Even if you’ve never thought too hard about what sinuses actually are (air-filled cavities nestled beneath parts of your face), you know sinus pain when you feel it: a dull ache behind your eyes, forehead, nose and/or cheekbones, which intensifies when you lean forward. You might think you also know the cause: a sinus infection brought on by allergies or a cold. It seems obvious enough—but there’s a very good chance you’re wrong. According to the American Migraine Foundation, 90 percent percent of people who think they have chronic sinus headaches and sinus infections (fancy name: rhinosinusitis) are actually experiencing symptoms of migraine.
How are a sinus headache and migraine similar?
It’s weird but true—migraine often do cause symptoms usually associated with allergies and the common cold, like a stuffy nose or runny nose, sore throat (due to postnasal drip), facial pain, and watery eyes. These symptoms occur due to the way the autonomic nervous system is activated during a migraine attack. Meanwhile, true sinus headaches are actually rare and occur because of a specific chain reaction. Your sinuses—those aforementioned air-filled cavities—are lined with tissue that produces mucus that acts like a sticky trap for viruses, bacteria, and allergens. Sometimes, exposure to certain germs or allergens can cause your sinuses to churn out more and more mucus at the same time that the tissue becomes inflamed and swollen, preventing effective drainage. This leads to a sinus infection, which can cause a buildup of pressure that becomes a sinus headache.
How can I differentiate a true sinus headache from migraine?
There are several clues you can look for to confirm that you have a true sinus headache. If your headache pain and facial pain have lasted for more than a couple of days, you have a fever, have nasal discharge that’s discolored and thick, lose your sense of smell, or are experiencing aches in your upper teeth, it’s likely that your sinus headache is the result of a viral or bacterial infection. Another telltale clue: If you get tend to get sinus headaches seasonally in the fall and spring, they could be related to allergies.
What are the sights that it’s actually migraine?
On the other hand, if your sinus headaches also come with sensitivity to light or sound, nausea or vomiting, last only a day or two max, and your nasal mucus is thin/clear, it’s likely that their real cause is migraine. If you get sinus headaches frequently, it’s best to make an appointment with your primary care doctor, who will ask questions and sometimes perform tests (like an X-ray, endoscopic exam, or CT scan) to identify the root cause. Sometimes, factors like a deviated septum or nasal polyps (growths inside your sinuses) can cause people to get frequent sinus infections. If it’s determined that your sinus headache is the result of a sinus infection, your healthcare provider may prescribe antibiotics as well as recommend antihistamines or decongestants and over-the-counter pain relievers until your sinus blockage and nasal congestion resolve. You might also be given a corticosteroid nasal spray to bring down sinus inflammation more quickly, and using a humidifier is another way to effectively loosen nasal congestion and ease sinus pressure (just like when you’re fighting any type of upper respiratory infection).
How do I treat a sinus headache related to chronic migraine?
If your healthcare provider thinks your sinus headache is the result of migraine, you’ll need to take a very different approach. Migraine is treated using preventive habits and medications as well as acute pain relief medications; it can take a little trial and error to identify your migraine triggers (which, just to confuse matters, can include allergens and illnesses) and find the best migraine medications for you. Once you figure out a migraine treatment plan—or treat the other root cause of your sinus headaches—you can hopefully get back to never thinking about your sinuses at all. As it’s meant to be.
