Headaches are very common and there are many different types. Two that you may have heard of are migraine and sinus pain, which is often confused with a headache.
These two types of headache can have very similar symptoms. Because of this, it’s often challenging to tell the difference between the two.
With sinus pain — which may feel like headache pain — you may have:
The exact cause of migraine isn’t known. It’s believed that changes in levels of chemicals that are produced by the brain, such as serotonin, may affect how the nervous system regulates pain. Genetic and environmental factors may also play a role in causing migraine.
The symptoms of a migraine attack can include:
- pain that’s moderate to severe, often characterized as throbbing or pulsing
- pain that typically impacts one side of your head, but can also affect both sides
- sensitivity to lights and sounds
- nausea and vomiting
- pain that gets worse with physical activity
Additionally, migraine can also impact the area of your sinuses. When this happens, you may feel pain in your face or around your eyes.
- a runny nose
- stuffy nose
- excessive eye tearing
Some people with migraine may also experience symptoms before a migraine attack, such as:
- Prodrome. These symptoms can happen up to 24 hours before a migraine attack and can include:
- Aura. This is a collection of symptoms that can happen up to 60 minutes prior to a migraine attack, but can also occur during an attack. Not everyone experiences aura with migraine. Symptoms of an aura can include:
According to research, many people who have pain in the sinus region are actually experiencing migraine or another type of headache. Sinus headache is the most common incorrect diagnosis given to someone who really has migraine.
So, how do you know if you’re experiencing sinus pain or migraine?
When trying to tell the two conditions apart, there are a couple of important things to consider, including symptoms and timing.
Ask yourself about the symptoms that you’re experiencing. For example, pain in your sinus region isn’t typically associated with symptoms like:
- severe headache pain
- nausea and vomiting
- sensitivity to lights and sounds
- prodrome or aura
If you have one or more of the above symptoms, you may actually have migraine.
Additionally, while migraine can happen with sinus and nasal symptoms, there are some symptoms that may indicate sinusitis, such as fever and thick nasal mucus that’s greenish in color.
Consider the timing of your headache. A migraine attack can be triggered by many different factors. If your headache seems to coincide with any of the following, it may be migraine-related:
- consuming certain food and drinks, such as alcohol, caffeine, or cured or processed foods
- consuming food additives like aspartame and monosodium glutamate (MSG)
- higher levels of stress than normal
- overexerting yourself
- skipping meals
- sleep-related factors, like not getting enough sleep or experiencing jet lag
- changes in weather or barometric pressure
- bright lights
- sudden loud noises
- very strong smells or fumes
- medications like oral contraceptives and nitroglycerin
- hormonal changes in women, such as during menstruation, menopause, or pregnancy
To diagnose migraine, your doctor will ask you questions about your headaches, such as:
- how often they occur and how long they last
- what types of symptoms you experience
- if the headaches happen at specific times or due to specific triggers
- if you have a family history of migraine
Your doctor may also order blood tests or imaging tests like a CT scan or MRI scan to help diagnose migraine.
Some of the criteria that doctors use to differentiate pain in the sinus region from migraine or other types of headaches include the following:
- The pain must occur toward the front of your head, in the region of your face, ears, or teeth.
- There must be documented evidence of either acute or chronic sinusitis, such as through a nasal endoscopy.
- The pain must occur along with symptoms of sinusitis.
- The pain goes away within 7 days of treatment for sinusitis.
If you have pain that’s caused by sinusitis, the following self-care measures may help ease your symptoms:
- Inhaling steam. Inhaling steamy air may help loosen mucus and ease inflammation. You can do this by draping a towel over your head and leaning over a bowl of warm water. Standing in a warm, steamy shower may also help.
- Using a nasal wash. A nasal wash is a saline solution and helps to flush out your sinuses. You can buy saline washes over-the-counter (OTC) or make your own at home.
