When pain is present in the face and sinus regions, a person may think they are experiencing a sinus migraine. However, sinus headaches and migraine are two different types of headache with distinct symptoms and causes.
This article examines the difference between sinus headaches and migraine, including their associated symptoms and causes. We also discuss whether sinus pain could be a symptom of COVID-19, and provide tips on when to see a doctor for headaches.
The sinuses are a network of hollow cavities inside the skull and facial bones. The three main sets of sinuses are:
- The frontal sinuses: On each side of the forehead
- The maxillary sinuses: Inside each cheekbone
- The ethmoid and sphenoid sinuses: Behind the nose
The primary function of the sinuses is to produce mucus that moisturizes the nasal cavity. This mucus helps protect the body against dust, dirt, and infectious agents.
A sinus headache is a symptom of sinusitis, which is the medical term for inflammation of the sinuses.
Possible causes of sinusitis include:
- viral, bacterial, or fungal infections
- blockages within the sinuses, which may be due to the following:
- foreign bodies
- tooth abscess
- facial injury
- structural abnormalities of the septum, which is the bone or cartilage that separates the nose into two
Symptoms of sinusitis may include:
- pain in the face over the sinus areas
- thick, colored nasal discharge
According to the American Migraine Foundation (AMF), around 90% of self-diagnosed sinus headaches are actually migraine. In fact, there are some important distinctions between the two types of headache.
Migraine is a chronic headache disorder characterized by moderate to severe headache pain, usually on one side of the head. In some cases, the pain may extend across the face or neck.
Some people who have migraine also experience a sensory episode prior to or during a migraine attack. This phase is referred to as an aura phase.
During an aura phase, a person may experience the following:
- visual phenomena, such as seeing geometric shapes, or bright or flashing lights
- blurred vision, or temporary loss of sight
- numbness and tingling on part of the body
- a sensation of being touched
As indicated above, the symptoms of a sinus headache differ from those of a migraine headache.
A sinus headache will involve pain in the sinus cavities of the face, which includes the forehead, cheeks, and areas around the eyes. People may also experience pain in the upper teeth or jaw.
Other symptoms of sinusitis may be present, including:
- nasal congestion
- thick nasal discharge
- postnasal drip, in which mucus drips down the throat and into the stomach
- puffy eyes
- stuffy ears
- sore throat
Sinusitis does not generally cause stomach upset, nausea, or vomiting. However, if a person is experiencing excessive postnasal drip, stomach upset and vomiting may occur.
Symptoms of migraine include:
- moderate to severe headache pain, typically on one side of the head
- head pain that is pulsing, throbbing, or pounding
- sensitivity to light, noise, or smells
- pain that worsens with movement
- nasal congestion or a runny nose
- nausea or vomiting
If a person has these symptoms or their headaches interfere with their ability to function, it is much more likely they are having a migraine headache than a sinus headache.
Sinus headaches and migraine have different causes.
Some potential causes of sinus headache include:
- Infection: Sinus headaches are commonly caused by sinusitis, which is an infection of the sinuses. The infection causes the sinuses and nasal passages to fill with mucus, resulting in sinus pressure and associated headache.
- Allergens: Allergens can cause the respiratory system to produce an excessive amount of mucus. This mucus can become trapped inside the sinuses and nasal passages, causing sinus headache.
- Deviated septum: A deviated septum is a condition in which the bone or cartilage that divides the nose in half is crooked. This can cause mucus to accumulate in one side of the sinuses, resulting in sinus headaches.
Many people report that they experience migraine in response to certain triggers.
Common migraine triggers include:
- hormonal changes
- changes to sleeping patterns
- use of stimulants, such as alcohol and tobacco
- consumption of certain foods, such as dairy and artificial sweeteners
- changes in the weather
Sinus headaches and COVID-19 may both cause sinus-related symptoms, such as nasal congestion or a runny nose. Despite this, sinus symptoms are rarely associated with COVID-19.
People with COVID-19 are more likely to experience one or more of the following
- fever or chills
- shortness of breath
- muscle aches
- loss of taste or smell
- nausea or vomiting
Anyone who has any of the above symptoms of COVID-19 should speak to their doctor about getting tested for coronavirus.
The treatment for sinus headache depends on its underlying cause. A person may start off treating the sinus headache using self-care and home remedies. If these methods are not successful, a person may want to talk with their doctor about medical treatments.
Self-care and home remedies
The key to alleviating a sinus headache is to open up the blocked sinuses so that they can drain any excess mucus. Things to try, include:
- inhaling steam via a humidifier or shower
- using saline spray or mist to lubricate the nasal passages
- using nasal irrigation to flush secretions from the nasal passages and sinuses
- drinking plenty of fluids to help lubricate the sinuses
- applying warm or cool compresses to alleviate facial pain
- avoiding nasal irritants, such as smoke and air pollution
Some over-the-counter drugs may also help to alleviate symptoms. Examples include:
- pain relievers
If sinus headaches persist or recur despite several days of home treatment, a person should see their doctor. They may have an infection, allergy, or sinus blockage that requires appropriate treatment.
The doctor will take a thorough medical history and carry out a careful examination to determine the cause of sinus pain. They may order imaging studies to see inside the sinuses, or use a scope to see directly inside the nasal passageways.
The treatment for sinus headaches will depend on the cause. Possible treatment options include:
- antibiotics to treat bacterial causes
- antihistamines or steroids to treat allergic causes
- surgery to:
- enlarge the sinuses
- treat structural abnormalities that may contribute to sinus blockages
- remove foreign bodies or other blockages from the sinus cavities
A person should see their doctor if they experience persistent or recurrent sinus headaches despite several days of home treatment. They may have an underlying issue that requires medical attention.
A person should also contact their doctor if they experience any of the following:
- a headache that lasts more than 72 hours with less than 4 hours pain-free
- a headache that feels like the worst headache the person has ever experienced
- headaches that increase in frequency or severity
- headaches that interfere with normal activities
- headache accompanied by loss of vision or consciousness
- uncontrollable vomiting
Sinus headaches are different from migraine headaches. Sinus headaches typically cause head or facial pain, nasal congestion, or postnasal drip.
They are caused by inflammation or blockages in the sinuses. In contrast, migraine are painful and localized headaches that are the result of a chronic neurological condition.
Mild cases of sinus headache may respond to home treatment. However, a person who experiences persistent or recurrent sinus headaches should see their doctor.
People commonly misdiagnose their own migraine headaches as sinus headaches. Anyone who is in doubt about the type of headache they have should see a doctor for a diagnosis and appropriate treatment.