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The Difference Between a Migraine and Sinus Headache

Posted by Migraine Relief Center on May 6, 2015 7:00:00 AM

The allergy season is in full swing, and your daily sinus headache is ruining your spring. Is it really a sinus headache, however, or could you possibly be suffering from a migraine headache instead? It’s not unusual to confuse the two, according to Mark A. Zacharek, MD, residency program director for the department of otolaryngology and head and neck surgery at Henry Ford Hospital in Detroit.

Here’s how to tell the difference between a migraine and a sinus headache:

Pain Location

The location of your pain is the first clue to the type of headache you are suffering from. Migraine headaches typically feel more “localized,” occurring either in patches, on one side of the head or making themselves felt at the front, top or back of the head. The pain can reach into the neck or cause your face to hurt as well, but it isn’t usually an overall pain, although it can occur in several areas at the same time.

Sinus headaches, however, usually have some effect on the front of your face where the sinuses are located. The pain occurs in:

  • the bridge of the nose
  • the cheek areas, and
  • above your eyes.

It can be on one or both sides of the head and doesn’t usually affect the neck. 


Migraines and sinus headaches have different symptoms, apart from the pain of the actual headache itself. Symptoms include thick, discolored nasal discharge, pressure on the sinuses, pain, fever and a reduced sense of smell. The headaches typically get worse in cold, damp weather, if you bend over or it’s early in the day. They might be inconvenient but don’t usually cause the patient to be unable to work or function.

Migraine symptoms, however, often include nausea and vomiting, sensitivity to light and a pulsing, throbbing pain. The symptoms are worse than those of a sinus headache, and become significantly worse with physical movement. Some of the symptoms associated with sinus headaches might occur, too, such as nasal congestion and irritation. Sufferers find that over a 3-month period they miss a number of activities such as school, work or family events. Often, the only action that helps is to lie down in a darkened room with a cold compress on your head. If that sounds like you, this is very likely not just a sinus headache!


Sinus headaches are generally caused either by allergies or a head cold that results in blocked sinuses. This obstruction causes congestion of the mucus in the sinuses, preventing it from draining away. This builds up and becomes a perfect incubation area for bacteria, which can cause the sinuses to become infected. 

Migraines have a different cause and triggers entirely. The headaches are a result of changes in the brainstem and the way it interacts with the trigeminal nerve, which is a primary pain pathway. They are usually triggered by consuming particular foods, stress, alcohol, hormonal issues, medications or changes in your environment or sleeping habits. Stimuli such as scents, sounds, lights and smells also play a role in triggering an attack.

Getting Relief

These two types of headaches respond differently to various treatments, which can help you to determine where you should go for medical care. Sinus headache sufferers typically get relief by taking antibiotics to reduce any infection, using steroid-based nasal sprays to dry up the congestion and home remedies such as nasal irrigation to clear out the residue. Over-the-counter analgesics help with the pain. 

Migraine headaches are initially treated with medications such as anti-depressants, epilepsy preparations and hormone therapy, however. Using over-the-counter pain relievers such as analgesics can have the opposite effect by causing the pain to rebound. Lifestyle modifications aimed at reducing stress and avoiding triggers help, and in some cases having BOTOX® injections can relax the muscles that put pressure on the nerves causing the migraines.  

Long-Term Outlook

In the long term, treating a sinus headache requires a completely different approach to medical care than a migraine does. The good news, however, is that if your persistent, nagging pain turns out to be migraine there are multiple avenues you can explore to find permanent relief. These include migraine surgery, clinical massage and neuro-stimulation, among others.

Don’t self-diagnose. If you’re suffering from regular headache pain along with your spring allergies, get an evaluation by a medical professional. It may well be a sinus headache, but it could also be a migraine and if so you could be treating it all wrong. The correct diagnosis gives you the opportunity to find effective medical care sooner rather than later.

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Topics: Migraine

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