Right now, my arthritis is being well-controlled with injectable Methotrexate, and lupus with the help of Quinacrine (and a cadre of other, less powerful prescription medications). I also can’t deny that our unseasonably mild winter may also have something to do with my lack of pain.
That being said, the main symptom I have been having is headaches. When I used to get headaches, my entire head would ache. But the headaches I am getting now are either or one or the other sides of my head, or at the base of my skull. These headaches pound, and I feel nauseous and dizzy. At their worst, I have to take ibuprofen, turn off the TV and lights, put a cold compress on my head, and attempt to sleep.
When I have tried to bring this up with my rheumatologist, it is one of many things he has scoffed at as not being part of arthritis or lupus. But I think he’s wrong about this. And so does the Internet.
To back up, in general, there are five main types of headaches.
Tension headaches are basically mild headaches, with pain and pressure around the head. Cluster headaches are intense throbbing headaches, typically behind one eye or in the eye region, or on one side of the head. Sinus headaches are consistent with pain in the cheekbones, forehead, and nose. Rebound headaches are caused by over-medicating to treat head pain. Migraines cause moderate to severe pounding pain, sensitivity to light, noise, and odor, and nausea.
Given what I’ve learned about types of headaches, I see possibly a combination of cluster headaches, rebound headaches, and migraine headaches as contributing to my head pain.
I would say at this point that I probably get a full-blown type of headache once or twice a month. But I will sometimes get headaches that are similar, but not as painful and debilitating. I also often wake up with the same kind of head pain, especially at the base of my skull.
I’ve tried to watch for potential triggers for my headaches, but that has been difficult. I do know, however, when I move my neck, the headaches get precipitously worse.
According to various sources, headaches are in fact a very common RA symptom. The National Headache Foundation says that, “Headaches felt as a pain in the neck, may be caused by arthritis if the first, second or third vertebrae are involved” (http://www.headaches.org/education/Tools_for_Sufferers/Headache_-_Frequently_Asked_Questions). If your jaw is impacted by arthritis, this too, can cause headaches.
Looking at this briefly from the lupus angle, headaches are also a common occurrence.
According to the Lupus Foundation of America, “People with lupus experience headaches which are unrelated to their lupus […but…] Approximately 20 percent of patients with SLE experience severe headaches which are related to the disease and known as lupus headache” (http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutaffects.aspx?a=102&z=0&page=2).
In the case of SLE, headaches can be a sign of neurological involvement of the disease, and this can usually be diagnosed via an MRI or spinal tap. However, this is not agreed upon, and some experts doubt the existence of the so-called “Lupus Headache.” It is thought that migraines are more likely in lupus patients who also have Raynaud’s Phenomenon, which I do.
So it really could be that the pain is literally all in your head. At least for me, at the moment, that’s where my pain mainly is.
So what’s this all about? Is it Rheumatoid Arthritis related? Is it Lupus related? Is it something else?
I’ve been having issues with my blood pressure, but my primary care doctor does not think that is related to either the headaches or dizzy spells I have been having. So she gave me a referral to see a neurologist. I’ll be going to that appointment at the end of next month. And if it yields anything transformative, I will let you all know.