Case in point: sinus headaches. A study published in the Archives of Internal Medicine found that of the 2,991 participants who thought they’d had at least six “sinus headaches” in the six months prior, 88 percent of them actually had migraine, according to the ICHD guidelines on diagnosing migraine. “Migraine is far more common than sinus headache,” says Kevin Weber, MD, a neurologist at the Ohio State University Wexner Medical Center in Columbus. About 35 million Americans have migraine, according to the Migraine Research Foundation. Unsure of what type of headache you have? Here are some clues for distinguishing between sinus headaches and migraine.
What Is a Sinus Headache?
A headache can be one of the symptoms of sinusitis, or inflammation and swelling of the sinuses, possibly caused by an infection or allergy. Sinusitis symptoms can also include facial pain and pressure, nasal drainage, nasal or facial congestion, postnasal drip, cough, and sore throat, according to Dr. Weber. “Some people do actually have true ‘sinus headache,’ typically caused by nasal septal deviation causing contact or pressure on the nasal walls and headache. This is also called a rhinogenic headache or a contact point headache. Typically, this headache worsens with sinus congestion and improves with relief of congestion,” he says. RELATED: What Is Sinus Infection?
What Are the Risk Factors for Migraine and Sinus Headache?
The exact reason why a person has migraine isn’t known, but it’s believed to be a combination of genetics and environmental factors, says Kiran Rajneesh, MBBS, a neurologist and pain medicine specialist at the Ohio State University Wexner Medical Center. “By genetics we mean something that you’re born with — a propensity for headaches that includes family history or mutations that involve certain channels in the brain,” Dr. Rajneesh says. Migraine is most common in people ages 18 to 44, and women are about three times more likely to have migraine than men, according to the Migraine Research Foundation. People are born with some propensity for migraine, and then there is a threshold for symptom attacks; people can reach that threshold when they are exposed to certain environmental factors or lifestyle changes, says Rajneesh. These can include certain foods, drinks, lack of sleep, or even changes in the weather, he says. A sinus headache is a symptom of a sinus infection. According to the Centers for Disease Control and Prevention (CDC), the risk factors for sinus infection can include a previous cold, seasonal allergies, smoking and exposure to secondhand smoke, structural problems with the sinuses such as nasal polyps, and a weak immune system or medications that compromise the immune system.
What Are the Overlapping Symptoms of Migraine and Sinus Headache?
Migraine attacks usually include a one-sided (or two-sided) headache that is typically moderate to severe, with throbbing and pounding when severe, says Weber. Facial pain and headache can occur with a sinus headache, too, according to the American Migraine Foundation. Both migraine attacks and sinus headaches can cause watery eyes and a runny nose.
How Is a Sinus Headache Different From a Migraine Attack?
Whereas a sinus headache is a result of pressure on the nasal walls, migraine attacks originate in the brain, says Rajneesh. “There’s often a clear association in a person who has a history of allergies, and then their allergies flare up, which then leads to headaches, and the headache is usually frontal,” he says. According to the American Migraine Foundation, people with allergic rhinitis are more than 10 times more likely to have migraine. Although both migraine and a sinus headache can come with a runny nose, with migraine the discharge is usually clear, whereas in a headache that comes with sinusitis, it can be colored or foul smelling, says Rajneesh. Migraine attacks are often associated with other symptoms besides a headache, which can include nausea, vomiting, light sensitivity, and sound sensitivity, according to Weber. “Some migraine patients have an aura, typically visual, with spots, lights, or colors prior to the onset of a migraine attack,” he says. To help your doctor make the correct diagnosis, it can be really helpful to track what you’re experiencing, says Lauren Doyle Strauss, DO, a headache specialist and assistant professor at Wake Forest Baptist Health in Winston-Salem, North Carolina. Write down your symptoms, says Strauss. “Where is the pain located? Are you tired or dizzy? Are you sensitive to light or sound? Do you have an upset stomach or vomiting?” In addition to considering your symptoms, there can be tests used to identify sinus problems. A headache caused by a sinus infection is typically diagnosed with a CT scan of the sinuses, says Weber.
Can You Have Both Migraine and Sinus Headaches?
People with migraine can get a sinus headache, says Rajneesh. “Migraine headaches have both genetic and environmental factors, and one of the environmental factors is allergies. If the allergies flare up in a person with preexisting migraine headaches, the migraine headache can get worse in the setting of sinus conditions or sinus disease,” he says. “In that case, as a neurologist, I would co-treat the headaches along with the primary care physician or the ear, nose, and throat (ENT) surgeon. I would work on addressing the migraine, and the other care provider would treat the underlying sinus headaches,” says Rajneesh. Because sinus congestion can be a trigger for migraine, “it can lead patients without a diagnosis of migraine to believe they are having sinus headaches,” Weber says.
Does It Make Sense to Try Home Sinus Remedies?
If you suspect that you are experiencing sinusitis, there are a few things you can do to improve the symptoms, including headache, says Rajneesh. But if your efforts to relieve your symptoms are unsuccessful, consider seeing a doctor to help diagnose what’s causing them. Use a humidifier. By humidifying the air, you can get a decrease in sinus pressure, which should translate into decreased incidence of headaches, says Rajneesh. Drink plenty of water. Hydrating is important, because it can help keep the mucus thin and loose, which can decrease infection and irritation, says Rajneesh. Use a neti pot, but make sure you’re using it correctly. A neti pot is a ceramic vessel with a spout that can be used to flush out nasal passages to relieve congested sinuses. Research published in 2016 in the Canadian Medical Association Journal found that people with chronic sinusitis who used a neti pot with a salt solution saw improvement in symptoms, including fewer headaches, and less use of over-the-counter medications. Researchers also looked at people who inhaled steam — this group had improvement in headaches as well, although no improvement was seen in any other sinus symptoms. If you do use a neti pot, be sure to use distilled, sterile, or previously boiled water. Tap water isn’t safe to use because it can contain low levels of bacteria and protozoa, including amoebas, according to the U.S. Food and Drug Administration (FDA). The water is safe to drink, because stomach acid kills those organisms, but they can stay alive in nasal passages and cause potentially serious infections and, in some rare cases, even death. Try over-the-counter pain relievers. Analgesics such as acetaminophen or ibuprofen can help relieve the pain of a sinus headache. A nasal decongestant or steroid spray may help alleviate discomfort as well. Learn More About Sinus Infection Treatment and Remedies
