Sinus Headache vs. Migraine: What's the Difference?
You've got a stuffy, runny nose, and your forehead and cheeks hurt. That means you have a sinus headache, right? Maybe not. Headaches and nasal congestion are also possible symptoms of migraine.
It's a common misunderstanding. Misdiagnosis happens so often that one study found 95% of people who thought they had a sinus headache actually had a migraine headache.
The two conditions have different causes. True sinus headaches are caused by sinusitis, which means inflammation of the tissues lining your sinuses — spaces in your forehead, cheeks, and nose that are usually filled with air. Colds and allergies are common triggers. Some people have chronic sinusitis, caused by bacterial infections.
On the other hand, migraine headaches are part of a chronic condition involving your brain, nerves, and blood vessels. It tends to run in families.
There are ways to tell the difference between the two. Some symptoms are rare in sinus headaches but common in migraine attacks, while some are rare in migraine attacks but common in sinus headaches. Since treatments for the two kinds of headache differ, it's important to find out which kind you have to ensure relief.
Sinus Headache vs. Migraine: Symptoms
Both sinus headaches and migraine headaches can cause:
- Pain that gets worse when you bend forward
- Pressure on your forehead and cheeks
- Runny nose
- Stuffy nose
- Watery eyes
Adding to the confusion, people with both kinds of headaches may describe their pain as throbbing.
Migraine symptoms
Here are some symptoms you might have if you have migraine, but not a sinus headache:
- Sensitivity to light, sound, and sometimes smell and touch
- Nausea
- Vomiting
Sinus headache symptoms
Here are some of the symptoms you might have if you have a sinus headache, but not a migraine attack:
- Thick, discolored nasal mucus
- A decreased sense of smell
- Pain in your upper teeth
- Fever
- Bad breath
- Cough
Can a sinus infection cause dizziness?
People with sinusitis often report dizziness and say it goes away when their sinus problem clears up. It's not clear whether the dizziness is directly caused by the sinus problems. One possibility is that the same things that cause sinus problems, such as allergies and infections, affect the inner ear or brain, throwing off balance.
Sinus Headache vs. Migraine: How to Tell the Difference
In addition to noting your symptoms, you might consider:
Possible triggers
Did your symptoms start after you came down with a cold, flu, or other respiratory illness? If yes, it's more likely to be a sinus headache.
If you get headaches after changes in the weather, stressful events, missing a meal, or exposure to bright lights, noises, or strong odors, there's more reason to suspect migraine. Triggers for migraine headaches vary from person to person and can include hormonal changes, medications, sleep changes, and heavy exercise. Some people have migraine attacks after drinking alcohol, especially wine, or too much caffeine.
How long it lasts
Migraine episodes typically last 4-72 hours.
A sinus headache often lasts longer, typically a week to 10 days, and sometimes more.
Whether there's an aura
Many people with migraine get brief episodes of added symptoms before their headaches start or during the headache. These are called auras. Auras differ from person to person but often include visual disturbances, such as seeing bright spots or flashes of light. Or you might feel prickly sensations, weakness, numbness, or have trouble talking.
Your medical and family history
Migraine runs in families because of genetic links. So, consider whether anyone you are related to has a migraine history.
You're also more likely to have migraine if you have depression, a sleep disorder, epilepsy, or anxiety.
Medical advice
While all of these factors can be clues, if you are having headaches that disrupt your life, you'll need medical help to confirm the cause.
If your primary care doctor thinks you might be having migraine attacks, they may refer you to a neurologist or headache specialist. After examining you and getting your medical history, the specialist might order an MRI or CT scan to rule out other possible causes. For chronic sinusitis, you might be referred to an ear, nose, and throat specialist (ENT). The ENT might look into your sinuses with a thin lighted tube to look for swelling, signs of infection, or other problems.
Sinus Headache vs. Migraine: Treatment
Your head hurts. Does it really matter why? Yes, because treatments for sinus headaches and migraine are different. Getting relief means using the right treatment for the underlying cause.
Sinus headache treatment
For a short bout of sinusitis, you may get relief with:
- Over-the-counter cold and allergy medications, including decongestants
- Saline nasal rinses
- Drinking plenty of fluids
If your sinusitis lasts longer than 10 days, your doctor might prescribe:
- Antibiotics, if there's reason to suspect a bacterial infection
- Decongestants
- Nasal steroid sprays
- Antihistamine sprays or pills
- Medications called leukotriene modifiers, which block the production of a chemical in your body involved in allergic reactions
In some cases of chronic sinusitis, if medication doesn't help, your doctor might recommend surgery. Sinus surgery can be used to treat structural problems, take out polyps, or remove built-up fungal masses (a cause of some sinus infections).
Migraine treatment
Most of the treatments used for sinus headaches won't help with migraine attacks. Instead, your doctor may recommend:
Medications to stop migraine symptoms after they start. If your symptoms are mild to moderate, these can include nonprescription painkillers such as ibuprofen, aspirin, acetaminophen, naproxen, and caffeine (found in some headache remedies). But if you need these more than two or three times a week, your doctor may suggest prescription drugs. Some treat symptoms such as nausea and light sensitivity, in addition to pain.
Medications to prevent migraine attacks. If you have frequent or severe attacks, you might get a daily medication to prevent them.
Learning and avoiding your migraine triggers. Because triggers differ from person to person, you might keep a daily journal to see what foods, drinks, activities, or other things might trigger your symptoms. Then, you can try avoiding or cutting down on those things.
Self-care. During a migraine attack, you may ease symptoms by lying down in a dark quiet room with a cool cloth on your head and drinking plenty of fluid. Caffeine helps some people. You might reduce future attacks by staying physically active, eating regular meals, and following a consistent sleep routine.
Biofeedback and relaxation training. You might be able to reduce your headaches and other migraine symptoms by learning techniques to control your breathing, heart rate, muscle responses, and other bodily functions. Your doctor can refer you to providers who know how to work with migraine patients.
Are Sinus Headaches and Migraine Related?
The main link between migraine headaches and true sinus headaches (caused by sinusitis) is their similar symptoms. The best explanation is that migraine affects nerves that connect to your sinuses, as well as your eyes, ears, teeth, and jaw. When these nerves are activated, you can get congestion, a runny nose, and watery eyes, whether the cause isa migraine attack, an allergy, or a sinus infection.
Also, some research suggests migraine is more common in people with allergies, which is one cause of sinusitis. It's possible that problems caused by allergies, such as nasal congestion, inflammation, and disrupted sleep, help trigger migraine attacks in some people. So, treating your allergies might help prevent both migraine and sinus headaches.
When to See a Doctor
Make an appointment when your headaches:
- Are coming more often or are more severe
- Don't get better with over-the-counter medications
- Keep you from working, sleeping, or doing your normal activities
- Cause other problems
Your doctor may talk to you about your health, both now and in the past. They may also run some tests to rule out other possible causes of your headache before coming up with a treatment plan.
A severe headache may be a symptom of a serious condition such as a stroke, meningitis, or encephalitis. Seek emergency care if you:
- Are confused or have trouble understanding speech
- Faint
- Have a fever over 102 F
- Are numb, weak, or paralyzed on one side of your body
- Have a sudden and severe headache
- Have a stiff neck
Takeaways
If you think you've a sinus headache, there's a good chance it's really a migraine attack. While some of their symptoms are similar, they are different conditions with different treatments. It's important to figure out what's going on so that you can get relief.
