Psoriatic arthritis (PsA) is an inflammatory form of arthritis. About 30% of people with psoriasis, an autoimmune skin disease that causes skin cells to build up and form plaques, also have PsA. Symptoms of psoriatic arthritis can include joint pain and swelling, skin lesions, back pain, and nail deformity.

Recent research has linked psoriasis and psoriatic arthritis to migraines. People with the two conditions are believed to be at higher risk of new-onset migraines.

Migraines can be moderate-to-severe headaches accompanied by nausea and sensitivity to light and sound. More research is needed to better understand the relationship between PsA and migraines.

What Is Psoriatic Arthritis?

Psoriatic arthritis is an autoimmune disease where your immune system attacks healthy cells by mistake. The disease often appears in people between the ages of 30 and 50. For many, it starts about 10 years after psoriasis develops, but some develop PsA first or without ever developing or noticing psoriasis.

Some people may develop PsA in a joint after an injury, or it may be related to genetics. Researchers have estimated that at least 10% of the general population inherits one or more of the genes that create a predisposition to psoriasis.

PsA can develop slowly, with mild symptoms, or it can develop quickly and severely. Common symptoms of PsA include:

  • Fatigue
  • Tenderness, pain, and swelling over tendons
  • Swollen fingers and toes that sometimes look like sausages
  • Stiffness, pain, throbbing, swelling, and tenderness in one or more joints
  • Reduced range of motion
  • Morning stiffness and tiredness
  • Nail changes, such as pitting or separation from the nail bed
  • Redness and pain of the eye (uveitis)

Psoriatic Arthritis and Migraines

Recent studies have found links between psoriasis, PsA, and migraine. The inflammation in the body from psoriasis can make its way around the body, including the brain.

A 2015 study investigated the link between psoriasis and PsA, and the risk of new-onset migraine. Research showed a significant rate of migraine in people with mild or severe psoriasis and PsA. They also found that the risk of migraines increased with the severity of psoriasis.

Another study in 2017 linked psoriasis with migraine, and more frequently, migraine with aura. Similarly, a 2019 study found migraine and neuropathic pain (nerve pain) frequently occur in people with rheumatic diseases, conditions that affect the joints. The study recommends getting checked and treated for headaches or migraines even if the underlying rheumatic disease is under control.

Diagnosis of Psoriatic Arthritis and Migraines

There is no one definitive test for PsA. The diagnosis is usually made through careful observation and a process of elimination. Your doctor will perform a physical exam and order X-rays and blood tests to rule out other conditions, such as rheumatoid arthritis, another inflammatory type of arthritis.

To diagnose a migraine, your healthcare provider will take a thorough medical history—not just your history of headaches, but your family’s history as well. Also, they’ll want to learn more about your migraine symptoms. They will likely ask you to:

  • Describe your headache symptomsRemember when you get themDescribe the type and location of your painRemember if anything makes your headache better or worseTell how often you get migraine headachesTalk about the activities, foods, stressors, or situations that may have brought on the migraineDiscuss what medications you take to relieve the pain and how often you take themTell how you felt before, during, and after the headacheRemember if anyone in your family gets migraine headaches

Your healthcare provider may also order blood tests and imaging tests (such as a CT scan or MRI) to make sure there are no other causes for your headache. An electroencephalogram (EEG) may be ordered to rule out seizures.

Diagnosis can be made by a primary physician, neurologist, or headache specialist.

Treatment for Psoriatic Arthritis and Migraines

PsA is treated with nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), immunosuppressants, biologics, steroid injections, and joint replacement surgery.

Psoriatic Arthritis Doctor Discussion Guide

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Over-the-counter (OTC) medications are effective for some people with mild to moderate migraines. Three OTC products approved by the Food and Drug Administration for migraines are Excedrin Migraine, Advil Migraine, and Motrin Migraine Pain.

If the pain from your migraine is severe and cannot be eased with OTC medications, your doctor may recommend a prescription medication. Examples include triptan, calcium channel blockers, beta-blockers, and antidepressants. Your doctor may also prescribe a medication to help with nausea if needed.

What to Expect During Treatment

Migraines may not be a quick and easy fix. Due to the range of symptoms and underlying conditions, a mix of therapies may be required to target and reduce migraines and symptoms adequately.

All migraine medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. 

It’s important to mention all symptoms to your PsA doctor, so further exploration can be done to determine if there is a direct link and if treatments can overlap.

Ways to Prevent Migraines

These tips can help you reduce how often you get migraines and how severe they are:

How to prepare for a visit with a headache specialist:

  • Keep a migraine diary: Take note of any foods and other triggers that you think may have caused you to develop a migraine. Make changes in your diet, and avoid these triggers as much as possible.Get a prescription for CGRP monoclonal antibodies: This injection was created specifically to help with migraines.Get enough sleep: Get seven to nine hours of sleep a night.Eat at regular intervals: Don’t skip meals. Drink plenty of water.Manage your stress: Learn techniques to control stress, such as meditation, yoga, relaxation training, or mindful breathing.Take medications as directed by your healthcare provider: Doing so can help you manage a migraine and prevent one.Ask about hormone therapy: Talk to your healthcare provider about hormone therapy if your migraines are thought to be linked to your menstrual cycle.Consider trying a transcutaneous supraorbital nerve stimulation device: This battery-powered electrical stimulator device is worn like a headband or on your arm. It emits electrical charges, which stimulate the nerve that transmits some of the pain experienced in migraines.Get counseling from a therapist: They can help you manage your stress. Ask your healthcare provider for a referral.

Summary

Recent research has found a link between psoriatic arthritis and migraines, mainly that people with PsA are more likely to experience new-onset migraines. PsA is closely linked to the autoimmune disease psoriasis, and about 30% of people with psoriasis develop PsA. Studies have shown that the more severe a person’s psoriasis is, the higher the risk they may develop migraines. Both conditions can be managed with medications and a treatment plan you work out with your doctor.

A Word From Verywell

Research is still being conducted to better understand the link between and possible treatments to address migraines with rheumatic diseases like psoriatic arthritis. It’s essential to keep your doctor up to date on all the symptoms you’re experiencing with your psoriatic arthritis, even if they seem unrelated. Also discuss with your provider ways to prevent and treat migraines with psoriasis.

Frequently Asked Questions

How long do psoriatic arthritis headaches last?

Migraine can last from two to 72 hours without treatment. OTC and prescription treatments can help avoid or reduce the symptoms of migraines.

What is the best way to prevent psoriatic arthritis flare-ups?

Psoriatic arthritis flare-ups can occur for different reasons in different people. For some, skin symptoms from psoriasis can precede arthritis pain, which is a good indicator of a flare-up that’s about to happen. Overall, preventing flare-ups involves avoiding triggers, adhering to your treatment plan, and managing your stress.

What does a psoriatic arthritis headache feel like?

Psoriatic arthritis is linked to migraines. A typical migraine will cause symptoms like pain, dizziness, nausea, and sensitivity to light and sound.