You’ve probably heard friends or family members complaining of recurring sinus headaches. Maybe you yourself feel that pressure over your sinuses on a regular basis. If you or others you know experience these types of headaches routinely, new research suggests that what you may actually have is migraine headaches.
"There is a great under-recognition of migraine." says Curtis Schreiber, MD, associate director of the Headache Care Center in Springfield, Missouri, who led a study published in the September 13th issue of the Archives of Internal Medicine.
In the study, Dr. Schreiber and his colleagues screened almost 3,000 people who had a self-described or physician-diagnosed "sinus" headache, specifically people who complained of intermittent headaches marked by sinus pressure, pain and nasal congestion. They excluded patients with obvious signs of sinus infection, such as fever or colored nasal discharge.
The researchers found that 88 percent of participants who thought they were suffering from sinus headaches actually had a type of migraine headache. Below, Dr. Schreiber discusses why there is so much confusion between sinus and migraine headaches.
When do sinuses cause headache?
Headache can occur as part of an acute sinus infection. Infections of the sinuses are commonly caused by viruses and bacteria. Typically, when people have sinus infections, they develop a fever and colored nasal discharge. Sinus infections are identified by these symptoms and sometimes CT scans of the sinuses and laboratory tests.
The kind of "sinus" headaches that neurologists and headache doctors are skeptical about are those that are episodic and recurrent. Although pain may start over the sinus areas, other symptoms occur as the headache progresses. A typical patient might say, "I get sinus headaches once every month or every couple of weeks. I don’t have fever with it. I really don’t get much discharge or drainage with it, but it starts over my sinuses and it gets to be severe."
In what way does a migraine look like sinus headache?
If you look at a headache textbook and read how migraine headache is defined, you’ll see a relatively small number of symptoms included in that diagnostic definition. Those features include moderate to severe intensity, throbbing pain, light sensitivity, sound sensitivity, nausea or vomiting, and pain that worsens with routine physical activity. That’s the mental checklist that clinicians are trained with, and it doesn’t include "sinus" symptoms.
