9 in 10 Sinus Headaches Really Migraines
Untreated Migraine Cause of Most 'Sinus Headaches'
What Is a Sinus Headache? continued...
There are many types of primary headaches officially recognized by the International Headache Society. Sinus headache (without an infection) is not one of them. On the other hand, they do recognize headaches attributed to infections as a cause of headaches.
But Eross says that one in 10 patients actually does seem to have what he calls a NIRSH -- a non-infectious rhino-sinus headache.
Eross says that mild cases of NIRSH may be common. Since they're mild, headache specialists rarely see them. And Marple says that patients suffering disabling pain from these rhino-nasal headaches may get relief from surgery.
"In studies where researchers diligently ruled out migraine and cluster headache and other neurogenic headaches -- that one out of nine patients in the Eross study -- if you do surgery on them, there appears to be a real improvement," he says.
Getting the Right Help
If you are missing work or your child is absent from school because of a sinus headache, you need professional help. But which professional you see makes a difference.
The 100 patients in the Eross study went to an average of four doctors each -- and still went on suffering. Relatively few got to a headache specialist: 64% saw their family doctor, 59% saw an ear-nose-throat (ENT) specialist, 25% saw an allergist, and only 19% saw a neurologist.
"Among folks who saw neurologists, 83% got a [correct] migraine diagnosis," Eross says. "Among those who saw ENTs, only 8.1% got a migraine diagnosis. Only 6.3% got a migraine diagnosis from an allergist."
Most health plans require patients to see a general practitioner first. Eross says it's important to ask for a referral to a headache specialist if you get frequent or disabling headaches.
Eross ended up treating about half of the "sinus headache" patients in his study.
"Most of them have dramatically improved with migraine management," he says.