Sinus headaches are those that cause pain and pressure in the sinuses, which are a network of hollow cavities inside the skull. Migraine is a neurological condition that causes moderate to severe headaches, usually on one side of the head.

Sinus headaches and migraine are different conditions with different symptoms, causes, and treatments. Knowing the difference between the two conditions will help people seek the appropriate treatment.

This article outlines the differences between sinus headaches and migraine episodes, including their associated symptoms, diagnosis, and treatment. We also list other types of headaches a person may experience and provide information on when to see a doctor.

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Sinus headaches affect the sinuses, which are a network of hollow, air-filled cavities inside the skull. The sinuses produce mucus and help moisten the nasal cavities.

Sinus headaches often result from sinus infections, also known as sinusitis. Blockage within the sinuses can cause pressure, pain, and tenderness in the following areas:

  • the forehead
  • the area between the eyes
  • the area behind the cheekbones

Other symptoms of a sinus headache include:

  • pain that worsens with head movements or straining
  • gnawing pain in the nasal area that may increase during the day
  • thick, discolored nasal discharge
  • reduced or nonexistent sense of smell
  • fever, which could indicate a sinus infection, particularly if accompanied by discolored nasal discharge

Although many people report experiencing sinus headaches, true sinus headaches are rare. According to the American Migraine Foundation, 90% of self-diagnosed sinus headaches are actually migraine episodes.

Causes of true sinus headaches include:

Migraine is a neurological condition that causes moderate to severe headaches, typically on one side of the head. Experts do not know the exact cause of migraine. However, the condition is likely due to the following:

  • changes in brain chemicals
  • stimulation of certain cranial nerves
  • temporary dilation of blood vessels inside the head or neck

Migraine headaches can cause a variety of symptoms, including:

  • moderate to severe head pain that may involve the following sensations:
    • throbbing
    • pulsating
    • pounding
  • head pain that increases with physical activity
  • visual disturbances, such as:
  • sensitivity to lights, sounds, or smells
  • blocked or runny nose
  • nausea
  • vomiting

Sinus headaches and migraine headaches share some symptoms in common. Examples include:

  • pain or pressure around the eyes, cheeks, or forehead
  • blocked nose
  • runny nose
  • symptoms on one or both sides of the face

However, sinus headaches also cause a thick, discolored nasal discharge that indicates a sinus infection. If a person experiences the above symptoms without such nasal discharge, it is unlikely they have a sinus headache.

Additionally, migraine episodes are associated with certain triggers, such as:

  • stress
  • anxiety
  • hormonal fluctuations
  • bright or flashing lights
  • loud noises
  • strong smells
  • too much physical activity
  • too much or too little sleep
  • skipping meals
  • sudden changes in weather or environment
  • tobacco
  • caffeine
  • certain medications
  • overuse of migraine medication

Migraine headaches can also occur with auras. These are sensory disturbances that occur before a person has a migraine episode. Symptoms of migraine aura can include:

  • visual disturbances, such as seeing bright spots, sparks, or zigzags
  • tingling or numbness in the face, body, hands, or fingers
  • inability to speak clearly

Anyone who wants to determine the cause of their headaches should make an appointment with their doctor. A doctor will ask about a person’s symptoms, including their frequency and severity and whether they are associated with certain triggers. A doctor will also take a detailed medical and family history.

Additionally, they may perform a neurological exam to test the following:

  • mental status
  • vision
  • motor strength
  • reflexes

Diagnosing sinus headaches

If a doctor suspects sinus headaches, they may use a nasal endoscope to look inside a person’s nose. A nasal endoscope is a thin, flexible tube with a light and camera attached.

If a person continues to experience sinus headaches after 7 days or following antibiotic treatment, they may require a CT or MRI scan to check for underlying issues.

Diagnosing migraine

There is no specific test to diagnose migraine. Instead, a doctor will look for a pattern of recurring headaches alongside the associated symptoms.

Sinus headaches generally improve over the course of 7 days. Antibiotic treatment usually resolves sinus headaches caused by bacterial infection.

A person can use decongestants to help relieve blocked or swollen nasal cavities. The National Headache Foundation notes that surgical drainage may be necessary to treat certain cases of sinus headache.

