By Zahra Barnes– Self
Sinus headaches and migraines can both feel like tiny construction workers are jackhammering away inside your skull. Otherwise, though, they may seem like completely separate issues. The surprising truth is that sinus headaches and migraines are a lot more connected than you might think—so much so that what you think of as a sinus headache might be a migraine instead.
“I work with ear, nose, and throat doctors very closely. They get a lot of referrals for sinus headaches, but most of those end up being migraines,” Kevin Weber, M.D., a neurologist who specializes in treating patients with headaches at The Ohio State University Wexner Medical Center, tells SELF. “Sinus headache is very overdiagnosed, and migraine is underdiagnosed.”
Knowing the correct cause of your head pain is the first step toward making it go away. Here’s what you need to know about sinus headaches, migraines, and how to tell the difference.
Sinus headaches and migraines can present in painfully similar ways.
Sinus headaches happen due to sinusitis, or an inflammation of your sinuses, the cavities in your skull that are connected to your nose, according to the Mayo Clinic. It can be acute, meaning it lasts for under 10 days, or seems to recede then comes back with a vengeance. It can also become chronic and last for 12 or more miserable weeks. You can get sinusitis thanks to things like a cold, allergies, or abnormalities in your nasal passages, like a deviated septum.
Migraines, on the other hand, are bouts of severe head pain that can have various triggers, like hormonal changes, stress, sleep deprivation, and more, according to the Mayo Clinic.
Both sinus headaches and migraines can cause intense head pain, sinus pressure, and a runny or stuffy nose. This is mainly because all the stuff that gives your head and face feeling is packed closely together.
Your trigeminal nerve is a pain pathway that provides sensation to the head and face and is thought to be at least a partial cause of migraines, Jessica Ailani, M.D., associate professor of neurology at MedStar’s Georgetown University Hospital and director of MedStar Georgetown Headache Center, tells SELF. It happens to be connected to a bundle of nerves called the sphenopalatine ganglion. Also known as the SPG, these nerves help control autonomic (i.e., involuntary) functions like breathing. The connection between the trigeminal nerve and the SPG is why people with either migraines or sinus headaches can have head pain and pressure that come along with issues like a runny or stuffy nose.
To make things even trippier, sinus headaches and migraines can share triggers like weather and seasonal changes. “It can get very confusing when patients decide what kind of specialist to see,” Dr. Weber says.
There are a few key differences between sinus headaches and migraines that can help you figure out which you have.
Here are some clear signs you may indeed have a sinus headache:
You have other signs of infection, like a fever or a cough: These aren’t likely to come along with a migraine, Dr. Ailani says. If you’re experiencing them along with congestion and head pain, a sinus headache could be to blame.
When you blow your nose, you see green or yellow mucus: Changes in mucus color can signal that you have a bacterial sinus infection instead of a migraine. And these often can lead to sinus headaches.
Here are a few hints that migraines are actually your issue:
You’re experiencing aura: Having pain that comes along with aura—sensory changes like seeing weird shapes or flashes of light, vision loss, hearing random noises, physical numbness or weakness, smelling or tasting strange things, and more—is one pretty clear sign you’re dealing with migraines instead of sinus headaches, Dr. Weber says. But not everyone with migraines experiences aura; only around 15 to 20 percent of people with migraines do, according to the Cleveland Clinic. And it’s true that sinus headaches can cause sensory issues like a decrease in smell and taste, too. Still, these types of sensory changes are much more likely to accompany migraines than sinus headaches, Dr. Weber says.
You’re nauseous, vomiting, or experiencing sensitivity to noise or bright light: These are classic migraine symptoms that don’t typically occur with sinusitis, according to the Mayo Clinic.
Sinus infection treatments don’t help your symptoms as much as you’d expect: Sinus infections are typically treated with things like nasal sprays and decongestants, allergy shots, or potentially antibiotics if you have a severe bacterial sinus infection, according to the Mayo Clinic.
Since migraines and sinus infections have similar symptoms, some of these treatments may help relieve things like a runny or stuffy nose that accompanies a migraine, Dr. Ailani says. But while they can completely eradicate a sinus infection, they won’t do the same thing for a migraine. Figuring out a migraine treatment plan is typically more involved and can vary from taking a range of pain relievers to using triptans, which block pain pathways, to trying preventive medications that attempt to stop the pain from starting in the first place.
“If you actually have a sinus headache, the pain should recede as soon as the congestion does,” Dr. Weber says. “If [sinus infection medications] aren’t working, you may have the wrong diagnosis,” Dr. Weber says.
If you think you’re experiencing either sinus headaches or migraines, see your doctor and be very specific about your symptoms.
Your doctor can do exams or scans to check out your sinus area and/or brain functioning, then take it from there. Giving as much detail about your symptoms as possible can help them get to the bottom of your issue more quickly, which will help you find relief. “Don’t just label yourself as having sinus headaches,” Dr. Weber says. “Making sure that you get the proper diagnosis and see the right specialist is really key.”