- Taking OTC medications. Various OTC medications may help relieve symptoms like pain, inflammation, and sinus congestion:
If you visit your doctor due to pain in your sinus region, they may recommend:
- Corticosteroids. Corticosteroids can help reduce levels of inflammation in your sinuses. Depending on your condition, you may receive nasal, oral, or injected corticosteroids.
- Antibiotics. Antibiotics are prescribed if your condition is caused by a bacterial infection.
- Surgery. Surgery may be recommended if it’s believed an obstruction in your nasal passages is causing repeated episodes of sinusitis.
The treatment of migraine focuses on two things — acute treatment and prevention. This typically involves a combination of medications and lifestyle changes.
This type of treatment is aimed at easing the symptoms of a migraine attack. It can include:
- moving to a cool, dark room and closing your eyes
- placing a cool compress across your forehead or the back of your neck
- drinking plenty of fluids, especially if your migraine happens with vomiting
- medications to ease the symptoms of a migraine attack, including:
- OTC pain relievers, such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), or a combination of caffeine, aspirin, and acetaminophen (Excedrin Migraine).
- triptans, such as rizatriptan (Maxalt), sumatriptan (Imitrex), and almotriptan (Axert)
- ergot derivatives, including dihydroergotamine and ergotamine tartrate
- newer medications like ubrogepant (Ubrelvy) and lasmiditan (Reyvow)
- anti-nausea medications
There are also treatment options for preventing a migraine attack from happening. Some methods that may help include:
- avoiding the things that can trigger your migraines
- getting regular exercise
- finding healthy ways to manage stress
- setting up regular eating and sleeping routines
- taking medications that can help prevent migraine attacks, including:
- antidepressants, such as amitriptyline and selective serotonin reupdate inhibitors (SSRIs)
- blood pressure drugs like beta blockers and calcium channel blockers
- anti-seizure drugs like topiramate (Topamax) and valproate
- monoclonal antibodies, including erenumab-aooe (Aimovig), galcanezumab-gnlm (Emgality), and fremanezumab-vfrm (Ajovy)
In addition to migraine, there are other types of headaches that can potentially cause pain around your face, eyes, and nose.
- stress or anxiety
- clenching your jaw
- missing meals
- not getting enough sleep
- anxiety or depression
When you have a tension headache, you typically feel dull, achy pain or pressure on both sides of your head and across your forehead.
A tension headache is often described as feeling like a band is being tightened around your head.
A cluster headache is a severe type of headache. Its exact cause is unknown.
A cluster headache gets its name from the fact that headaches happen in clusters, typically at the same time of day over a period of weeks or months. These headaches often occur at night, sometimes waking people from their sleep.
Cluster headaches often only impact one side of the head. When an attack comes on, it can last for
- pain at or behind the eye
- runny or stuffy nose
- eye redness
- excessive tearing
- facial swelling
- feeling agitated or restless
- drooping eyelid
- aura-like symptoms or nausea prior to the headache
Rare headache types
There are also some rarer types of headaches that can cause facial pain. These include:
- paroxysmal hemicrania
- short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)
- hemicrania continua
- ice pick headaches
Make an appointment with your doctor if you have headaches that:
- require you to use OTC medications frequently
- cause a significant disruption in your daily activities
- happen most days out of the month and last for hours or days
Seek emergency medical care for any headache that:
- comes on suddenly and is severe
- occurs frequently when you previously didn’t have many headaches
- gets worse over the course of several days
- happens following a head injury
- occurs along with:
- is chronic (long-lasting) and becomes worse when you exert yourself or cough
Sinus-related pain — that feels like a headache — and migraine can have very similar symptoms, such as pain in the front of your head and runny or stuffy nose. Because of this, it can be challenging to know what type of condition you have.
Carefully evaluating your symptoms and the timing of your headache may help you or your doctor differentiate between sinus pain and migraine. In fact, most of the time, sinus-type headaches are actually caused by migraine.
If you have headaches that happen frequently and interfere with your daily life, see your doctor. They can help determine what’s causing your headaches and recommend an appropriate treatment plan.