It's Easy to Confuse Migraine for a Sinus Headache—Here's One Way to Tell the Difference


So, you've got a headache, but it's not just any headache—you feel the pain deep in your cheekbones, the bridge of your nose, and in your lower forehead.

It's cleary a sinus headache, right? Not so fast: Before you make a hasty decision and decide to self-treat, it's important to know that migraines are actually often misdiagnosed as sinus headaches—largely because they come with many of the same symptoms (yes, even run-of-the-mill nasal congestion).

So how do you know for sure if your headache is sinus-related or something a little more serious? Health spoke to doctors to find out what you need to know about sinus headaches, how to diagnose them, and what you can do to treat and prevent future ones.

RELATED: The 14 Different Kinds Of Headaches You Can Get—And How To Treat Each One

What is a sinus headache, and what causes them?

Most often, a true sinus headache stems from a viral infection or a condition called sinusitis, says Clifford Bassett, MD, a New York-based allergist and spokesperson for the Asthma and Allergy Foundation of America. Sinusitis is a result of inflammation in the tissue that lines your sinuses, which are air-filled cavities in your forehead, cheekbones, and behind the bridge of your nose. Pain in those areas is essentially what is labeled as a "sinus headache."

But here's the thing: Migraines are actually frequently misdiagnosed as sinus headaches, says Isaac Namdar, MD, an otolaryngologist at Mount Sinai West in New York—which means the only true way determine whether or not you have a sinus headache or a migraine is to get checked out by a doctor, specifically an allergist or an otolaryngologist. This can happen through a physical exam or doctors can also get a look at your sinuses through a nasal endoscopy.

Another misconception: Sinus headaches are often associated with allergies, and they shouldn’t be, says Dr. Bassett. “It is not a symptom in general due to seasonal and/or year-round allergies.”

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Okay, well what does a sinus headache feel like?

Again, because of the placement of your sinuses, “the pain is above the eyes, between the eyes, or over the cheekbones,” says Dr. Namdar. In addition to that pain, patients might also feel “tenderness over the affected sinuses,” says Dr. Bassett. More symptoms of sinus headaches include Additionally, “post-nasal drainage, congestion, discharge, as well as oral, facial or dental pain can occur with an infection, such as sinusitis,” Dr. Bassett adds.

And, interestingly, the severity of a sinus headache might differ depending on the time of day. “Some sufferers suggest their headache may be more significant earlier in the day (perhaps due to collection of mucus from during the nighttime,” says Dr. Bassett.

If you don't have a runny nose, fever, bad breath (or a change in how your breath usually smells), you're likely suffering from a migraine rather than a sinus headache, per the American Migraine Foundation. (The foundation warns that "self-diagnosed" sinus headaches are actually migraines a whopping 90% of the time. So if you suffer from frequent headaches and you're unsure of what's causing them, it's probably best to talk to a doctor about your symptoms.)

RELATED: 11 Surprising Headache Triggers

How are sinus headaches treated—and how are they prevented?

Once a doctor concludes that you’re suffering from a sinus headache, specifically, treatment options vary. Dr. Namdar says using nasal saline rinses, such as the Neti Pot, can help. He adds, “Some people use anti-inflammatory [medications, such as] Flonase.” Additionally, picking up an air purifier for your home can help you if you suffer from sinus headaches, and if a sinus headache is stemming from a bacterial infection, a course of antibiotics can be used to treat the problem.

As for the pain element, which is the real point of this article, Dr. Namdar says patients can take over-the-counter pain medications like ibuprofen and acetaminophen for the headache part of their sinus headaches.

While you can't necessarily prevent a sinus headache if you have sinusitis, you can do your best to prevent viral infections in the first place. Washing your hands with soap and water thoroughly and often is a good start, along with trying not to touch your nose, mouth, and eyes when your hands are unclean. Eating enough vegetables and getting enough sleep can also strengthen your immune system, which means you’re less likely to get sick.

But the main point here: Definitely get to the doctor if you suspect you have a sinus headache—only a medical professional can diagnose one, or let you know that something else (like chronic migraines) might be going on and recommend next steps to take in getting that checked out, as well.

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