Sinus Headache vs. Migraine: How to Tell the Difference

Each type of head pain has distinct causes, however, and can affect different parts of your head. The quickest route to relief is correctly identifying what's causing the pain so you can get effective treatment.

“Sinus headache” is technically a misnomer, says Megan Donnelly, DO, the head of the comprehensive headache center and women's neurology at Novant Health in Charlotte, North Carolina. “There's no International Classification of Headache Disorders code for it.”

Indeed, there's no single code for “sinus headache” in the ICHD, a guide that healthcare practitioners use when they record a diagnosis in your medical records. Instead, there are multiple codes for more specific diagnoses, such as “headache attributed to disorder of the nose or paranasal sinuses" and “headache attributed to acute rhinosinusitis,” among others.

Do Sinus Headaches Cause an Aura?

• Deviated septum
• Nasal polyps
• Allergies
• Asthma

Can Allergies and Infected Sinuses Trigger Migraine?

Ongoing sinus inflammation or congestion could trigger migraine for people with chronic sinusitis, says Dr. Trenkle. He adds that allergies or mild sinus inflammation that cause  congestion could also be triggers.

Can You Have Migraine and Sinus Headache at the Same Time?

It's possible to experience both sinus-related headaches and migraine, especially if you have chronic sinus disease and a history of migraine attacks, says Trenkle.

No specific diagnosis covers this combination, but doctors can address both when necessary. Trenkle says his practice often helps people dealing with both conditions come up with personalized treatment plans to manage sinus inflammation while addressing migraine.

Trenkle says he often sees patients who received a sinus headache diagnosis even though migraine was the root issue. Donnelly says that she gets a significant amount of referrals for migraine treatment from ear, nose, and throat specialists.

Doctors can use nasal endoscopy, a CT scan, or allergy testing to screen for sinus issues, says Trenkle. Migraine is a clinical diagnosis, so imaging isn't involved, says Donnelly. Your doctor might ask about symptoms specific to migraine to diagnose it instead.

Before a screening appointment, experts say it's a good idea to be ready to report on any recent infections, vision or language changes that occur before headaches, and allergies or other medical diagnoses you might have.

What Other Headache Types Do People Confuse for Sinus Headaches?

Each condition has a different treatment approach, so it's important to get the correct diagnosis first.

Migraine

Medication can be a significant part of migraine treatment.

• Resting in a dark, quiet room
• Hot and cold compresses
• Caffeine in small doses
• Peppermint tea or aromatherapy

Sinus Headache

Trenkle says sinus headache treatment depends on the root cause, so approaches vary from over-the-counter medicines to interventions like surgery (seeking a second opinion from a headache specialist is advised if surgery is recommended). If a sinus infection is the root cause, for example, antibiotics might help you get rid of the headache by fighting the infection.

“Chronic sinusitis may require consistent use of nasal steroids, allergy treatments such as antihistamines or immunotherapy, and sinus surgery for cases that don't improve with other treatments,” Trenkle adds.

You can also try these home remedies to relieve a sinus headache:

• Drink plenty of hot fluids
• Use a nasal rinse or neti pot
• Use a humidifier

• Migraine can cause sinus symptoms like facial pain, runny nose, and watery eyes, and is more common than sinus headaches.
• Light and sound sensitivity only accompany migraine attacks, while yellow or green snot and fever are unique to sinusitis.
• If you're not sure what's causing your head pain, reach out to a headache specialist physician who can help with screening, diagnosis, and treatment plans.