Rheumatoid arthritis (RA) is an autoimmune disease that can cause headaches. Some RA treatments and complications can also cause dizziness.

RA mainly targets the synovial tissue that lines the joints, and the primary symptoms are joint pain and swelling. But RA can also cause a range of other symptoms, including headaches.

In this article, we look at the links between headaches, dizziness, and RA. We also explore how to treat and manage these issues.

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RA is an autoimmune disease that causes inflammation and swelling. While these issues primarily affect the joints, they can develop in organs, including the brain.

One 2018 study examined how RA-related chronic inflammation affects the brain and found a link between inflammation and changes in brain connectivity patterns. This could lead to headaches.

Meanwhile, RA can cause cervicogenic headaches, which result from a problem in the spine of the neck.

Cervicogenic headaches may occur when RA damages the synovial joint C1-C2 in the upper spine. A person who experiences these headaches tends to have pain radiating from the neck to the back of the head.

RA can also cause vasculitis, which is inflammation of blood vessels. This swelling can limit blood flow and lead to brain, nerve, and spinal cord damage.

When vasculitis affects the central nervous system, people may experience:

  • chronic headaches
  • muscle weakness
  • confusion
  • vision problems
  • pain
  • a loss of sensation

Nervous system vasculitis can also lead to brain aneurysms, brain swelling, seizures, and blood clots.

In addition, a person with RA may have a higher risk of developing another issue that causes headaches.

As the Centers for Disease Control and Prevention (CDC) point out, people with RA are more likely to develop fibromyalgia, which causes:

And a 2017 study involving 58,749 participants suggests that people with migraine headaches have a higher risk of developing RA.

Migraine symptoms include:

  • sensory changes, such as flashing lights in the field of vision
  • one-sided head pain
  • nausea and vomiting
  • sensitivity to light and sound

Some RA treatments can cause headaches. For instance, aggressive corticosteroid use could trigger headaches and fatigue.

Doctors often prescribe disease-modifying antirheumatic drugs, sometimes called DMARDs, to treat RA. These drugs help slow the progression of the disease, but some can cause headaches, including:

While nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen (Advil) — can help relieve mild headache pain, side effects of NSAID use are headaches and dizziness.

Also, there is a small risk that a person might get rebound headaches from taking NSAIDs. These are also called “medication overuse headaches.”

Several conditions can cause headaches, and some can present similarly to RA. They can be serious, and anyone who may have symptoms should receive medical attention.

For example, infectious arthritis — also known as septic arthritis or reactive arthritis — can cause:

  • a fever
  • headaches
  • chills
  • weakness
  • joint pain and swelling

Also, several autoimmune diseases other than RA can cause headaches, such as Lyme disease.

When the headache stems from migraine, try:

  • avoiding triggers, which vary from person to person, but often include caffeine and alcohol
  • having a steady eating and sleeping routine
  • exercising regularly
  • practicing stress-management techniques

Because some headaches may stem from NSAID use, it may help to take a break from these medicines.

If headaches result from RA-related issues of the head and neck, try:

  • using relaxation techniques, such as yoga and deep breathing
  • following an exercise routine recommended by a physical therapist
  • improving sleep habits
  • going to therapy, for people with depression
  • taking NSAIDs as recommended

Below are some treatments that a doctor might recommend for RA-related headaches.

RA drugs

Certain RA medications, including those that suppress the body’s response to tumor necrosis factor (TNF), called TNF inhibitors, can help alleviate fatigue and other brain-related symptoms of RA.

Steroids

These are the primary treatment for vasculitis because they have a strong anti-inflammatory effect.

Nerve blocks

These are a treatment for cervicogenic headaches. They target nerve pain.

Pulsed radiofrequency therapy

One 2015 study found that pulsed radiofrequency therapy was an effective option for certain people with RA. These people had head and neck pain resulting from C2 nerve compression.

Migraine headache treatment

If a person has migraine headaches, treatment options are either acute or preventive. Acute treatments include:

  • over-the-counter NSAIDs
  • triptans
  • ergot derivatives

Preventive options include:

  • antidepressants
  • anticonvulsants
  • beta-blockers
  • anti-calcitonin gene-related peptide injections (anti-CGRPs)

Physical therapy

Physical therapy is a key treatment for cervicogenic headaches. Massage and specific exercises can help treat this type of pain.

A person with RA may develop vasculitis. This can cause headaches that do not go away, and it requires prompt medical attention.

It can cause serious complications in the brain, including a burst aneurysm or a stroke.

Symptoms of a burst aneurysm include:

  • a severe headache
  • vision issues
  • nausea and vomiting
  • neck stiffness
  • seizures
  • light sensitivity
  • loss of consciousness

Symptoms of a stroke include:

  • weakness or numbness on one side of the body, including one side of the face or one arm or leg
  • confusion
  • difficulty speaking
  • difficulty understanding speech
  • trouble seeing
  • a severe headache
  • difficulty walking
  • dizziness

Both are medical emergencies.

Anyone with RA and chronic migraine headaches that interfere with daily activities should make an appointment with a neurologist. They can confirm the migraine diagnosis and find an effective treatment.

While there is no cure for RA, it is possible to manage the symptoms — even severe headaches — and slow the disease’s progression.

If headaches result from a specific RA medication, there may be other effective options that do not have this side effect.

Anyone with RA and migraine headaches should speak with a doctor about the best approach. There is no cure for migraine, but emerging treatments have shown promise in minimizing symptoms.

Receiving prompt treatment for RA can help prevent complications of the disease — and avoiding complications such as vasculitis and brain inflammation may prevent headaches.

Preventive medications for migraine are also available. Anti-CGRPs are the newest option.

People with RA may develop headaches that are unrelated to the disease. Approximately 50% of adults worldwide have had at least one headache in the last year.

Headaches can also result from an RA treatment or complication. In addition, a person with RA may have a higher risk of another issue, such as fibromyalgia, that causes headaches.

Meanwhile, dizziness can also result from some RA treatments and complications. Many treatments for these issues are available, and a doctor can provide specific advice.

Receiving the right course of RA treatment early can help slow the progression of the disease and reduce the risk of complications, including those that cause headaches.