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how to know whether you have a migraine or sinus headache?

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Migraine Specialist in Hyderabad

how to know whether you have a migraine or sinus headache?

Sinus Headache Vs. Migraine: Owing to facial pressure and pressure in the forehead, nasal congestion and runny nose (typical symptoms associated with sinusitis and sinus headaches), migraine is often misdiagnosed as sinus headache. There is a lot of confusion pertaining to sinus headaches and migraines among masses owing to the similarities and associated symptoms between these two types of headaches. Therefore, it is better to get the condition properly and accurately diagnosed by a migraine specialist in Hyderabad prior to starting any sort of self-medication. Prior to going into further details, let us try to understand the facts regarding sinus headaches and migraines.

  • Migraine is most commonly misdiagnosed as a sinus headache.
  • Almost about 90% of the time many people self-diagnose migraine as sinus headache.
  • Most self-diagnosed sinus headaches are actually migraines
  • Physician-diagnosed sinus headache, in most of the cases, ends up as migraine

The following are the typical symptoms associated with sinus headache:

  • Headache with pressure in the head
  • Pain in the forehead
  • Pain getting worst when you lean forward
  • Uncomfortable pressure behind your forehead
  • Fatigue
  • Facial pain and pressure
  • Pain in the cheeks and jaws
  • Sometimes dental pain
  • Redness and swelling of cheeks
  • Fullness, loss of smell, nasal blockage
  • Fever
  • Headache with stuffy or runny nose, watery eyes and nasal congestion

Note: In the absence of fever, purulent discharge from your nose, alteration in smell or foul-smelling breath, you will likely have a migraine headache.

Symptoms of Migraine

Migraine is a severe headache with throbbing pain which can last for a few hours to days if untreated. Approximately one in ten men and one in six women have migraines. Women are at increased risk of migraines compared to men. Hormones foods and stress can trigger migraines.

Some people – may be around 15 to 20% have migraine with aura 15 to 20 minutes before the onset of a migraine. They see blind spots, dots, wavy line, flashing lights and may develop a blurry vision – this is known as an aura.

Migraine symptoms

  • Severe throbbing and pulsating pain on one side near forehead, eyes and temples – sometimes on both the sides of the head
  • Vision problems, nausea or vomiting
  • Sensitivity to light – a major sign
  • Sensitivity to mild exertion and sound
  • Debilitating and disabling headache which forces the sufferer to miss work and activities

The above migraine symptoms could be due to exposure to bright sunlight, cold weather, deep odour, a variety of foods, which are typical migraine triggers. Just keep a track of whether your migraines are due to the following migraine triggers:

  • Caffeine
  • Ice-creams
  • Flashing lights
  • Anxiety and Stress
  • Lack of food or sleep
  • Aged, fermented, and stored foods
  • Hormonal changes

If you keep a track of all the above migraine triggers, it will be better for you to discuss such triggers with the migraine specialist in Hyderabad.

Why Your Doctor’s Confirmation is Important?

Your doctor’s confirmation is important for accuracy, precision and best treatment as far as the type of headache is concerned.

In several research studies, it has been found that the participants who had never been diagnosed with migraine and had never been taken medicines for treating migraine were found to be having a migraine. Surprisingly they were being treated for sinus headaches for several months.

But the results of such studies were astonishingly surprising as nearly about 88% of the participants were found to be having migraine – not sinus headache for which they were being treated.

In those studies, it was found that the participants had nasal and sinus congestion, facial pain and pressure (typical symptoms associated with sinus headache) – in addition to pulsating and throbbing pain, nausea, sensitivity to noise and light, moderate to severe headache and worsening of headache with activity – the symptoms that are typical of migraine.

The participants took lots of over-the-counter medicines, anti-inflammatory, analgesics, nasal sprays, antihistamines and decongestants to treat their headaches, but they could not get satisfactory results – owing to which there was lots of dissatisfaction among them. It is worth to note here that the participants actually had migraine mimicking sinus symptoms. In actuality, they made no conscious efforts to treat migraine rather they were treating their sinus headaches.

Your diagnosis, therefore, needs health practitioner’s confirmation for accuracy and the best treatment.

Sinus Headache Symptoms and Migraine

In the above research study, we have seen that participants who had migraine showed a few common sinus headache symptoms (at least two to three) – including watery eyes and nasal congestion. The million-dollar question here is, how do you know whether you have sinus headache or migraine. To make your task easier, just focus on the following questions:

Question 1: How severe is your headache for the past three to four months. Did you miss work, activities, functions, job, family-related activities during this time? And, how often? How much did your headache interfere with your ability to function?

Question 2: Have you ever experienced severe headaches associated with nausea and vomiting? If yes, then how often?

Question 3: Do you have a sensitivity to light, sound and smell when you get headaches.

If you answer yes to two of the above three questions or if you meet two of the above three criteria, then your chances of having migraine may increase up to 90% and if you meet all the three criteria, then your chances of having migraine may increase up to 95%.

What else to look out for?

If you have facial pain, pressure, nasal congestion and watery eyes, then just go beyond these symptoms and see whether your headaches are associated with nausea, changes in weather, eating habits, stress, sleep disturbances, food triggers, and sensitivity to light. (These are all common triggers of migraine).

Sinusitis infection causes purulent nasal (yellowish and pussy) discharge associated with headache. Runny nose and watery eyes may be seen during a migraine, but the nasal fluid is clear. One should carefully make a note of these symptoms – in other words, knowing this distinction can get one to apt diagnosis and treatment.

Significantly, if the congestion is part of the migraine, it would be expected to resolve with the specific migraine treatment.


To conclude, the majority of sinus headaches are in fact migraines misdiagnosed as sinus headaches – due to sinus symptoms. If you understand this fact better, you can get the right diagnosis and apt treatment. To ensure this, it is better to approach a migraine specialist in Hyderabad. This will help free you from the recurring burden of failed headache treatments.

Dr Vikram Sharma

MBBS, MD, DN (London), FAAN (USA)

Senior Consultant Neurologist

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