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When you start to feel a pain at the front of your head, down behind your eyes and nose, you may be developing a sinus headache. But you’ve had migraine headaches before and they feel similar. How can you tell them apart? Is there such thing as a sinus migraine?
Though a sinus headache and a migraine share some common symptoms, you can often diagnose the problem if the headache is accompanied by other symptoms of sinus infection. You can also eliminate sinuses as the cause of your discomfort if the pain includes typical migraine symptoms, including nausea and a sensitivity to light.
Interestingly, a migraine headache is often misdiagnosed as a sinus headache, both by headache sufferers and physicians, says Robert Kaniecki, MD, assistant professor and director of the Headache Center at the University of Pittsburgh Medical Center. “A review of a number of studies suggests that far more people actually suffer migraine headaches than popularly thought,” he says. “Many people who are diagnosed as having ‘tension’ or ‘sinus” headaches are, in fact, suffering migraines.”
Making the distinction is important, because it affects how you should treat your headache.
Symptoms of Sinus Infection
When pain in the front of head and in the nasal passages is also accompanied by discolored mucus and a reduced sense of smell, you’re probably having a sinus headache.
Other symptoms of sinus infection include a fever, though that can depend on whether you have a viral or bacterial infection. A viral infection sometimes causes a fever, while a bacterial infection almost always leads to a fever, at least during a portion of your illness.
A migraine, by contrast, does not appear with a fever unless there is another underlying cause.
QUIZ: Are You Having a Sinus Headache or Migraine Headache?
Answer the following questions with a “yes” or “no” to find out whether you have a sinus headache or a migraine headache:
1. Do you have a fever?
2. Do you have thick, green mucous coming out of your nose?
3. Do you have diminished sense of smell?
4. Are you experiencing pain or pressure in your face and/or ears?
5. Do you have dental pain?
6. Are you experiencing pain on both sides of your head?
7. Do have a persistent cough?
If you’ve mostly answered “yes” to these questions, then you’re more likely having a sinus headache as opposed to a migraine headache. If you’ve mostly answered “no” to these questions, then you could be suffering a migraine or some other type of headache. For more information about the different types of headaches and what cause them, click here.
Pinpointing the Pain
A migraine may develop in the same location as a sinus headache, but sometimes a migraine can be felt on the top of your head or just on one side. A sinus headache, too, may feel worse on one side or the other, but it will still be located in the front of your head and somewhere in your sinus cavity.
The pain from a migraine may also travel into your neck or jaw. It can also get worse with activity, which is why rest in a cool, darkened room, is often how migraine sufferers find relief.
The pain itself tends to differ between migraines and sinus headaches. Migraine pain is usually described as pulsing or throbbing. Sinus headache pain is more like a buildup of pressure. Your face may feel tender to the touch. You may even feel pain in your teeth with a sinus infection.
What’s Unique to Migraines?
A true sinus headache often develops as other signs of sinus infection also appear. You can usually feel the pressure in your sinuses building as you deal with congestion and sometimes a fever.
A migraine, on the other hand, can come on suddenly, triggered by such things as bright lights or stress. If you regularly suffer migraines, you may already be aware of your triggers. If not, make a point to note factors that may have contributed to your migraine: sensory stimuli (bright lights, loud noises, strong odors, etc.), stress, physical activity, weather changes, certain foods or alcohol, hormonal changes in women (related to their periods, pregnancy or menopause), and medication side effects.
The better you can understand what causes migraines, the better you may be able to avoid them in the future.
Migraines also tend to run in families, so if you have a parent who suffered migraines, your odds of getting them are higher. Some migraine sufferers also get a tip-off that a bad headache is coming when they experience aura. It’s a sensation that may include dizziness or flashing lights and zig-zag lines interrupting your vision.
Treating Your Sinus Headache
Unfortunately, migraine treatment options are limited. There are medications that can help prevent migraines, but they must be taken daily. Once symptoms begin, you may find some relief with over-the-counter pain relievers, such as acetaminophen, ibuprofen, or naproxen sodium. Other medications, called triptans, can help block pain signals to the brain. Anti-nausea medications may also be recommended.
For many migraine sufferers, the pain may last several hours. Riding it out is sometimes the only solution. You should talk with your doctor about all possible treatment options. Some people find migraine relief from acupuncture, for example.
Sinus headache treatment usually requires that you deal with the cause of your sinus infection. A bacterial infection usually requires a course of antibiotics. A viral infection usually has to run its course—about a week or so.
In the mean time, you may find relief from saline sprays that can help break up congestion clogging your sinuses and causing that pressure. Nasal decongestant medications may also help, but should only be used for a few days.
No matter what the cause of your headache, if it lasts for hours or days, or is a recurrent problem, you should see a doctor to get a proper diagnosis. When you see a physician, be sure to share all of your symptoms. As Dr. Kaniecki notes, headaches can often be misdiagnosed. But a complete understanding of all your symptoms and health history will help you and your doctor plan the most effective course of action.
This article was originally published in 2017. It has since been updated.