis, or bladder pain syndrome, is a chronic condition that causes pain in your bladder and pelvis. It can cause bladder pressure as well. With interstitial cystitis, the walls of your bladder become inflamed, and you might feel like you need to pee more often than usual. If you have interstitial cystitis, you may have a greater chance of developing fibromyalgia. Your treatment for these conditions may vary, but some treatment options overlap, including pain relievers and antidepressants. Physical therapy can also help with both interstitial cystitis and fibromyalgia.

With both fibromyalgia and ME/CFS, you may feel extreme fatigue. But the two conditions differ in that the dominant symptom of fibromyalgia is pain, and the dominant symptom of ME/CFS is fatigue. With ME/CFS, you may feel severely tired, which is likely to worsen when you’re active and is not likely to get better after you rest. Other symptoms include muscle or joint pain and headaches. Your doctor may prescribe treatments and lifestyle changes that can help with both conditions, including medication, counseling, and physical activity.

If you have fibromyalgia, you’re more likely to have rheumatoid arthritis, an autoimmune disease where your immune system attacks your body’s tissues. It can cause chronic pain. Research has shown a close association between the two conditions, but it’s unclear how exactly they’re linked. The overlap in symptoms may make it harder to identify fibromyalgia in patients who have rheumatoid arthritis. Treatment options vary for these two conditions, but one lifestyle change that may help with both is getting regular exercise, which can strengthen the muscles around your joints and help you feel less tired. 

Lupus is an autoimmune disease, meaning your immune system attacks healthy tissue, and it can cause pain and inflammation throughout your body. Fibromyalgia is not considered an autoimmune disease: Although fibromyalgia causes pain, your muscles don’t show signs of inflammation. Research suggests that about 25% of people who have lupus also have fibromyalgia. It may be difficult to tell whether a symptom is from lupus or fibromyalgia, so it’s important to communicate with your doctors about your symptoms, and if you’re seeing multiple doctors for treatment, communication among them can be helpful. 

Sjogren’s syndrome is an autoimmune disease that can cause unusual dryness in your eyes, mouth, and vagina. It makes your glands produce less moisture than they should. Along with dryness, Sjogren’s syndrome can cause symptoms including joint pain, muscle pain, and fatigue —which can show up with fibromyalgia as well. One study found that people with fibromyalgia have a higher risk of developing Sjogren’s syndrome, especially between the ages of 20 and 49. Some treatments for Sjogren’s syndrome target the dryness it causes, but pain medications may also be prescribed.

Hashimoto’s thyroiditis, also called Hashimoto’s disease, is an autoimmune disease that can cause your thyroid to be underactive. Symptoms include fatigue, weight gain, and joint and muscle pain. While the prevalence of fibromyalgia is about 2% to 7% of the global population, the prevalence among people with Hashimoto’s thyroiditis is 30% to 40%. One study found that 62% of the patients it studied who had Hashimoto’s thyroiditis also had fibromyalgia. This study also found that thyroid autoimmunity may affect the development of fibromyalgia. If you have fibromyalgia and you also have symptoms of Hashimoto’s disease, be sure to talk to your doctor about them.

Endometriosis is a condition that causes tissue that’s similar to the lining of your uterus to grow in places where it shouldn’t be. It can cause pain, including severe menstrual cramps, pain in your back and abdomen, and pain when you pee and poop. One study of people with endometriosis found that chronic pelvic pain was much more common in women who had both endometriosis and fibromyalgia. Research has shown that, among women with endometriosis, about 6% also have fibromyalgia. And if you have both, you may be more likely to have psychiatric disorders and autoimmune diseases. If you have fibromyalgia and your pain includes chronic pelvic pain, talk to your doctor about your symptoms.