Headaches and arthritis are common problems and, therefore, create considerable interest in the possible role of arthritis in causing headaches. Several major forms of arthritis exist. Two of the most common types are rheumatoid arthritis and osteoarthritis.
Rheumatoid arthritis may begin at any age. It is a condition in which the body misconstrues its own tissues as being foreign and attacks them, leading to destruction of the bony areas around the joints. This condition may afflict any of body's joints and usually produces a deformity of the joint. The hands and fingers no longer appear straight but often appear angled towards one side. In some cases the spine may be involved, frequently the cervical spine (the vertebrae of the neck). The areas of the neck most commonly afflicted by rheumatoid arthritis are the first and second cervical vertebra. Curiously, rheumatoid arthritis, although often producing severe deformities, is not always painful.
The more common form of arthritis is osteoarthritis. It is a wear-and-tear form of arthritis and usually does not produce deformity of the joints or destruction of the bony tissues. Rather the ligaments weaken and may be calcified due to the body's attempt to heal the damage. The larger joints of the body and those joints that take the most stress and strain are the most often afflicted. In the neck region osteoarthritis usually involves the fifth, sixth and seventh vertebrae, as the effects of posture produce the most fatigue on them. Osteoarthritis is often more painful than rheumatoid arthritis.
During the workup for arthritis, a test evaluating inflammation and the sedimentation rate will be performed. In rheumatoid arthritis, this test will usually be elevated. Other tests for inflammation may also be elevated. In patients with osteoarthritis, x-rays of the neck or jaw joints will show changes from "lipping" of the vertebrae (caused by calcium deposits in the ligaments), narrowing of the space between the vertebrae, or spur formation (from calcium deposits). If severe, it may cause obstruction of the holes where the nerves pass from the spine to the body. In rheumatoid arthritis, dislocation of vertebrae may occur in the upper neck. CT scan and MRI in patients with osteoarthritis may show bulging of the discs that cushion the vertebrae. In the most severe cases, herniation of the discs may occur.
Headaches, felt as a pain in the neck, may be caused by arthritis if the first, second or third vertebrae are involved. This condition is due to the nerves that supply the scalp only originating from this area of the spine. Neck pain itself, whether alone or coupled with headaches, can involve any portion of the neck. If the jaw is involved, the symptoms are similar to those of Temporomandibular Joint Syndrome (TMJ).
The progressive severity of rheumatoid arthritis may be slowed by a variety of very potent prescription medications. In osteoarthritis, its progression is not usually hindered by medication. Life-style adjustment, exercise, rest and weight loss may be helpful in slowing the advancement of the disorder. Medications, such as the nonsteroidal anti-inflammatory agents (NSAIDs), are useful in reducing the pain and improving the reduction of motion that occurs in joints afflicted by arthritis. From some studies, the use of acetaminophen appears to be as effective in controlling the pain of arthritis as the NSAIDs. Physical modalities including heat, massage and exercise may also be useful for arthritis. However, physical therapy must be prescribed by a physician, just as most medications for arthritis.