When many people get a stuffy nose along with a headache, they assume it is a sinus headache. According to an article on EverydayHealth.com, that may not be the case.

Research has shown that sinus and migraine headaches are often misdiagnosed. Knowing how to accurately identify the type of headache you have will help you determine the right course of treatment.

Sinus and Migraine Headache Similarities

Perhaps one reason sinus and migraine headaches get misdiagnosed is the symptoms they have in common. Both involve pain and pressure in the face or forehead, nasal congestion, possibly with discharge and a throbbing headache. There are other characteristics that can also lead to a misdiagnosis:

  • The same nerve causes both sinus and migraine headache pain, thus pain occurs in the same areas.
  • Sudden atmospheric changes can trigger both a sinus and migraine headache headache, therefore a migraine headache may be mistaken for sinus pressure and pain.
  • Doctors caution that migraine headaches tend be worse in the spring and fall, which is also the same time seasonal allergies tend to flare up. What may seem like a sinus headache from allergy-related nasal congestion could actually be a migraine headache caused by the change in daylight hours and sleep cycles as a result of Daylight Savings Time.
  • Migraine headaches sufferers may have an abnormal thickening of the membranes lining the sinuses. This thickening, when detected on an X-ray or scan, may be misdiagnosed and treated as a sinus infection.

How to Know the Difference

Sinus headaches usually involve any (or all) of the following symptoms:

  • Fatigue
  • Fever
  • Pain and pressure in your brow, cheeks or forehead
  • Pain that worsens when you bend forward or lie down
  • Thick, yellow-green or blood-tinged nasal discharge
  • Impaired sense of smell
  • Sore throat and/or cough

You may have a migraine headache if your symptoms involve:

  • Throbbing pain on one or both sides of the head
  • Pain that worsens with activity
  • Blurred vision
  • Nausea and vomiting
  • Debilitating, severe headache
  • Sensitivity to noise, light or odors

Treatment for sinus headaches may include antibiotics, decongestants, nasal irrigation, nasal steroids and over-the-counter pain relievers. Surgery is also an option if medication is found to be ineffective.

Treatment for migraine headaches may require prescription medications such as ergotamine and sumatriptan, or barbiturate and narcotic medications for more severe migraine headaches. Antidepressants, propranolol and topiramate are commonly prescribed to prevent migraine headaches.

When to See Your Doctor

Do not hesitate to call your doctor, or go straight to the ER, if your headache is accompanied by the following symptoms (or any other symptoms that cause concern):

  • High fever
  • Neck stiffness, double vision, weakness or numbness, impaired speech, mental confusion or seizures
  • Suddenly occurs and is severe, like a thunderclap
  • Occurs–and worsens–after a head injury
  • Is a new headache, especially if you are over 50 years old

By Ramie A Tritt, MD, President, Atlanta ENT