Multiple sclerosis (MS) can lead to a wide range of symptoms that may differ from person to person. Some people with MS are more likely to experience certain types of headaches than those without MS.

A small 2017 study showed that headaches are one of the most common causes of discomfort in people with MS. Headaches may be an early symptom of this condition and happen at later stages as well.

However, not everyone with MS will have headache pain. Headaches are very common and can happen for many reasons in people with and without MS.

Headaches are a common cause of pain and discomfort in people with MS. It may even be an early sign that someone may have MS.

A small 2016 study from Iran found that individuals with MS have headaches more frequently than those without this condition.

A small 2017 study found that 78 percent of people in the study with MS reported headache pain within the last 4 weeks.

The types of headaches in the study varied, but about half of the participants with MS in the study stated they had throbbing or pulsating headaches.

About 30 percent of the study participants reported sharp headache pain, and 28 percent said they had dull or tension headaches.

It is not known exactly why some people with MS may have more frequent headaches.

As with any common symptom, the actual cause may not be known, or it may be due to another underlying experience. Some causes of headache pain may be linked to:

  • lifestyle habits
  • specific triggers
  • other health issues aside from MS

Health issues aside from MS that may cause headache pain include:

  • being dehydrated or not drinking enough water
  • consuming too much caffeine
  • drinking alcohol
  • eating certain triggering foods, like those containing monosodium glutamate, aspartame, or high amounts of salt
  • not eating enough or going without food for too long
  • sleep disorders, such as too much or too little sleep
  • stress and anxiety

Headache pain with MS may depend on whether you are more prone to headaches or have a history of headaches.

A 2013 study found that about 85 percent of people with MS reported severe headaches and the same number had headache pain that became worse during MS flare-ups.

Only 11 percent of people with MS in the study above had new symptoms of migraine or serious headache after their MS diagnosis.

According to a small 2016 study, in some cases, headaches may be caused by MS-related changes to your nerves in your brain and spinal cord.

Still, a small 2013 study found that common headache triggers like stress and fatigue may be heightened for people with MS, leading to sharp headache pain.

Headaches can take many forms and cause a range of symptoms and discomfort. According to the small 2013 study above, if you have MS, you may be more likely to have three of the following types of headaches:

Migraine is much more common in MS than these other headache disorders. In fact, a small 2017 study showed migraine can be the presenting symptom for MS.

Migraine can be serious and long-lasting. Afterward, you may feel tired or worn out for up to a day.

Cluster headaches are another common types of headache that may happen more often in early or newly diagnosed MS.

A 2013 study showed that tension headaches were slightly more common in men with MS than in women with MS.

Additionally, milder tension headaches may be more common in people who have had MS for many years.

If you have MS and experience headaches, you might be able to prevent or reduce this symptom if you recognize certain triggers or underlying causes.

One tip that might help is to keep a journal and record your headache symptoms and when they occur. Write down what you ate and any activities you did before your headache began.

You may reduce your headaches by managing common triggers such as:

  • stress
  • anxiety
  • fatigue

Talk with your doctor about counseling or therapy if you feel you may need help with managing stress and emotions.

If you find that certain foods, such as salty and spicy foods, trigger your headaches, you can try to limit them in your diet.

Healthy lifestyle changes and natural remedies may also help you manage headaches. These include:

  • getting regular exercise
  • drinking plenty of water
  • eating a balanced daily diet
  • avoiding excess screen time, such as on computers and smart phones
  • getting the proper amount of restful sleep
  • limiting alcohol, caffeine, and sugar
  • reducing stress with yoga, meditation, or massages
  • relaxing your neck and back muscles with a warm compress
  • maintaining an active social life with friends and family

Talk with your doctor about any changing symptoms and patterns you notice with your headaches. Get emergency medical care if you have sudden or severe headache pain or if the pain does not go away.

Your doctor may prescribe pain medication or other treatments. Your doctor may also adjust any prescription medications you are taking.

In serious cases, you may need to contact a nerve specialist, or neurologist, who can help diagnose and treat headache pain.

Common medications and prescription treatments for headaches include:

  • Pain medications like ibuprofen (Advil) or naproxen (Aleve) are common the first-line treatments for migraine.
  • Migraine medications like triptans, gepants, and “-ditans” are also common first-time or acute migraine treatments and may be available as pills, nasal sprays, and dissolvable tablets.
  • There are also some migraine prevention therapies that include antidepressants such as venlafaxine (Effexor), beta blockers, seizure medications, botox, CGRP, and monoclonal antibodies (MAbS).

MS is a chronic condition involving your central nervous system (CNS). It happens when your immune system affects myelin, the protective fatty layer around nerve fibers.

The myelin sheath insulates your nerves and also helps conduct nerve impulses or signals so that messages are passed faster.

In MS, your body mistakenly attacks the myelin sheath in some parts of your body. This can damage nerve cells in your:

  • brain
  • spinal cord
  • eyes
  • other areas

MS leads to inflammation and scar tissue or lesions on your nerves. This can slow signals that are sent between your brain and the rest of your body. This may also trigger headaches and other MS symptoms.

If you have MS, you may have a range of symptoms that can be managed with the right care and medical treatment. Some people with MS may experience headache pain.

Headaches in MS can also vary in symptoms and severity. You may have mild tension headaches or more serious migraine pain.

Keep a journal to track all your symptoms, and talk with your doctor about your headaches and any changes in symptoms.

Seek urgent medical care if you have a sudden, severe headache or headache pain that continues to worsen. The following practices can help you manage headaches when you have MS:

  • learning your triggers
  • leading a healthy lifestyle
  • getting the right medical treatment