Is It A Migraine Or A Sinus HeadacheIt’s one of the most common medical problems we see in our office: Patients describe their headache symptoms, believing that spring and fall allergies are the forces behind their throbbing and aching.  What these patients don’t realize is that their sinus headache may not be not a sinus headache, but a migraine, and therefore best managed through the services of a neurologist. But what is the difference between a migraine and a sinus headache?

Migraine 101

First, a quick overview: Migraines are severe headaches, frequently created by an underlying, inherited, neurological disorder. Although researchers not sure of the exact cause of a migraine, it is believed that “triggers” (such as smells, foods, hormonal fluctuations, stress) cause certain areas of the brain to become “overexcited,” resulting in a severe headache. Migraines are frequently accompanied by an increased sensitivity to light, smells, or sounds.  Twelve percent of the U.S. population—an estimated 36 million Americans—experience migraine headaches.

Sinus Headaches

Patients with chronic or acute sinusitis may also have a headache. As opposed to a migraine, which has a neurological cause, a sinus headache is caused by inflammation of the nasal passages. Other symptoms of sinusitis include:

  • Stuffy nose
  • Pain around the eyes, cheeks and forehead
  • Fever
  • Chills
  • Toothache
  • Facial swelling
  • Yellow or green nasal discharge

An otolaryngologist (ear, nose, and throat physician) is able to effectively treat the underlying cause of sinus headaches, and therefore provide relief from other seasonal symptoms.

How can you tell the difference?

Your otolaryngologist will be able to determine whether or not your headache is the result of a sinus or allergy issue. If the headache is likely related to a migraine, then no amount of sinus treatment or allergy medication will alleviate the underlying problem.  Neurologists, physicians who specialize in treating diseases of the brain, nervous system, and spinal cord.

While only a doctor can make an accurate diagnosis, below is some helpful information to use as a general guideline to illustrate the differences and similarities between headaches caused by migraines and sinusitis:


Migraine Headache

Sinus Headache

Sinus pain and pressure

Sinus pain and pressure

Nasal congestion

Nasal congestion

Increased sensitivity to  sounds and smells

May be difficult to smell and hear due to inflammation or fluid build-up

May cause watery eyes

May cause watery eyes

May be triggered by hormonal fluctuations, certain foods or stress

May be triggered by environmental factors, such as allergies

Usually not accompanied by other upper respiratory symptoms

May or may not be accompanied by upper respiratory symptoms

May cause nausea

May cause slight nausea

Can affect vision and may cause blind spots

Typically does not affect vision

Increased sensitivity to light

Typically not affected by light

May see flashing lights (“aura”) before an attack

No auras before an attack

Severe pain regardless of position

Pain may be made worse by bending over and then raising the head quickly

No fever

May have fever

No nasal secretions

Nasal secretions that may be yellow or green


What next?

First, you should always speak to your doctor when you have a severe headache, particularly if that headache causes vision or balance problems. Second, realize that treating a sinus infection will not help your headache if it is caused by a migraine. Therefore, if your otolaryngologist suspects that you may have a migraine, he or she will likely refer you to a neurologist or other physician who specializes in treating this specific type of headache.

For more information on migraines, visit the American Migraine Foundation.



American Migraine Foundation: "About Migraines." (2015).

U.S. Department of Health and Human Services: "Sinus Headaches." (2015).