Is It a Sinus Headache or a Migraine?

When it comes to sinusitis, there are some common symptoms and changes to your body that occur. For example, a sinus headache is an extremely common complaint within the US population. For most, it can lead to pressure within the sinuses, congestion in the nasal passage, and, of course, an aching sensation within the head.

Today, we tend to have a number of different medications that can be bought over-the-counter and this reinforces the belief that the issue is common and something that can be easily treated. Despite this, sinus headaches are not actually common and we know this thanks to a recent study entitled ‘American Migraine Study II’. Within this study, there were 30,000 people taking part and only half of the people diagnosed with a migraine were actually aware they were experiencing migraines. For the other half, they fell into the trap of thinking they were experiencing sinus headaches instead.

A woman is experiencing pain in her nose and forehead due to a sinus headache.

Is it a sinus headache or a migraine? Sometimes it’s hard to tell, so talk to your doctor to receive diagnoses and proper treatment.

What Is a Real Sinus Headache?

With misdiagnosis relatively common these days, you might be surprised to hear that ‘real’ sinus headaches aren’t actually all that common. Sometimes known as ‘rhinosinusitis’, this form of headache is rare and can be characterized by a change in the ability to smell, thick nasal discharge, a fever, and pressure within the sinuses. Often, this is led by a virus of some sort or even a bacterial infection which means that the issue should resolve itself within a week (as long as your doctor prescribes antibiotics and other appropriate medications).

In a different study with 3,000 participants, the blurred lines between a migraine and a sinus headache were highlighted and the results were quite shocking. Prior to the study, the participants had six or more ’sinus headaches’ within six months. At this point, they had never been diagnosed with migraines nor had they been treated for the condition.

Of 3,000 people, a whopping 80% (2,400 people) were found to be suffering from migraines as opposed to sinus headaches. For the scientists in control of the study, they used the International Classification of Headache Disorders to differentiate between the two problems. In addition to the nasal congestion, facial pain, and headache symptoms that seem to be common for both issues, participants also reported the following:

• Sensitivity to noise and/or light
• Throbbing or pulsing in the head
• Nausea
• Increased symptoms after certain activities
• Headache urging on ‘severe’ pain

Up until the study revealed their true health, many participants were taking medications bought over-the-counter or prescriptions designed to help with sinus headaches. Of course, a high percentage of these people noted how the medication wasn’t providing results and this is because they actually had migraines that were causing the sinus issues. Often, this is where the confusion comes in because people assume migraines can’t cause nasal congestion or watery eyes but they can (and do!).

The Difference

As the patient, you need to ask yourself a couple of questions to get to the bottom of the problem. Namely, are your headaches causing you to miss work, school, or any section of your life? After this, you need to consider whether the headaches cause a sensitivity to light and whether you get nausea with the headaches. According to an ID Migraine Questionnaire, your issue is 93% likely to be a migraine if you experience two of these three criteria. If you can relate to all three, it’s 98% likely to be migraines so this is a fantastic indicator.


All things considered, having nasal symptoms doesn’t automatically mean that you’re experiencing a sinus headache. With these symptoms also possible with migraines, we urge you to look a little deeper at sensitivity to light and sound, your ability to function during a typical day, whether you experience nausea, stress, sensitivity to changes in the weather, and more.

If you feel as though your problem could be migraine-related, feel free to ask your doctor whether migraine medication would be more appropriate for your situation. For the next two or three headaches, you can try this new medication to see whether or not it’s more effective than the sinus headache medication. In some cases, your doctor may recommend a CT scan so they can rule out any sinus issues including sinus disease.

Once the correct diagnosis is given, you can be happy and confident in the treatment you’re receiving. With this, your life can return to normal and your days don’t have to be affected by a burdening migraine!
Posted in Sinusitis Tagged with: , ,