When listing the common symptoms of multiple sclerosis (MS), migraine headaches aren’t usually included. However, some research has suggested that people with MS have a higher incidence of certain headaches, like migraines.

It’s been reported that migraines occur three times more often in people with MS than the general population. So what does this mean? We explain.

While migraines are fairly common, multiple sclerosis is not. About 12 percent of U.S. people get migraines, while it’s estimated that between 400,000 to 1 million people in the United States are living with MS. That’s less than 1 percent of the U.S. population.

Many people with migraines don’t have MS, while people with MS may or may not experience migraines.

Does MS cause migraines?

The majority of people with MS and migraines were actually diagnosed with migraines prior to being diagnosed with MS. This leads researchers to believe that MS doesn’t cause migraines.

However, a relationship does exist. An MS lesion in the periaqueductal gray matter (PAG) — an area of gray matter found in the midbrain — can cause migraines in some people.

Can migraines be caused by MS medications?

Many people with migraines learn that they have specific triggers. Just a few typical migraine triggers include:

  • foods such as salty foods and aged cheese
  • food additives such as monosodium glutamate (MSG) and aspartame
  • drinks such as wine and caffeinated beverages
  • stress
  • changes in weather

Some medications — such as oral contraceptives and vasodilators — can also trigger migraines.

Some medications used to treat MS may exacerbate headaches, possibly triggering migraines in the process. Certain MS drugs, like beta interferons and fingolimod, may cause headaches as a potential side effect. However, it’s been suggested that MS medications may only trigger migraines in people with a family history of migraines.

Headache treatments are generally based on what’s causing the headache. For example, if you’ve been prescribed fingolimod — as a disease-modifying therapy (DMT) for MS — and find that it triggers migraines, your doctor might alter the dosage or prescribe a substitute.

Some medications that can be used to deal with migraines in people with MS include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter (OTC) painkillers such as ibuprofen (Advil) or naproxen (Aleve) are often the first response to a migraine.
  • Triptans. Triptans are available in many forms, such as pills, nasal sprays, injections, and dissolvable tablets. Some examples of triptans include:
    • rizatriptan (Maxalt)
    • almotriptan (Axert)
    • sumatriptan (Imitrex)
  • Antidepressants. Many people with MS also experience depression and are prescribed antidepressants. Antidepressants can also be used as an effective migraine treatment. Venlafaxine (Effexor), an SNRI, is one example.

If you have MS, you may be more likely to experience migraines than someone without MS. But there’s currently no medical consensus regarding the relationship between MS and migraines.

Future research may find a specific relationship, including the possibility of migraines as a precursor to MS. However, more research is needed.

In the meantime, if you have MS and experience migraines, talk to your doctor about possible triggers, what you can do, and treatment options for managing both.