Is your Sinus Headache Really a Sinus Headache?

Joseph E. Safdieh, MD

Spring has definitely sprung. For many Americans, along with the blooming flowers and budding trees come the dreaded perennial springtime allergies. You know the symptoms: red eyes, running nose, sneezing, coughing and sinus pressure. For many allergy sufferers, headaches are a nagging problem too. Can you relate?

So many of my allergy-prone patients suffer in May, popping sedating antihistamines like Benadryl like candy and taking over-the-counter nasal decongestants like Sutafed and pain killers like Advil and Tylenol. As a neurologist, I see many patients who have severe headaches in the context of seasonal allergies which don’t respond to over-the-counter pain meds. I am surprised at just how many of them do not actually have sinus headaches. In many of these cases, patients are surprised to be told that the headaches are not sinus headaches at all. They are migraines.

Migraine headache is a very common condition, affecting 6% of men and 18% of women in any given year. Studies have clearly demonstrated that 50% of patients with migraine are never actually diagnosed by their doctor. Why is it so important to know if your headache is a migraine anyway? Migraines have specific treatments that are different from other types of headaches.

Quite often, migraine sufferers need to take prescription medications in the triptan family (sumatriptan or Imitrex is the most common example). Patients with chronic migraines can take daily preventative medications, or even regular Botox injections to prevent the headaches. How do you differentiate migraine from other headaches? In general, headaches which are incapacitating are usually migraines. Migraines typically last 4-72 hours, usually occur on one side of the head and are generally throbbing. Patients experiencing a migraine headache almost always have either nausea or are bothered by bright light and loud sound.

Sinus headaches do not cause nausea or sensitivity to light and sound and are generally dull and on both sides of the head. Sinus congestion can offer trigger migraines by irritating the same nerve endings which cause pain in the head. So, if you have a bad headache with nausea or sensitivity to light and sound, speak to your doctor because you do not have to suffer needlessly.