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Harvard’s Deep Dive Into Migraines and Sinus Headaches

Dec 30, 2016
Distinguishing between migraine headaches and sinus headaches is notoriously difficult, even for some people who are trained in medicine. Because the two headaches share so many symptoms, and tend to follow similar timelines, it is easy to get them...

Distinguishing between migraine headaches and sinus headaches is notoriously difficult, even for some people who are trained in medicine. Because the two headaches share so many symptoms, and tend to follow similar timelines, it is easy to get them mixed up. Often patients fixate on one diagnosis over the other, and fail to adequately treat their real issue as a result.

When you consider the telltale symptoms of each headache, it’s not hard to see why there’s so much confusion. Both are associated with sensations of pressure; both can be triggered by changes in weather or barometric pressure; and both may cause collateral symptoms such as a runny nose or redness in the face.

But they are distinct phenomena, with separate etiologies and distinct courses of treatment. Migraines may be triggered by dietary or environmental factors, including certain lights, foods, hormonal shifts, and stress. They tend to be accompanied by numbness, tingling, and nausea, as well as increased sensitivity to light. Migraines also tend to run in families – i.e., they have a genetic component.

Sinus headaches are caused by a completely different pathway. They are not brain-centered at all, but skull-centered, caused by a buildup of pressure inside the sinus cavities of your face. But as mucus presses on the walls of your skull, the resulting pain can trigger a number of similar collateral symptoms, including tingling and even vision problems.

Further confusing matters, some of the medicines we use to treat migraines may treat sinus headaches too. Steroids, for instance, tend to make both sets of patients feel better . And even though antibiotics are unrelated to migraines clinically, they have been shown to provide some placebo relief to migraine sufferers who believe they have a sinus infection. Here’s the Harvard article:

The reality of the situation is that steroids can be effective for the treatment of sinus issues and migraines. Even without steroids, antibiotics can be perceived as an effective treatment for two reasons. First, the patient truly believes he or she has an infection, so the antibiotic has a powerful placebo effect. The other reason is that with time, the migraine would have gone away anyway.

So how can you be sure you have a sinus headache instead of a migraine headache? Some symptoms are specific to migraine alone, including visual auras and nausea. Sinus headaches, on the other hand, can be distinguished by fever and by the discharge of thick mucous that bears the signs of infection. The final diagnosis must come from your local ENT, who can examine you via CT to determine whether or not you have an accumulation of mucus in your sinuses.

The Los Angeles Sinus Institute is the premier health center for the treatment of sinus pain, sinus pressure, and sinus headaches in Los Angeles. Contact us to get fast help today.