Differences Between Sinus And Migraine Headaches

Sinus and migraine headaches have similar initial presentation. Often the similar and overlapping symptoms of both the sinus and migraine headaches lead to mistaken diagnosis. However, whether it is sinus or if it is migraine, a headache always needs careful evaluation.

Sinus headaches are associated with the air-filled cavities in the forehead, behind the nose bridge and also in the cheek bones. These sinus cavities help to secrete mucus for air filtration and also to humidify air. Sinus headache occurs when an inflammation takes place in the sinuses leading to decreased mucus drainage and a gradual increase of pressure within the sinus.^[1]

Migraine headaches on the other hand, are intense pulsing and throbbing pain and sensation, producing from one particular point in the head or from one side of the head, or even from both the sides. Most of the time, people feel the pain behind one ear or one eye or from the head temples of ears and eyes. The pain from migraine headache can usually last for hours and sometimes it is so severe that it lasts even for days.^[2] Light, sound and smell can increase the sensitivity, causing increased pain in migraine headaches. In migraine headaches, the only thing that one can probably think of is finding a quiet place to lie down.

Sinus headaches are caused by the inflammation of sinuses. The sinus inflammation can occur due to viral or bacterial infection. This inflammation can increase the production of fluid and decrease the fluid drainage capacity. As a result, the stagnant fluid creates a pressure inside the head and behind the nasal cavity, leading to the severe pain or headache. Bacterial, viral and fungal infection has a tendency to travel through the nasal cavity and infect the fluid in the sinuses.^[3]

There is no specific cause for migraine headache. Whatever the reason may be, fluctuation in the chemical levels of certain neurotransmitters is the persistent reason why migraines occur. There are various factors that increase the extent of the migraine headache.^[4] These factors which increase the risk and can potentially cause migraine headaches are:

• Hormone fluctuations.
• Foods like aged cheese, red wine, MSG, chocolate, artificial sweeteners, dairy products and preservatives.
• Alcohol.
• Oversleep or lack of sleep.
• Stress.
• Light, sound and certain smell.

Genetic factors and changes in environmental pressure can also cause migraine headaches. Chemical imbalances cause the pain in the head. Serotonin is a brain chemical that regulates the pain in the nervous system.^[5] An imbalance in brain chemical reduces the serotonin level, and causes migraine headaches.

Deep and constant pain in the head is associated with sinus headaches. The pain is severe in the frontal, maxillary, ethmoid and sphenoid sinus. Fullness in the cheekbones, forehead and behind the nasal cavity and pain throughout this region are the common symptoms of sinus headache. Other symptoms of sinus headache include: stuffy nose, nausea, vomiting, itchy and watery eyes and pain associated with movements.

Migraine symptoms are more severe, complex and persist longer than the sinus symptoms. The symptoms of migraine headaches occur in 4 stages and are:

Before one or two days of the start of the actual migraine headache attack, these symptoms are seen: food cravings, depression, hyperactivity, constipation, neck stiffness, irritability and uncontrollable yawning. Migraines are more common in women; and people who are in the age group between 15 to 55 years.

The nervous system symptoms of migraine headaches occur just before the migraine attacks and these are associated with visual disturbances, speech (verbal) disturbances, touching sensations (sensory), smell (olfactory) disturbances and movement (motor) disturbances. These are called Aura. The migraine headache aura symptoms include:

• Vision loss.
• Visual problems like seeing various shapes, flashes of light or bright spots.
• Pins and needles sensations in an arm or leg.
• Limb weakness (hemiplegic migraine).
• Speech or language problems (aphasia).

Although these last for 20 to 60 minutes just before the migraine attack, many people are there who do not face any trouble of Aura symptoms from a migraine headache.

When the migraine headache attacks, the symptoms that you experience include:

• Throbbing and pulsating pain on both sides of your head or on only one side.
• Nausea.
• Vomiting.
• Sensitivity to light, sounds and sometimes certain smells.
• Blurred vision.
• Light-headedness and sometimes fainting.
• The migraine attack lasts for 4 to 72 hours.

After the migraine attack has occurred, the final phase of migraine symptoms, that is the postdrome, occurs. In this phase, the person after experiencing a migraine headache feels drained out.^[6]

Sinus headaches are mostly caused by viral or bacterial infection. The treatment procedures of sinus headaches mostly revolve around treating the causative sinus infection. Antibiotics are given to treat the infection and other drugs are prescribed to relieve the symptoms associated with sinus headache. Decongestants such as Sudafed and Afrin, antihistamines such as Benadryl and some over-the-counter pain relievers like Naproxen sodium (Aleve), Acetaminophen (Tylenol) and Ibuprofen (Advil, Motrin IB) are given to relieve the symptoms of a sinus headache.^[7]

Migraine headaches do not have any cure. However, with proper drugs and medicines, the extent and severity of the pain from a migraine headache can be reduced.

Treating Migraine Headaches with Pain Relieving Medications:

Non-steroidal anti-inflammatory drugs (NSAIDs) like Aspirin, Ibuprofen (Advil, Motrin IB) etc. are given for migraines. For severe migraine pain, acetaminophen (Tylenol) and combination of acetaminophen, aspirin and caffeine (Excedrin Migraine) are given for relieving the symptoms of Migraine Headaches.

Triptans and Ergots. Triptans like sumatriptan, rizatriptan, naratriptan, frovatriptan, almotriptan, eletriptan and zolmitriptan are given to block the pain pathways in the brain and to alleviate Migraine Headaches. However, these have some sort of side effects like nausea and vomiting. To reduce these, combination drugs of Ergotamine and Caffeine (Migergot, Cafergot) are given.

Anti-Nausea Drugs. Chlorpromazine, Prochlorperazine (Compro) or Metoclopramide (Reglan) etc. are some anti-nausea drugs prescribed for alleviating the associated nausea from a migraine headache.^[8]

To summarize, some of the important differences between sinus and migraine headaches are:

• Sinus headache has a definite cause (sinus infection); whereas, a migraine headache doesn’t have any definite cause.
• The pain in sinus headache is felt over the area of sinuses; whereas, pain in the migraine headache can be felt behind the eyes, ears etc.
• The severity and the duration of the symptoms of migraine headache are more intense and acute and occur in 4 stages; whereas the symptoms of a sinus headache are relatively milder when compared to a migraine headache.
• Treating the cause of sinus headache will relieve the sinus headache; whereas, there is no definite treatment for migraine headache and its treatment is more preventative in nature and more focused in managing the associated symptoms of migraine headache.

Whatever the kind of headache may occur to you, it is crucial that you see a doctor. The doctor will diagnose whether it is a Sinus or Migraine Headache and treat accordingly.

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