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Migraines vs. Sinus Headaches

Illustration of different types of headaches such as: migraine, tension, cluster and sinus


A migraine is frequently misdiagnosed as a sinus headache. 9 out of 10 people who think they have a sinus headache are actually suffering from a migraine. The problem is, treating migraine like a sinus headache or the other way around does not work. Often times, people who think they have a sinus headache try several over the counter medications to relieve sinus headaches but they simply don’t work. It’s probably because they have a migraine instead of a sinus headache that’s why the sinus medication is not relieving the headache.

A migraine

A migraine is a common primary headache disorder that is caused by a neurological malfunction that is believed to originate in the brain stem. It can be due to genetic and environmental factors. It is defined by frequent headaches that can have a moderate to severe intensity that often occurs with vomiting and nausea, and a sensitivity to sound and light. The headaches typically affect half or a part of the head, may have an onset that is gradual or abrupt, last from 2 to 72 hours, and are pulsating in nature. The pain may be felt on one side or may also distribute, cramped to the top, front, or back of the head, and often extends to the neck. It may also cause pain in the face. The occurrence of a migraine is familiar and distinct and its duration and resolution are predictable.

A sinus Headache

Sinus headaches are brought about by sinus infections. The build-up of pressure when the sinus gets inflamed because of an infection or an allergic reaction causes pain that feels like a headache. A sinus headache is a common complaint but it is actually rare and is just secondary to a bacterial or viral sinus infection that is defined by a thick and discolored nasal discharge, facial pressure or pain, alteration in smell or foul-smelling breath, and fever. A sinus headache can occur on one or both sides of the head and it doesn’t reach the neck.


The reason why migraines are thought of as sinus headaches is that the symptoms presented are similar to that of sinus headaches.

Common Symptoms of a Migraine and Sinus Headache

Both conditions share the same symptoms such as:

  • Pain in the head particularly in the forehead
  • Pain when moving
  • Head pain triggered by changes in the weather
  • Pulsating pain
  • Watery and itchy eyes
  • A runny nose
  • Facial pain and pressure
  • Puffy eyelid
  • Sinus pressure
  • Sinus and nasal congestion and irritation

Symptoms of a Migraine

Aside from the common symptoms of both conditions, the other symptoms of a migraine may include:

  • Severe throbbing pain on one side of the head
  • Vomiting and nausea
  • Pulsing and throbbing pain
  • Sensitivity to light and sound

Individuals who suffer from a migraine miss a number of activities such as family, school, or work events. What usually helps in easing the pain is laying down in a dark room and putting a cold compress on the head.

Symptoms of a Sinus Headache

Other symptoms of a sinus headache include:

  • Thick and green or yellow nasal discharge
  • Fever
  • Pressure on the sinuses
  • Reduced sense of smell

The headaches usually get worse in damp weather, when bending, or early in the day.
The pain can be inconvenient but it does not make a person unable to function or work.

Location of Pain

The location of pain is one clue as to which kind of a headache an individual is suffering from. Headaches caused by a migraine are more localized which means that it can occur in patches, on one side of the head, or on top, in front, or at the back of the head. The pain can also reach the neck or cause pain on the face but the pain is not an overall pain.
The pain can occur in different areas at the same time.

The pain caused by a sinus headache is usually felt in front of the face where the sinuses are located. The pain occurs in the bridge of the nose, above the eyes, and the cheeks. It can be felt on one side or both sides of the head but it does not usually reach the neck.


Migraines are due to changes in the brainstem and the way it communicates with a primary pain pathway called trigeminal nerve. The consumption of particular foods, alcohol, stress, medications, hormonal issues, sleeping habits, or changes in the environment can trigger headaches due to a migraine. Other stimuli like lights, sounds, smells, and scents can also trigger a migraine attack.

Sinus headaches are due to colds caused by blocked sinuses or allergies. The obstruction causes a congestion of the mucus in the sinuses which hinders it from draining away.
The mucus builds up in the sinuses which makes it a perfect breeding ground for bacteria which may result in an infection of the sinuses. Sinus headaches are usually due to an inflammation or infection of the nasal passages that results in congestion. This causes pressure and pain behind the cheekbones and in the forehead.


The treatment for the headaches caused by these two conditions vary. Taking over the counter medicines to treat sinus headaches that are actually migraine headaches will only make things worse because most medications for sinus problems contain analgesics

Treatment for a Migraine

The treatment for a migraine doesn’t just alleviate a headache and stop it once it starts. The treatment also works to prevent it from occurring, and reduce the frequency, duration, and severity of pain.

Individuals with a migraine can take medication such as triptans when having a migraine attack to help alleviate the pain and get back to their normal activities. The medication should only be taken with doctor’s consent.

A doctor may also prescribe other medicines that are used to treat depression, high blood pressure, and epilepsy as they can hinder migraine attacks. Botox shots can also work. Women who get a migraine as an effect of their menstrual cycles can also be prescribed with hormone therapy.

Most of the time, lifestyle changes are also needed to ease the stress that may trigger a migraine. Exercise, biofeedback, and relaxation can help keep a migraine away or at least lessen the pain caused by it. Avoiding the factors that trigger a migraine is also part of the treatment process.

Treatment for a Sinus Headache

Initial treatment for a sinus headache starts with pain relievers, decongestants, and nasal irrigation to ease the congestion and the pressure in the sinuses and to also help in the drainage of mucus.

Nasal steroids and antibiotics are used to treat the underlying infection.

A headache should be gone once treatment for is started.