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Is It Really a Sinus Headache? The Surprising Link to Migraine

When you feel facial pressure, nasal congestion, or a headache around your forehead or cheeks, it’s easy to assume you’re dealing with a sinus headache. But did you know that the majority of self-diagnosed sinus headaches are actually migraine? Research consistently reveals that most sinus-like headaches are misdiagnosed, leaving patients with ineffective treatments. Let’s dive deeper into this often-overlooked connection and learn how to identify the true cause of your pain.

Sinus headache misdiagnosed as migraine

Why Does Migraine Mimic Sinus Headaches?


Migraine and sinus headaches have overlapping symptoms, such as:

  • Facial pressure or pain

  • Nasal congestion

  • Forehead or cheek tenderness

  • Upper dental pain


However, migraine is not caused by sinus issues. Instead, the neurological changes during a migraine can trigger symptoms like nasal congestion or sinus pressure. This is why many people with migraine mistakenly believe they have a sinus infection.


Sinus Headache vs. Migraine: How to Spot the Difference


While the symptoms of these two conditions overlap, key differences can help you distinguish them:

1. Sinus Headaches Are Rare

True sinus headaches are almost always caused by sinus infections (rhinosinusitis). Symptoms include:

  • Thick, discolored nasal discharge

  • Fever

  • Facial swelling

  • Pain that worsens when leaning forward

Most of these symptoms are absent in migraine.

2. Migraine Has Distinct Features

Migraine often involves:

  • Sensitivity to light, sound, or smells

  • Nausea or vomiting

  • Pulsating or throbbing head pain

  • An aura (visual disturbances) in some cases

It is important to note that with “sinus” headaches that are really migraine some of the classic migraine features may be absent due to the evolution of the headache.

3. Chronic “Sinus” Headaches Are Unlikely

If you experience frequent sinus-like headaches, especially without infection-related symptoms, migraine is the more likely culprit.


Triggers That Could Be Behind Your “Sinus Headache”


Many migraine sufferers report experiencing sinus-like symptoms when exposed to specific triggers. Common triggers include:

  • Weather Changes: Barometric pressure shifts can cause migraine to feel like a headache in your sinuses due to increased nasal pressure.

  • Allergies: Seasonal allergies and environmental allergens may lead to nasal congestion, exacerbating migraine symptoms.

  • Stress: Emotional or physical stress is a major migraine trigger, contributing to tension in the face that mimics sinus pain.

  • Dietary Factors: Foods like aged cheeses, red wine, chocolate, or those high in MSG or nitrates can trigger migraine.

  • Sleep Disturbances: Too little or too much sleep can disrupt your body’s natural rhythms and trigger migraine.

  • Hormonal Changes: Fluctuations during menstruation, pregnancy, or menopause are common migraine triggers.


Identifying triggers can help some individuals manage their symptoms more effectively.


Why Accurate Diagnosis Matters


Misdiagnosing migraine as a sinus headache can lead to ineffective treatments like decongestants, antibiotics, steroids and even irreversible surgeries. Worse, untreated migraine can become more frequent and debilitating over time resulting in migraine becoming chronic. Consulting an orofacial pain specialist ensures an accurate diagnosis and tailored treatment plan.


Effective Treatments for Migraine That Feels Like a Sinus Headache


If your “sinus headache” is actually migraine, the right approach can provide lasting relief:

  • Medications: Acute treatments, such as triptans, can stop a migraine in progress, while preventive medications, like beta-blockers or antiepileptics, help reduce frequency.

  • CGRP Inhibitors: These newer treatments target calcitonin gene-related peptide (CGRP), a key molecule in migraine attacks. CGRP inhibitors have shown great promise in both preventing and treating migraine.

  • Lifestyle Adjustments: Regular sleep patterns, hydration, stress management, and avoiding known triggers can significantly reduce migraine frequency.

  • Therapeutic Interventions: Options like botox andnerve blocks may be beneficial in some patients. For those with temporomandibular joint disorders, trigger point injections and TMJ orthotics (custom oral appliances) may help underlying triggers like bruxism or jaw dysfunction.


What Does the Research Say?


Multiple studies conclude that nearly 90% of patients who believed they had sinus headaches were actually experiencing migraine. This research underscores how common it is to confuse these two conditions and highlights the importance of expert evaluation.


According to insights from leading headache specialists, many patients seek care for sinus headaches during allergy season, believing their symptoms are allergy-related. However, unless there’s a true infection, migraine is often the underlying cause.


Take Control of Your Headache Relief


If you’ve been treating recurring sinus-like headaches without success, it might be time to explore whether migraine is the real issue. By addressing the root cause, you can finally find effective, lasting relief.


Don’t let the wrong diagnosis hold you back—if schedule a consultation with us today!

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