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Sinus Headache vs Migraine

Sinus Headache vs Migraine: Identifying the Difference

When was the last time you woke up with a throbbing headache? Perhaps, today? Headaches occur quite often, mostly due to excessive screen time, dehydration, wrong postures, and poor sleep. But, at times, your headache might not be just another ‘day-to-day’ headache that goes away on its own. 

Remember the last time you had a cold or nasal infection? Apart from a runny or stuffy nose and watery eyes, you might have gotten a headache in the front of your head or temples. While you might have shrugged it away as a sinus headache caused by your sinusitis, it might not be the case. 

Sinus headaches, are in fact, quite rare unlike the black sheep of headaches – you guessed it right – migraines. If you suffer from a headache quite often, perhaps reading further might help you in learning about the differences between migraines and sinus headaches so that you can reach out for help when needed.

Sinus Headaches – Anything More Than a Cold?

Sinus headaches commonly accompany clogged or runny sinuses, which are mostly due to nasal inflammation. Nasal sinuses can either get irritated due to an allergy such as that to pollen or quite often due to a cold or a viral infection. Apart from congested sinuses, you might also get a stuffy or runny nose, along with fever, fatigue, thick mucus, and a diminished sense of smell.

Sinus headaches usually occur around the nasal sinuses and might result in a throbbing, dull ache around the cheeks, forehead, and eyes. Most importantly, your headache might worsen in severity if you bend over or lean forward. But, sinus headaches resolve as soon as the cold goes away or the underlying infection gets treated. 

Migraines – The Common Culprit of Headaches

Remember the last time when you had to take an off or leave work early due to a pulsating headache within the back of your head or at the temples? 

Migraines are caused due to neurological imbalances in neurotransmitters and chemical pathways, which might dissipate the pain irregularly. But, such irregular neurological activity also affects the surrounding blood vessels, leading to a host of symptoms arising from the affected part of the brain.

A migraine attack usually involves a pulsating or throbbing headache within different areas of the head. The headache most commonly originates from the back of the head and usually spreads to one or both sides of your head or face. 

Migraines also impact the face and concurrently, the sinuses, leading to symptoms that mimic sinus headaches. Apart from facial pain around the cheeks and nose, about 45.8% of people with migraines complain of watery eyes along with a runny or stuffy nose. 

Other common symptoms of migraines include sensory sensitivity such as heightened awareness and response to external stimuli of smell, light, or sounds. Photosensitivity also occurs with nausea and vomiting with occasional dizziness and fatigue.

Diagnosing migraines seems simple, right? On the contrary, a migraine attack comprises four stages, each of which comes with its own specific set of symptoms.

Prodrome Phase: 

Also known as the no-pain or pre-headache phase, the prodrome phase begins 24 hours prior to the onset of headache in migraines, as its name suggests. 

This phase includes non-specific symptoms such as constipation and at times, frequent urination which might appear to be caused due to a change in diet or UTI, respectively. Other symptoms such as increased tiredness, fatigue, mood swings, and food cravings also occur along with a characteristic stiffness in the neck

Aura Phase: 

This phase usually attacks 60 minutes before the onset of a migraine attack and can also get stronger during the episode. The aura phase might vary from person to person but is less common as compared to other symptoms of migraine. 

The aura phase affects a person’s capability to perceive light causing vision disturbances due to increased photosensitivity, and blind spots. Though rare, this phase also affects the touch sensation, resulting in numbness, pain, and tingling sensations in one side of the arm. Speech might also be affected leading to difficulty in speaking and articulating words. 

Headache Phase: 

The aura phase can serve as a premonition to the actual culprit of migraines – the pulsating headache. Headaches in migraines can resolve within  4 hours, but if untreated, can go up to 72 hours as well. Migraines are also worsened by nausea, vomiting, smell triggers, and exposure to light. 

Post-dromal Phase: 

This phase can be very tiring and exhausting, especially if the migraine attack takes over 3 days to resolve on its own. 

The Difference Between the Two?

The only difference that sets the two diagnoses apart is either the severity of the headache or any accompanying symptoms such as those found in the prodrome or aura phase of migraines. 

  • Discharge: Migraines include the presence of a thin, watery, colorless nasal discharge in contrast to the thick, greenish mucus in sinus headaches.
  • The severity and timing of other prodrome and aura symptoms in migraines help to contrast the two.
  • Migraines can be triggered by photosensitive stimuli such as bright light, loud noises, and strong smells. Sinus headaches, despite being rare, will only occur during sinusitis, rhinorrhea, or cold.

Treatment of Migraines Vs. Sinus Headaches

Sinus Headaches:

Sinus headaches are usually relieved by inhaling steam to unclog the nasal sinuses and over-the-counter painkillers such as Paracetamol and NSAIDs. Long and hot water baths or showers with steam can also help to reduce nasal inflammation. Nasal decongestants such as saline washes and inhalers also help to unclog the nasal pores and relieve inflammation. 

If your sinus infection is caused by bacteria, you might be prescribed an antibiotic as well. In severe and recurrent cases of sinusitis, doctors might suggest oral corticosteroids or surgery for relieving obstructed nasal passages.


Mild migraines can be managed with over-the-counter painkillers such as Ibuprofen and Naproxen, in particular. But, migraines should not be overlooked as they can occur recurrently (usually once a month) and only worse with time. Since migraines are complex and severe in nature, OTC medications might not work as they do with other headaches. 

Triptans are a class of drugs that help to relieve migraines even if there is significant control over your surrounding triggers. Other drugs such as ergotamines, beta-blockers, antidepressants, and occasionally, anticonvulsants are also prescribed in refractory or painkiller-resistant cases. 

Lifestyle changes such as stress management techniques are necessary for preventing or coping with migraines. Incorporate exercise and a proper sleep schedule to prevent migraines from happening recurrently.

– Disclaimer –
This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.

Medically Reviewed

Last reviewed by Dr. Syra Hanif, M.D. on 04/18/2022

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  • About The Author

    Dr. Syra Hanif M.D.

    Board Certified Primary Care Physician

Dr. Syra Hanif is a board-certified Primary Care Physician (PCP) dedicated to providing compassionate, patient-centered healthcare.

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