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Sinus Headache vs. Migrane

Which One is Causing Your Pain?

Allergy image

Headaches. About 70 to 80 per­cent of us get them, with half the North American population experiencing at least one headache per month. While the majority of head­aches are not a sign of a serious or life-threatening illness, they can affect your quality of life.

Allergies and sinus problems can sometimes lead to a person having headaches. Headaches with rhinitis, or hay fever, may be due to sinus dis­ease in and around the nasal passages. However, headache specialists consider true sinus headache to be rare. Recent studies have shown that many people who appear to have sinus headaches actually are experiencing migraines.

Types of Sinusitis
Acute sinusitis occurs when there is a bacterial infec­tion in one or more of the sinuses in your head. Sinusitis is often over-diagnosed as a cause of headaches because of the belief that pain over the sinuses must be related to the sinuses. In reality, pain in the front of the head is more often caused by migraines. Migraines are confused with true sinus headaches because of their similar locations.

Headaches attributed to acute bacterial rhinosinusitis are a specific, rare diagnosis. Antibiotics are often used for treatment. Other options include steam, corticosteroids, and deconges­tants. If sinusitis does not respond to medical treatment, surgery may need to be considered.

Allergies and sinus problems can sometimes lead
to a person having headaches.

Chronic rhinosinusitis is one of the most common problems experienced with allergic rhinitis. People with chronic rhinosinusitis may also describe experi­encing “sinus headaches.” However, the jury is still out on whether constant blockage of the nasal passages caused by allergic inflammation can lead to chronic headaches.

People who experience blocked nasal passages should visit an allergist for testing. An allergist can find out what you are allergic to and help you manage your symptoms. Treatment strategies could include avoiding spe­cific allergens, taking medications, and undergoing allergy immunotherapy, or allergy shots.

Sinus Headache vs. Migraine
If you have headaches that seem like they’re originating in the sinuses, you should visit your doctor for a thorough evaluation to determine whether you are experiencing sinus headache or migraine. Making the right diagnosis is important because primary headache disorders, like migraines, and rhinosinusitis re­quire very different treatment regimens.

Doctors use the following criteria to diagnose rhinosinusitis headaches:

  • A headache in the front of your head with pain in one or more areas of the face, ears, or teeth and clinical or laboratory evidence of rhinosinusitis; for example, your doctor might do a nasal endoscopy, which lets him or her see what is happening in your nasal and sinus passages
  • Headache and rhinosinusitis symp­toms that occur at the same time
  • Headache or facial pain that goes away within seven days after decreased symptoms or successful treatment of rhinosinusitis

The majority of people with self-diagnosed sinus headaches are really experiencing migraines, which is why it is important to see a doctor to get a correct diagnosis. Research also supports a link between migraine and allergy, so your physician will consider both migraine headache and sinus headache if you are experiencing headaches along with allergic rhinitis.


Source: American Academy of Allergy, Asthma & Immunology,

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2013-2014.