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RA Can Be a Real Headache – Literally!

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.

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.

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.

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. 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. 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 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.

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.

[1] http://patients.aan.com/disorders/?event=view&disorder_id=936 [2] http://ard.bmj.com/content/48/4/312.full.pdf [3] http://livingwithra.wordpress.com/2012/11/28/brain-fog-cognitive-dysfunction-caused-by-ra-medicines/ [4] http://now.aapmr.org/pain-neuro/pain-medicine/Pages/Cervicogenic-Headache.aspx [5] http://www.rheumatologynetwork.com/persistent-headache-patient-ra

Comments

  • jan curtice
    4 years ago

    Hi Andrew, Thanks for sharing another wonderful posting. Migraines are my nemesis. My neurologist had me retire after years of trying to unsuccessfully control the migraines. He used to tell me the migraines and RA liked to party together. It took 2 years of sleeping/napping when my body demanded it for the migraines to become more manageable. Here are a couple of things I found that help me. First of all, the minute a migraine threatens, I place a lidocaine (pain) patch on the cervical area of my neck/upper back. This interrupts the pain cycle and any spasms occurring in stem area. Something else, some of the infusion medications given can help the migraines … this is something to talk to your rheumy about. Next, one of the problems I have occurs in the voice box. There is a joint there which can be RA-affected. Mine causes problems with air flow and symptoms similar to an asthma attack. This in turn causes the most horrible headaches. So far, my doctors haven’t come up with a good solution for this challenge except breathing treatments. Vicks on my throat and neck helps some. Finally, pushing through the migraine doesn’t work for me. I have found that unless I rest, I am inviting a flare and/or rapidly escalating migraine. I have blue lights (“Headache lights”) that I use when I have a migraine. These seem to help the brain waves calm down faster and ease the pain. Blessings …. my heart goes out to my fellow RA-migraine suffers. Everyday we become stronger and stronger as we successfully overcome this disease. =^^=

  • Andrew Lumpe, PhD moderator author
    4 years ago

    Jan, thanks for sharing the tips. When on Remicade, I got terrible migraines post infusion. Had to go off it. It also happened this past week post Rituxan infusion. First time since starting on Rituxan over two years ago. Methotrexate also triggered migraines. Where do you get the lidocaine patch? Who prescribes them for you? I’ve had cervical surgery and am still having problems. The neck pain probably helps trigger migraines.

  • Hillary Ross
    5 years ago

    I’ve got RA, Ankylosing Spondylitis, Fibromyalgia, and a new diagnosis of occipital neuralgia.
    I have horrible temporal headaches. My Dr. said its from my cervical spine is pressing on the nerves and the pain radiates from my neck all the way to my temporal area. It’s bizarre.
    I’m considering a procedure called a radio frequency ablation. It kills the nerves for anywhere from a month to almost a year.
    Eventually, the nerves regenerate and the procedure needs to be repeated, but I’ll take the relief!
    Has anyone here ever had a RF ablation? I’m a lil nervous about it :-/

  • Andrew Lumpe, PhD moderator author
    5 years ago

    Hillary, so sorry so all you’re dealing with. I’ve heard of RFA. It provides heat on nerve pathways. Does insurance pay for it? I hope you find relief!
    Andrew

  • Sue Ervin
    5 years ago

    When I was working 40+ hours a week and raising teenagers and later starting a business I had several headaches a month. Since I went on disability I no longer have migraines. I wonder if always pushing to “do” instead of listening to my body caused them. I think my body was just saying STOP.

  • Andrew Lumpe, PhD moderator author
    5 years ago

    Very well could be Sue. Maybe was a trigger for you. Glad they subsided now.

  • Jen
    6 years ago

    I was happy to see this article, I asked my Dr. about my headaches and she said that it was not a symptom. I thought that I was going crazy. I get at least a really bad one once a week, but wake up with a headache most days. I was diagnosed last May by my Rheumatologist. My primary didn’t take me serious until he saw first hand, no pun intended, how red and swollen my hands were. That’s when he ordered the blood work. I have been having these headaches for a long time and haven’t been able to get relief from the really gad ones, I just have to ride it out. Thank you for making the connection for me.

  • Jen
    6 years ago

    I have redness and hot to touch in my joints and areas around the joints, my Dr. said that is part of the disease. My question is this…If I have the redness and heat on my face, could that mean that the fluid around my head is being affected by the RA? My nose, the “t” area on my face and my ears get red hot, so much that my head feels like it can break out if I come in contact with paper and start an actual fire. My Dr. said that this isn’t from my RA, however I can’t get passed the point that I really think it is. Has anyone else ever had this problem? I’m on Enbrel and Methotrexate. I also suffer from chronic back pain~I’ve had 3 surgeries, I have spinal stenosis and degenerative disc disease. Among other medical problems. And oh, by the way was just told last week that I have fibromyalgia!!

  • Andrew Lumpe, PhD moderator author
    6 years ago

    Hi Jen, glad you liked the article. Sorry for your recent diagnosis. Headaches may or may not be a symptom of RA or the meds used to treat it.

  • Nancy G
    6 years ago

    I have been diagnosed with RA for three years. I have always had migraines since starting menstruation, twice a month like clockwork. When I turned 50 they came on strong so it was rare when I didn’t have one. Many trips and tests later,and drugs, I am down to 1-2 a week. Which is handled with imitrex and excedrin. The RA diagnosis was three years ago and have tried many drugs but ended up in hte hospital two years ago, the result of immocompromised system. I have always wondered if there was a connection between the RA and the migraines. I have had intermitten joint pain over ten years. Interesting arcticle! Thanks.

  • Andrew Lumpe, PhD moderator author
    6 years ago

    Glad you liked the article Nancy. I can’t relate to the female hormonal reasons for migraines but understand that they are quite common. 🙂 They can’t tell a direct cause and effect between RA and migraines but there sure seems to be a higher number of people with autoimmune diseases who have them. 1-2 migraines a week are still too many! Are you on a long term preventative medicine? Andrew

  • Karen
    6 years ago

    great article. I was diagnosed with RA just this past June. For four years I had daily migraines and about 2 years ago I started having joint pain. Now that I am on meds my migraines are less frequent (once to twice a week) but still very debilitating. I have also met several others with RA who frequent migraines so it is very helpful to read about the connection.

  • Andrew Lumpe, PhD moderator author
    6 years ago

    Thanks Karen. It seems that migraines and RA go hand in hand for many. Glad you find the articles helpful and that your migraines are less frequent! Andrew

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