#sinus headache

omg this is crazy did you guys know that 90% of self-diagnosed sinus headaches are actually migraine, and that true sinus headache is pretty rare? And that migraine can cause sinus symptoms like congestion, a runny nose, or watery eyes? And that migraine is treatable and there are migraine specific medications available if simple OTC medications don’t work for you? Woahhhhhh this screening questionnaire is just three questions long and super easy to take:

In the past three months, how disabling are your headaches? Do they interfere with your ability to function? Are you missing work, school or family activities?

Do you ever feel nausea when you have a headache?

Do you become sensitive to light while you have a headache?

Nonstop headache.

me 5 days after saying that, 3 days into being sick with a sinus headache that could down a god:

(This post is not to diagnose anyone or say anyone is misdiagnosed. It does not replace medical advice or care by medical professionals, if you have concern of misdiagnosis please talk about it with a medical professional)

Migraine and sinus diseases share a number of symptoms leading to both patients and providers mixing up the 2. Migraine is a primary headache disorder classified in the International classification of headache disorders 3rd edition (ICHD3) and most known for its headache that often presents unilaterally (one sided) and moderate to severe pain wise. Other common and well known symptoms of this disorder are nausea, vomiting, sensitive to sensory stimuli. Headache attributed to disorder of the nose or paranasal sinus (“sinus headache”) is classified in the ICHD3 as a secondary headache disorder. The criteria for this disorder specify that inflammation or infection of the sinuses must be confirmed by imaging or nasal endoscopic procedure. (Link 4)

Many with migraine have been misdiagnosed by self diagnosis or professional diagnosis with “sinus headache” despite the need for confirmation of current or past sinus inflammation or infection, delaying their diagnosis of migraine. Those misdiagnosed by professionals can also end up being treated, including surgical treatments, for something they do not have. One study found 81.5% of participants had been misdiagnosed as having sinusitis when they had really had migraine. (link 2) Harvard has stated that over 85% of those suspecting a sinus related cause to their headaches actually have migraine. (Link 1)

Both of these disorders have multiple features in common including pressure in the face, seasonal and barometrical triggers, and cranial autonomic symptoms. (link 1). Cranial autonomic symptoms, symptoms related to the autonomic nervous system in and around the head and face, are a common but lesser known type of symptoms of migraine. (link 3) These include nasal congestion, runny nose, tears, ear fullness, and more (link 3). These things can also be seen in sinus infections and inflammation.

While their symptoms present similarly in certain aspects, they also have their differences. Thick, infectious looking mucus and fever are a sign that it’s a headache cause by a sinus disease. (link 1) Sensitivity to sensory stimulus, nausea and vomiting, one sided, moderate to severe headache are common features of migraine attacks not associated with sinus infections or inflammation or the headaches they may cause. (Link 1)

Sources and more information

https://www.mdpi.com/2075-4418/13/4/590