A person with multiple sclerosis (MS) may experience various types of headaches. Triggers for MS headaches include stress, muscle tension, or certain foods. However, a range of medications and alternative treatments, such as relaxation techniques, may help relieve the symptoms.

MS affects the brain and spinal cord. It can cause symptoms, such as minor muscle weakness, or it can lead to severely disabling effects, including the inability to walk.

This article explores the causes of headaches and migraine headaches that may be due to MS and looks at preventive measures and treatment options. It also discusses causes and treatments for other headache symptoms.

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The World Health Organization (WHO) says that most people get a headache sometimes, with individuals most frequently reporting tension headaches. The organization adds that migraine headaches affect 1 in 7 people globally and affect females more than males.

However, the Multiple Sclerosis Foundation states that researchers are not certain if there is a relationship between MS and headaches. In addition, some people who get a headache also have migraine symptoms, although there is no proven link to migraine being a symptom of MS.

Migraine

A migraine headache involves intense throbbing or pulsing pain in one area of the head. There may also be other symptoms, such as nausea, vomiting, and sensitivity to sound or light.

A small 2017 study of 50 people showed a higher prevalence of headaches in individuals with MS than previously indicated. The research also stated that headaches were a frequent symptom associated with the early onset of MS. However, the authors said this did not consider any of the participants’ previous history of headaches or any emotional stress.

Other research from 2014 found a strong correlation between MS and reports of migraine headaches with an aura. An aura is a warning sign that a headache is imminent, and it can occur among people who do not have MS. The researchers concluded that more research needed to link migraine headaches with an aura to a potential MS relapse.

Tension

Tension headaches may also have links with MS. One older study from 2013 showed that some MS headaches might result from tension pain rather than migraine headaches. The research added that headaches of various types may be a symptom of MS and that more research is needed.

The National Institute of Neurological Disorders and Stroke (NINDS) says that MS is a lifelong condition, with symptoms ranging from relatively mild to severe. What causes them is unclear, although some researchers believe it occurs when the immune system attacks myelin, the material that coats and protects nerve cells.

Remission or relapses can happen unexpectedly, while treatments may slow the progression of the disease. However, some people with milder forms may be able to manage the condition without treatment.

The onset of MS typically affects people aged 20–40 years, although it can occur after a person is 50 years of age, according to the National Center for Complementary and Integrative Health. The condition affects around 400,000 people in the United States, and some research suggests MS may also begin in the childhood or teen years.

Receiving a diagnosis of MS can be difficult due to the condition’s unpredictable symptoms, which can include:

  • vision issues
  • muscle weakness
  • balancing difficulties
  • pain
  • paralysis
  • hearing loss
  • speech impediment
  • problems with concentration

Learn more about MS here.

The triggers for migraine and tension headaches vary. If a person can recognize the possible symptoms and causes, they may wish to seek medical advice for treatment.

Migraine headaches

Migraine headaches generally affect people aged 35 and 45 years old, although children, young adults, and older adults may also experience them. Although experts do fully understand why they occur, the American Migraine Foundation (AMF) lists the following factors as possible triggers:

  • Stress: Among people who get migraine headaches, around 70% report stress as one of their triggers.
  • Dehydration: About 33% of people with migraine headaches report that dehydration is a trigger.
  • Hormones: Up to 75% of females with migraine headaches experience the disorder during their menstrual cycle.
  • Alcohol and caffeine: Many people report their symptoms are worse after consuming either of these substances.
  • Weather changes: Storms, high heat, and large changes in barometric pressure are common triggers.
  • Smells: Exposure to certain odors may worsen or trigger attacks.
  • Food: Common triggers include chocolate, cheese, artificial sweeteners, cured meats, and food containing the additive monosodium glutamate (MSG).
  • Light: Sunlight, bright indoor lighting, and flickering lights can be a trigger.
  • Medication: Taking prescription drugs for migraine headaches for more than 10 days per month can be a trigger.

Learn more about migraine headaches here.

Tension headaches

People most commonly report tension-type headaches — several factors may cause them, including the following:

  • stress that triggers the contraction of muscles in the face, jaw, neck, and scalp
  • intense work
  • anxiety or depression
  • missed meals
  • too little sleep

Learn more about tension headaches here.

Measures that may help prevent migraine and tension headaches include lifestyle changes, alternative therapies, and relaxation techniques.

Migraine headaches

Some common foods may trigger migraine headaches. The National Headache Foundation suggests keeping a food diary to identify especially problematic foods.

Aside from dietary measures, the AMF advises these lifestyle practices:

  • maintaining regular bedtimes
  • reducing stress
  • exercising regularly
  • following a medication treatment plan
  • taking slow, deep breaths

Learn more about the mental and physical health benefits of exercise here.

Tension headaches

To prevent tension headaches, the AMF recommends:

Learn more about 14 types of therapy here.

Medications and nondrug treatments are available for migraine and tension headaches. Some treatment options include:

Migraine headache treatment

In the early stages, doctors may advise:

  • resting in a quiet, dark room with an ice pack
  • drinking plenty of fluid
  • consuming small amounts of caffeine

Additional treatments may involve taking medication at the onset of symptoms during the acute phase. There are also daily medications to prevent or reduce the severity of more attacks during the preventive phase.

Acute phase treatment may include:

  • triptan drugs, which increase levels of the neurotransmitter serotonin in the brain
  • nonprescription pain relievers for mild headaches, such as acetaminophen, aspirin, or ibuprofen
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • antinausea drugs to relieve nausea and vomiting from the headaches
  • opioids for brief use

Preventive phase treatment may include:

  • anticonvulsant medications
  • antidepressants
  • nondrug therapy, such as relaxation techniques or biofeedback

Tension headache treatment

The first step in treating a tension headache involves addressing any underlying health issue. For example, a corrective mouth device may help relieve tension due to a disorder of the jaw joint. Doctors may also prescribe:

  • pain relievers
  • NSAIDs
  • antidepressants
  • sedatives

While researchers are uncertain if there is a relationship between MS and headaches, people who experience MS headaches can make lifestyle changes that may help prevent them. These include avoiding foods that are common triggers, such as those that contain MSG, as well as staying hydrated, reducing stress, getting exercise, and maintaining a consistent sleep schedule.

Medications can ease pain and help prevent recurring headaches. Doctors may also prescribe drugs to reduce other symptoms of migraine headaches, such as nausea.