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Sinus Headache Symptoms = Migraine?

For Many, Misdiagnosed Migraines Mean More Misery
By
WebMD Health News

March 18, 2003 -- Got sinus headache symptoms? What you call a "sinus" attack may be a migraine.

It's not just a name game. If you're taking lots of headache pills for ongoing "sinus" headaches, it can make your migraines worse. And you're likely missing out on effective treatments, says Robert G. Kaniecki, MD, director of the headache center at the University of Pittsburgh. His update on headache diagnosis appears in the March 19 issue of the Journal of the American Medical Association.

A person with a sinus infection does indeed suffer head pain. But there's no evidence that chronic, ongoing sinus infections are linked to recurring headaches. Such headaches likely are migraines.

"Sinus headache: We are the only country in the world that sees a significant health problem in this," Kaniecki tells WebMD. "Other countries don't see sinus headache apart form acute sinus infection. I think part of this is Madison Avenue convincing us of something that is more accurately part of migraine. "

It's really a problem, agrees headache specialist David C. Haas, MD, a neurologist at SUNY Upstate Medical University in Syracuse, N.Y.

"Everyone in the headache business knows that in America, sinus headaches are overdiagnosed by the public -- and, unfortunately, by doctors," Haas says. "When people get sinusitis, they do get head pain over, under, and behind the eyes. But these people usually have other symptoms of acute sinus infection. The problem is that when they don't have these symptoms, a lot of people say they have sinus headaches. That sort of thing is misdiagnosis. I see a lot of patients come in with migraines who are on antibiotics for sinus headaches."

This is a significant part of antibiotic overuse in the U.S., Kaniecki suggests. Moreover, overuse of headache pills leads to rebound headaches.

The underlying problem is that migraines are more common than most people realize. Migraines are known to affect 18% of U.S. women and 6% of U.S. men. But fewer than half of migraine headaches get diagnosed. Many get misdiagnosed as sinus or tension headaches.

A big part of the problem, Kaniecki says, is that people suffering sinus headache symptoms go to their doctor and say they have sinus problems. Doctors with limited time may focus on sinus issues and fail to diagnose a migraine.

Kaniecki says people with headaches should see a doctor to rule out underlying health problems. He says if there's no other explanation, you likely have a migraine:

  • If your headache interferes with your life.
  • If your headache makes you adjust your daily schedule, lie down, or miss work or school.
  • If your headache makes you sick to your stomach.
  • If your headache is often throbbing and one-sided.
  • If your headache gets worse with activities such as bending over or going up stairs.
  • If your headache makes you sensitive to strong light, noise, strong odors, or sudden movements.

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