RA Can Be a Real Headache – Literally!

In addition to my rheumatologist, I’ve seen two orthopedic surgeons for RA joint issues and surgeries and an otolaryngologist (ear, nose, throat) for sinus infections related to immunosuppressant drugs. Now another specialist has been added to the mix - a neurologist – due to persistent headaches.

Can rheumatoid arthritis cause headaches?

My neurologist said that headaches are generally inflammatory conditions.1 He suspects that I already had a propensity for headaches as I used to get migraines several times a year before my RA diagnosis. But he believes that the battle with RA and the medicines I take are probably contributing to an increase in headaches.

Why do rheumatoid arthritis patients have headaches?

A survey of patients with autoimmune disease demonstrated that migraine headaches are quite common for this group of patients.2 There could be a number of reasons that rheumatoid arthritis patients get regular headaches.

Side effects of rheumatoid arthritis medications

Almost every biological medicine and disease-modifying drug (DMARD) lists headaches as a side effect.3 If regular headaches come after starting a new RA medicine, talk to your rheumatologist.

Upper respiratory and sinus infections

Since many of the medications used to treat RA cause the immune system to become suppressed, the chance of getting upper respiratory infections including sinus infections is increased. Anytime there is an infection in the sinuses, the inflammation may cause pressure and headaches. I dealt with recurring sinus infections for a long time and finally had sinus surgery.

Cervicogenic headaches

If joint inflammation and damage from RA is impacting neck bones (cervical involvement), there may be resultant cervicogenic headaches.4


In some rare cases, RA patients will have something called pachymeningitis which is a thickening of the outer layers of the brain called the dura.5 In such cases, migraine-type symptoms are present.

Dealing with headaches or migraine?

Dealing with the joint pain, swelling, stiffness, and fatigue associated with RA is cruel enough. Fighting regular headaches can add insult to injury. If you’re a regular migraine headache sufferer, talk to your doctor and check out RheumatoidArthritis.net’s sister website Migraine.com for excellent information and patient community.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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