What is the Link Between Headaches and Lupus?

Is Lupus Causing My Headache?. Adam Gault/SPL/Getty Images

Systemic lupus erythematosus (SLE) — often shortened to just "lupus"— is an autoimmune disease that affects 300,000 people in the United States, according to a 2008 article in Arthritis and Rheumatology.

Headache has been reported as common in people with lupus, but there is debate as to the precise link between these two conditions. Let's explore the basics of lupus and probe into the headache-lupus connection in a question-answer style format.

First...How is Lupus Diagnosed?

The diagnosis of lupus is usually confirmed by a rheumatologist using either criteria derived from the American College of Rheumatology or from the Systemic Lupus International Collaborating Clinics (SLICC).

Since lupus is a systemic or whole-body disease, there are a number of signs and symptoms a person with lupus may have.

Some of these signs or symptoms include:

  • Rash
  • Photosensitivity — sensitive to sunlight, causing a skin rash
  • Oral ulcers
  • Arthritis of 2 or more joints
  • Pleuritis (i.e., inflammation of tissue lining the lung) or pericarditis (i.e., inflammations of tissue lining the heart)
  • Kidney disease
  • Neuropsychiatric disease (i.e., seizure, headache, psychosis)
  • Blood Disorder (e.g., low blood cell counts which may cause a person to be anemic or be more prone to infection or bleeding
  • Laboratory evidence of antibodies in the blood (e.g., anti-double stranded DNA, anti-Smith)

    Are Headaches More Common in People with Lupus?

    The answer to this question is controversial — with some studies finding an increased prevalence  of headaches in the lupus population and others not. A recent 2013 study in Arthritis and Rheumatology did not find that headaches were more common in people with lupus, when compared to the general population.

    Is There a Headache Syndrome Attributed to Lupus?

    Two common types of headaches described in patients with lupus include migraine and benign intracranial hypertension. Scientists debate over the presence of a unique headache syndrome that signals lupus activity in a person's body. This unique headache has been termed a "lupus headache" and is a severe, persistent headache that resembles a migraine, but is not responsive to opioids for pain relief.

    Is Headache a Sign of Lupus Activity Within the Body?

    Not necessarily. In one 2013 study in Arthritis Rheum, scientists found that most headaches in people with lupus were not a sign of increased lupus activity occurring within the body, with the exception of a lupus headache. Even so, scientists propose that this rare lupus headache could reflect the nonspecific effects of having a whole-body illness and is still not always a sign of worsening disease activity.

    Why Is It Important to Know Whether a Headache is Related to a Person's Lupus?

    When a person with lupus has a headache, it's important for the person and her doctor to be able to distinguish between a lupus-related headache and another form of headache, like a migraine.

    A lupus-related headache suggests that a lupus-related process is occurring within that person's nervous system. In this case, a doctor may escalate lupus-related medications. In the case of a suspected migraine in a person with lupus, a doctor can treat with traditional migraine-alleviating medications, like triptans or NSAIDs.

    Take Home Message

    It appears that most headaches in people with lupus are not a reflection of worsening disease activity in the body. That being said, headache in a patient with lupus needs to be evaluated by a doctor — to be certain there is nothing else more serious going on with the body.


    Hanly JG et al. Headache in systemic lupus erythematosis: results from a prospective, international inception cohort study. Arthritis Rheum. 2013 Nov;65(11):288-97.

    Helmick CG, Estimates of the prevalence of arthritis and other rheumatic conditions in the United States:Part I. Arthritis Rheum. 2008 Jan;58(1):15-25.

    Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012 Aug. 64(8):2677-86.

    The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999 Apr;42(4):599-608.

    DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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