Fibromyalgia and Myositis Linked to Higher Burden and Disability in Patients with Migraine

The increase in migraine frequency—with shift towards chronicity—promotes an enhancement of the central hypersensitivity which has been linked with fibromyalgia and myositis (FM). Migraine patients with FM have been known to have higher burden of headaches across studies, but this is the first population-based study to evaluate disability and morbidity in migraine patients with concurrent FM.

We performed a retrospective cross-sectional analysis of migraine hospitalizations using the nationwide database to determine cost, hospital stay, disability, and discharge disposition. This analysis was performed in migraine patients with and without FM using ICD-9-CM codes. We performed weighted analyses using chi-square and t test. Among year 2014 hospitalizations, we identified FM patients and regression analysis was performed to evaluate whether migraine or other headache disorders were predictors of FM hospitalization.

Between years 2003 and 2014, of the total 446,446 migraine hospitalizations, 22,735(5.09%) patients had concurrent FM. Migraine patients with FM had higher prevalence of loss of function (8.4% vs. 6.5%, p<0.0001) and transfer to rehabilitation facilities (5.5% vs. 4.5%, p<0.0001) compared to those without FM. Migraine patients with FM also had higher hospitalization stay and cost. Through regression analysis, we found that migraine (aOR, 3.03; p<0.0001), cluster headache (aOR, 1.71; p=0.0124), and tension headache (aOR, 1.87; p<0.0001) were highly associated with FM hospitalization.

FM was associated with significant increase in disability, morbidity, hospitalization stay, and cost in patients admitted with migraine. On the basis of this study finding, it would be reasonable to screen migraine patients with depression, anxiety, or other psychiatric disorders for symptoms of FM to mitigate the burden.