Ask the Expert: Sinus Headaches vs. Migraines

Ask the Expert is a recurring feature on the Excedrin.com Newsroom written by Alex Romero, PhD, Associate Director, U.S. Medical Affairs at Novartis Consumer Health, the makers of Excedrin.

If you experience sinus headaches, you know the pressure and pain are not to be taken lightly. But are you sure it’s a sinus headache?

The sinuses are air-filled pockets in the skull located behind the forehead, nasal bones, cheeks and eyes. Typically, mucus drains easily from the sinuses, keeping them free of bacteria and viruses. However, if the sinuses’ openings become blocked, or if too much mucus builds up in them due to an illness such as the common cold, the resulting pressure changes in the sinuses can trigger headaches in some people. Symptoms include pressure and pain behind the eyes along with typical cold symptoms, including cough, sore throat and stuffy nose.

Those suffering from sinus headaches can take measures to help clear mucus from their sinuses, thus relieving pressure and the potential for headaches. For example, increasing fluid intake, inhaling steam two to four times per day, using a humidifier, irrigating nasal passages with saline, or taking an OTC nasal decongestant such as pseudoephedrine can help relieve congestion.

However, it’s important to note that many people often confuse sinus headaches with migraines because the signs and symptoms of the two types of headaches overlap. In fact, the Sinus, Allergy and Migraine Study (SAMS) revealed that 86 percent of the study patients diagnosed with sinus headache suffered from undiagnosed migraines. ¹ Similarly, a large population-based study called American Migraine Study II showed that out of almost 30,000 study participants, only about 50 percent who were diagnosed with migraine knew they had migraine before the study. The most common misdiagnosis was sinus headache. ²

The confusion may occur partly because migraine headache involves activation of the same nerves that innervate both the sinuses and the meninges, a membrane surrounding the brain that may be involved in the generation of headache. As a result, the site from which the pain originates is difficult to pinpoint and could lead you to believe that you have a sinus headache when in fact you have a migraine.