Your Sinus Headache? It Could Be a Migraine

3 min read  |  August 28, 2019  | 

Many people claim that they have recurrent sinus headaches.  After all, their face hurts, their nose is stuffy, and the headache gets worse when they bend over.  Who could blame them? It certainly does appear like their sinuses are at fault. However, there is a good chance that a majority of those headaches are actually migraines.

In fact, in a 2004 study of almost 3,000 people who had self-described or even diagnosed sinus headaches, 88 percent of them were determined to have “migraine type headache.”

“The sinuses get blamed for a lot of things,” says Dr. Roy Casiano, an otolaryngology expert with the University of Miami Health System. He sees many patients with nasal symptoms who think they are having sinus headaches. But actually, they are experiencing migraines.

In a paper he co-authored published in the American Journal of Otolaryngology (AJO) this year, Dr. Casiano urged the medical community to consider migraine when diagnosing patients who self-diagnose with sinus headaches.

“The most severe pain known to man”

Dr. Teshamae Monteith, a clinical expert in headaches and migraines at UHealth, says that migraine is not the only primary headache disorder associated with sinus symptoms.  Cluster headache, which she describes as being “the most severe pain known to man,” is diagnosed in part by the presence of sinus symptoms including red and watery eyes, nasal congestion and runny nose.

“It’s important to get the diagnosis, which can take up to 7 years, because of the severe disability and suffering associated with the disorder,” she says.

Why don’t people think they may suffer from migraines? There are a few reasons.

Both conditions have similar symptoms – facial pressure, tearing of the eye, and nasal congestion. Migraines affect the central nervous system, which responds with nasal symptoms, says Dr. Casiano.

Also, similar people suffer from both migraines and sinus headaches; specifically, more women than men, and people ages 30  to 60.

Another reason? Many patients report migraine triggers that are commonly associated with the sinuses, according to The Sinus, Allergy and Migraine Study (SAMS) published in 2007. This includes allergies and weather changes.

“If you have severe headaches with light sensitivity, it is likely a migraine,” says Dr. Casiano. “On the other hand, if you have discolored mucus, it might be a sinus headache.”

Three questions that medical practitioners should ask, according to the AJO paper:

  1. “Has a headache limited your activities for a day or more in the last three months?
  2. Do you feel nauseated or sick to your stomach when you have a headache?
  3. Does light bother you when you have a headache?”

If you answer yes to two of these three questions, according to the paper, there is a 93 percent chance you are suffering from a migraine. If you answer yes to all three, the likelihood jumps to 98 percent.

Dr. Monteith agreed and added that “disability at work, school, home, or in one’s social life is a strong indicator of migraine which may vary with individuals.”

So, why does it matter?

If you have the right diagnosis, you may finally get relief from the pain affecting your life.

“Also, in 82 percent of office visits for sinus headache, antibiotics are prescribed, which means that many patients may be taking antibiotics unnecessarily,” says Dr. Casiano.  “Some patients may even be undergoing surgery that they don’t need and that won’t resolve their headaches.”

“It’s important to sort this out because a diagnosis is needed to initiate highly effective migraine-specific therapies,” says Dr. Monteith.

Natasha Bright is a contributing writer for UMiami Health News.

Tags: allergies, Dr. Roy Casiano, Dr. Teshamae Monteith, headaches, migraine, sinusitis

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