A Pain in the Head

My head is pounding as I type this. Pounding, throbbing, aching. Like RA, it's a familiar pain and a chronic condition that I desperately do not want to have. But I do have it--right now anyway. For the last couple of weeks, my tension headaches have been severe and constant, rendering me unable to work or do just about anything. Thankfully, unlike RA, I can usually manage to get my headaches to go away. But it's not an easy or fast process and they often flare up again.

RA doesn't operate alone. It affects everything

Do I really need this debilitating head pain on top of my RA pain? NO. It feels very unfair for life to throw this at me, too, when I'm constantly struggling to fight against the assault of RA on my body. One thing I have learned from living with RA pain for 21 years and headache pain for almost as long is this: pain does not act alone; it connects to everything and even in ways that seem strange or unrelated. It connects everything, feeds off everything, affects everything. Is it a coincidence that my headaches began not long after I was diagnosed with RA? I don't think so.

According to an article from Everyday Health, "about 61 percent of people with severe headaches or migraines also have chronic pain conditions, including RA."1

I definitely fit into that category, and my headaches began about a year after I was diagnosed with RA, which was in July 1997. I remember spending the majority of the summer 0f 1998 lying on my parents' couch, suffering from constant, unrelenting and throbbing pain that enveloped my whole head. What was this? After months of doctors' appointments, tests, and wrong diagnoses, I finally found out what was behind my debilitating headaches: tension.

Tension headaches and RA

Many people probably think: tension headaches? Oh, that's not a big deal. It's not a migraine or anything. Well, yes it is a big deal, actually. And if my tension headaches get bad enough, they sometimes morph into migraines. Tension pain, consisting of severely tight and knotted and inflamed muscles, can be unbearable. There are also no quick fixes for these types of headaches. Tylenol, ibuprofen, and other over-the-counter medications don't touch them. I've been devouring muscle relaxers like candy lately and they're not doing much to lessen the pain. Tension headaches like the ones I often have can require a combination of drugs, exercises, and sometimes physical therapy. I'm doing all three right now and I'm still in a lot of pain.

So what's the RA connection with headaches?

Maybe it's somewhat obvious...the stress of RA pain causing pain elsewhere? I think my RA definitely plays a large role in my headaches. From what I've been able to discern so far, my head pain is caused by two main things: 1. stress and unconscious tensing/clenching of the muscles in my head/neck/shoulders, 2. clenching my teeth/jaw.

Why am I doing this? Why am I contorting my poor, delicate muscles into excruciating bands of tension and tight knots? I don't know! My theory is that the involuntary tensing of my muscles is something that I do in response to stress and coping with my RA pain. When your joints are in constant pain, often severe, your body has to compensate for it somehow. You brace for it, you wince with it, and you hold your body differently, trying to survive the assault against your joints. Unfortunately, that pain has to go somewhere, and for me, it goes straight to my shoulders and neck which then eventually takes over my entire head.

How to deal with these headaches

I honestly don't know the best approach to dealing with these headaches. I've had physical therapy for them several times and I know that I'm supposed to keep up doing my exercises regularly to prevent these bad flare-ups. However, real life means that I get wrapped up in working and living and I often forget to do my exercises until I'm trapped in the middle of a bad headache explosion. When this happens, it's kind of too late. The pain is raging and I get knocked down by what feels like a constant stream of semi trucks running over my head.

So, I have recently returned to physical therapy and I'm also looking into getting trigger point injections at my pain management clinic. Honestly, I think the physical therapy is a waste of time, but I'm hopeful about the injections. And in the meantime, I'm working hard to not clench my teeth while doing all of the silly-looking exercises that have actually helped in the past. It's either this or cut off my head. We'll see.

Am I the only one who deals with this on top of RA pain? I feel like I can't be.

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