Sinus Headaches vs. Migraines

How can you tell if you have a sinus headache? At Willamette Ear, Nose, Throat, we see many patients who come in seeking treatment for sinus infections when they are suffering from a migraine or tension headache instead. Migraines often mimic sinus infections because they irritate the trigeminal cranial nerve that spans the forehead, cheeks, jaw and sinus cavity.

It is important to note that sinus pain does not automatically constitute a sinus disorder. Sinus headaches are not a medical diagnosis, but rather a description of a headache caused by pressure that spans the sinus area.

People with migraines and tension headaches may also have nasal and sinus symptoms such as runny nose, nasal congestion, sinus pressure and pain. As many as 80 percent of patients reporting sinus headaches have migraines or tension headaches rather than a sinus infection. In fact, only three to five percent of those who come in are experiencing sinusitis.

Migraine/tension headaches and sinusitis share the following symptoms:

• Pain and pressure around the eyes, cheeks and forehead.
• Nasal congestion.
• Postnasal drainage.
• Runny/stuffy nose.
• Red, swollen or watery eyes.

These shared symptoms often can make it difficult for patients to separate these two conditions.

Those experiencing an infection of the sinus will suffer from thick nasal discharge, which is often discolored or cloudy, nasal congestion, facial pain and pressure of the sinuses. They may also have a mild fever.

Your doctor will provide recommendations for treating your headaches based on severity, frequency and underlying cause. Migraines and tension headaches are typically treated with over-the-counter and prescription medications. You may be asked to keep a headache diary to record your symptoms and possible triggers. You may also be referred to your primary care physician or a pain specialist for further management.

Headaches caused by sinusitis are treated by addressing the underlying cause.
Your otolaryngologist will help you distinguish if your facial pain, nasal congestion and nasal drainage is due to a headache, allergies or sinusitis. This may require medication trials, CT imaging or allergy testing. Willamette Ear, Nose, Throat offers a comprehensive center for diagnosing and treating allergies and sinusitis. We strive to successfully treat your symptoms with both medicine and surgery, if needed.