The Centers for Disease Control and Prevention (CDC) recommend the following treatments to relieve pain from sinus infections:

  • placing a warm compress over the nose and forehead to help relieve sinus pressure
  • breathing in steam from a shower or bowl of hot water
  • taking pain medication, such as ibuprofen or acetaminophen
  • taking cough and cold medications

People who experience sinus headaches due to anatomical deformity or nasal growths may require surgery to treat the underlying cause.

Some medical treatment options for migraine include:

  • Over-the-counter pain relievers: Examples include ibuprofen and acetaminophen.
  • Triptans: These are medications that narrow dilated blood vessels to reduce migraine pain.
  • Antiemetic medications: These medications can help treat migraine, even in people who are not experiencing nausea or vomiting.
  • Medications for migraine prevention: The following medications can help to reduce migraine frequency:

The following can help ease symptoms of a migraine attack:

  • resting with the eyes closed in a cool, dark, quiet room
  • placing a cool cloth or ice pack on the forehead
  • drinking plenty of fluids

Sinus headaches and migraine headaches are just two of many different types of headaches a person may experience. Some other types of headaches are outlined below.

Tension-type

Tension-type headaches are the most common type of headache. They are typically associated with the following symptoms:

  • a constant, dull ache, usually on both sides of the head
  • a feeling of pressure behind the eyes
  • tightening of the neck muscles
  • pain that feels like a circle around the head

Tension headaches may last from 30 minutes to several hours. In some cases, they may persist for several days.

Cluster

Cluster headaches are excruciating headaches that frequently develop during sleep. A cluster headache can last between 15 minutes and 3 hours and may cause the following symptoms:

Cluster headaches occur daily for weeks or months before stopping completely for up to a year.

Hypnic

Hypnic headache is a rare type of headache that only occurs during sleep. Hypnic headaches usually occur at the same time each night and are sometimes called “alarm clock headaches.” They occur at least 15 times per month.

Hypnic headaches occur most often in people over the age of 50 years.

Thunderclap

Thunderclap headaches are sudden and severe headaches that may occur alongside other symptoms, such as:

  • nausea
  • vomiting
  • fever
  • weakness
  • visual disturbances
  • speech problems
  • confusion
  • seizure

Thunderclap headaches can be harmless, or they can be the result of a potentially life threatening condition, such as:

A person who experiences a thunderclap headache should seek immediate medical attention.

Tumor

A brain tumor can increase pressure inside the skull, causing a headache. However, the vast majority of headaches are not due to a brain tumor.

A person who has a brain tumor will likely experience additional symptoms, such as:

Anyone who experiences a headache along with one or more of the above symptoms should seek prompt medical attention.

In most cases, a person can treat sinus headaches and migraine using over-the-counter medications and home treatments. However, anyone who is worried about headaches should speak with their doctor for further advice.

A person who experiences any of the following symptoms should seek immediate medical attention:

  • thunderclap headache
  • headache that does not go away
  • constant headache in the same location
  • headaches that occur with exertion
  • headaches that increase in intensity when changing positions
  • substantial change in headache pattern
  • new headaches in people over 50 years old or with underlying medical conditions
  • immediate neurological symptoms lasting longer than an hour
  • fever
  • chills
  • night sweats
  • unexplained weight loss

Sinus headaches and migraine headaches are different types of headaches with different causes, symptoms, and treatments. Sinus headaches are comparatively rare. Often, when people think they are experiencing a sinus headache, they are in fact experiencing migraine.

Sinus headaches are typically the result of a sinus infection and involve a thick, discolored nasal discharge. Such headaches usually resolve after 7 days or following a course of antibiotic treatment.

Migraine headaches often occur alongside other symptoms, such as nausea, vomiting, or auras. Some treatments help alleviate the symptoms of a migraine attack, while others help reduce the frequency of attacks.

Sinus headaches and migraine are just two of many different types of headaches a person may experience. Anyone who is concerned about headaches or associated symptoms should speak with their doctor for a diagnosis. People who experience serious and potentially life threatening symptoms should seek immediate medical attention.