Rheumatoid Arthritis and Headaches—Is There a Connection?

Medically Reviewed By William C. Lloyd III, MD, FACS

Chronic pain is a hallmark symptom of rheumatoid arthritis (RA). For many people with arthritis, pain comes in the form of headaches and migraines.

In RA, your immune system attacks your body’s tissue and joints. In some cases, your immune system attacks the vertebrae in your neck. This is known as your cervical spine. There isn’t a great deal of research exploring the connection between RA and headaches. However, experts believe that inflammation in your cervical spine can generate pain signals in the nerves of your neck and affect your brain’s blood supply. This can trigger head pain or headaches.

There are steps you can take to better manage RA and headache or migraine pain. Managing stress, getting more exercise, and examining your medication use may ultimately add up to less pain.

Check Your Meds

Are you heading to the medicine cabinet for ibuprofen (Advil) or acetaminophen (Tylenol) a little too often? Leaning on over-the-counter analgesics—everyday pain relievers that help with everything from minor aches and pains to migraines—can actually set off “rebound” headaches. If you’re taking over-the-counter medications daily and not experiencing relief, cutting back and finding a new approach may help.

More Exercise, Less Stress

Stress is a known trigger for migraines and headaches. Living with RA can cause stress, anxiety, and depression. Exercise is a known stress reliever. Exercises that can help alleviate stress include walking, bicycling, and tai chi. Exercise may also ease any muscle tension around your cervical spine and neck. This could help reduce your chances of getting a headache. Need another reason to get moving? Inactivity actually can make RA symptoms worse.

Focus on Omega-3s

Fish oil has been touted for multiple health benefits, though in most cases the scientific evidence is modest. One recent study showed that people with early-stage RA who took daily fish oil capsules for one year, in addition to getting standard treatments, experienced a greater reduction in their symptoms. And most were able to quit using NSAIDs for pain relief. Herring, mackerel, salmon, and tuna are high in omega-3 fatty acids. These are also critical for brain health and blood flow. The health benefits of eating fatty fish are supported by more evidence than are the benefits of taking fish oil supplements.

Get Your Z’s

The joint pain and stiffness that people with RA experience can also interrupt sleep. Unfortunately, a lack of sleep increases your risk for headaches and migraines. This creates an unpleasant cycle. Cutting out possible headache triggers, such as caffeine found in coffee, tea and chocolate, as well as getting regular exercise, can help you enjoy deep, quality sleep and wake up feeling rested.

Key Takeaways

  • For many people with rheumatoid arthritis, inflammation in the cervical spine may lead to headaches and migraine.

  • Managing stress, getting more exercise, and examining your use of medications and supplements may lead to fewer headaches and migraines.

  • Joint pain can interrupt sleep, which increases your risk for headaches and migraines. Cut out possible headache triggers and get regular exercise to enjoy deep, quality sleep.
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  1. Proudman SM, et al. Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use. Ann Rheum Dis. 2015;74(1):89-95.

  2. Wasserman BR, et al. Rheumatoid Arthritis of the Cervical Spine Clinical Considerations. Bull NYU Hosp Jt Dis. 2011;69(2):136-48.

  3. Starling AJ, et al. Risk of Development of Medication Overuse Headache With Nonsteroidal Anti-inflammatory Drug Therapy for Migraine A Critically Appraised Topic. Neurologist. 2011;17(5):297-99.
  4. Headaches: In Depth. National Institutes of Health. National Center for Complementary and Alternative Medicine. https://nccih.nih.gov/health/pain/headachefacts.htm?nav=gsa

  5. Physical Activity for Arthritis. Centers for Disease Control and Prevention. http://www.cdc.gov/arthritis/basics/physical-activity-overview.html

  6. Arthritis. National Headache Foundation. http://www.headaches.org/2007/10/25/arthritis/

Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Aug 11
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