MS headaches

Reviewed by Dr Jason Ray MBBS FRACP, Neurologist and Headache Sub-Specialist, Alfred Health and Austin Hospital.

Headaches are one of the most common neurological conditions and a leading cause of neurological disability. Many people living with multiple sclerosis (MS) experience headaches or migraines that significantly impact quality of life. Understanding the link between MS and headaches can help you manage symptoms and improve your wellbeing.

Are headaches a symptom of MS?

Headaches are common in the general population, so it can be difficult to determine whether they are directly caused by MS. Research shows that people with multiple sclerosis are more likely to experience certain headache disorders – particularly migraines.

Headaches in MS may be primary (such as migraines or cluster headaches) or secondary (caused by a second condition or another factor). Your doctor can help determine the type and best approach for relief.

Are migraines linked to MS?

Migraine, especially migraine with aura, is more common in people with multiple sclerosis. MRI scans can show 'spots' in the brain that look similar to MS lesions, but migraine spots are not linked to disability or disease progression.

Studies show that migraine and headaches are up to 40% more common in people with MS, over two-thirds of people with MS have a history of headaches or migraines, and aA family history of migraines or headaches is more frequent among people with MS.

Because triggers such as stress, sleep loss and medication can affect both migraines and MS, it's important to work with your healthcare team to manage both.

What types of headaches do people with MS have?

People with multiple sclerosis (MS) can experience several types of headaches, including migraines, cluster headaches and tension headaches. Each has distinct symptoms and treatments, so understanding how they differ can help you and your healthcare team manage them effectively.

Managing MS headaches

There are three key areas to focus on when managing headaches associated with multiple sclerosis.

Lifestyle and prevention: Identify and reduce triggers such as stress, fatigue, anxiety or certain foods and drinks. Support your health with a balanced diet and good hydration, regular exercise and quality sleep, stress-relief techniques such as yoga or meditation, and limiting caffeine and screen time.

Acute treatments: Have an action plan for headache episodes. Medications can help, but frequent use may worsen headaches, so always consult your healthcare team.

Preventative treatments: If headaches occur weekly or disrupt your life, your doctor may prescribe preventive medications to reduce frequency and intensity.

When to seek help

If your headaches worsen, change suddenly, or you notice new neurological symptoms, speak with your healthcare team, MS nurse or neurologist. They can review medications, check for other causes, and help create a management plan that supports your overall MS care.

Sources

The statistics cited in this article have been sourced from the following studies:

1. Steiner, T.J., Stovner, L.J., Jensen, R. et al. Migraine remains second among the world’s causes of disability, and first among young women: findings from GBD2019. J Headache Pain 21, 137 (2020). opens in new tab" class="redactor-autoparser-object">https://doi.org/10.1186/s10194opens in new tab...
2. Biscetti L, De Vanna G, Cresta E, Corbelli I, Gaetani L, Cupini L, Calabresi P, Sarchielli P. Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms. J Neuroinflammation. 2021 Nov 8;18(1):259. doi: 10.1186/s12974-021-02229-5. PMID: 34749743; PMCID: PMC8573865.
3. Mirmosayyeb O, Barzegar M, Nehzat N, Shaygannejad V, Sahraian MA, Ghajarzadeh M. The prevalence of migraine in multiple sclerosis (MS): A systematic review and meta-analysis. J Clin Neurosci. 2020 Sep;79:33-38. doi: 10.1016/j.jocn.2020.06.021. Epub 2020 Aug 4. PMID: 33070914.
4. Chen J, Taylor B, Winzenberg T, et al. Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis. Multiple Sclerosis Journal. 2020;26(12):1550-1559. doi:10.1177/1352458519872644.
5. Tabby D, Majeed MH, Youngman B, Wilcox J. Headache in multiple sclerosis: features and implications for disease management. Int J MS Care. 2013 Summer;15(2):73-80. doi: 10.7224/1537-2073.2012-035. PMID: 24453766; PMCID: PMC3883008.