Difference Between Migraine and Sinus Headache

Sinus headaches and migraine have similar symptoms and are often misdiagnosed. Putting pressure on the affected area by bending forward might aggravate either disease. Pressure in the face, congestion, and nasal discharge are all symptoms that can occur when a migraine is present.

Nine in ten patients who report sinus headaches really suffer from migraines. Nonetheless, correct diagnosis is essential for treatment because the two illnesses have different aetiologies, characteristics, and treatments.

What is Migraine?

Attacks of severe, throbbing pain are a hallmark of the chronic illness known as migraine.

Migraine headaches are characterized by spasms and subsequent dilatation of the blood vessels in the dura mater. When trigeminal neurons are stimulated, their terminals go to the walls of blood vessels, where they produce physiologically active chemicals, resulting in localized neurogenic inflammation and edema.

Although its exact cause is still unknown, it is recognized that genetics play a significant part in migraine development. Bouts can be triggered by −

  • Hormonal changes (e.g., menstruation)

  • Stress

  • Fatigue

  • Insufficient sleep

  • Meteorological changes

  • Prolonged sun exposure

  • Noise

  • Certain odors

  • Certain foods and beverages − chocolate, nuts, citrus fruits, sausages, cheese, coffee, tea, alcohol

  • Medications − nitro drugs, hormonal contraceptives, oral antidiabetic drugs.

In general, migraine has four stages, but not every patient with migraines goes through all of them. The stages and the respective symptoms are −

  • Prodrome − a day or two before a migraine

    • Neck stiffness

    • Mood changes

    • Increased thirst

    • Food cravings

    • Frequent yawning

  • Aura − before or during migraines

    • Vision loss

    • Seeing flashes of light, bright spots, different shapes

    • Hearing noises

    • Pins and needles sensations in the limbs

    • Numbness or weakness in the face.

  • Attack

    • Pain on one side, rarely – on both sides of the head

    • Pain in the head that throbs or pulses

    • Nausea and vomiting

    • Facial pressure

    • Congestion, nasal discharge

    • Sensitivity to sound, light, rarely – to smell and touch.

  • Post-drome

    • Tiredness

    • Confusion

    • Pain after sudden head movement.

Migraine is diagnosed using a patient's anamnesis, which details the headache's history and associated symptoms, as well as any relevant personal or familial details, such as how the pain has changed since they last went to sleep.

Avoiding triggers, such as certain foods, is an important part of migraine management.

It is advised that, during an attack, the patient be placed in a supine posture in a dark, quiet environment. Assault medications include −

  • Analgesics and non-steroidal anti-inflammatory drugs

  • Ergotamine derivatives

  • Antiemetics against nausea and vomiting.

If the attacks occur more than 3 times a month, drug prophylaxis is undertaken for several months with −

  • Beta-blockers

  • Calcium antagonists

  • Tricyclic antidepressants

  • Non-steroidal anti-inflammatory drugs.

What is Sinus Headache?

When the sinuses become inflamed and impinge on the brain's sensory nerves, the outcome is a severe and persistent pain in the cheekbones, forehead, or brow.

The mucus produced by the sinuses drains via the nasal passages. Inflammation in the sinuses, whether from an infection or an allergy, prevents mucus from draining, leading to pain and pressure. This leads in a headache.

The sinus headache is caused by allergies, infections, or other irritants, most typically by viral infections.

The symptoms of a sinus headache include −

  • Pain and tenderness in the cheeks, forehead, or brow

  • Pain when bending forward

  • Stuffy nose

  • Pain and discomfort in the upper teeth

  • Fatigue

  • Fever

  • Chills

When you get a sinus headache, it's because of something else going on in your body, making it a secondary headache.

The anamnesis data indicate the usual aspects of the headache and the associated symptoms, the family history, the variations of pain after sleep, typical inciting causes, and so on, which are used to make the diagnosis of sinus headache.

If you want to relieve the discomfort and pressure of a sinus headache, you need to tackle the underlying reason.

The effectiveness of the therapy is proportional to the degree of the infection. As a general rule, if the infection is on your forehead or brow, it is best to wait for it to clear up on its own. Fever and discomfort can sometimes be alleviated with just symptomatic care.

Several home treatments can be employed to lessen the severity of the symptoms, such as saline solution irrigation, breathing in steam, using a wet, warm washcloth to the face, etc.

Medications which can be applied to treat the sinus headache include −

  • Analgesics

  • Decongestants

  • Mucolytics

  • Antibiotics (in case of a bacterial infection)

  • Antihistamines or corticosteroids (in case of allergies)

Differences: Migraine and Sinus Headache

The following table highlights the major differences between Migraine and Sinus Headache −



Sinus Headache


Recurring episodes of severe, throbbing headaches define the chronic illness known as migraine.

A sinus headache is characterized by severe, persistent pain in the cheekbones, forehead, or brow and is caused by pressure and swelling in the sinuses.

Headache type

The migraine is a primary headache.

The sinus headache is a secondary headache.

Localization of the pain

Migraine discomfort often occurs on one side of the head, but can affect both sides very rarely.

Sinus headache symptoms often manifest as discomfort in the cheekbones, forehead, or brow.


After extensive research, researchers still don't know what causes migraines. But, genetics seem to have a significant impact.

Hormonal shifts, stress, exhaustion, lack of sleep, weather shifts, sounds, scents, specific meals, beverages, and medications can all trigger episodes.

As mucus tries to drain out of an irritated sinus but an infection or allergy blocks its natural path, the consequence is a painful sinus headache. A headache will develop as a result of this.


When a migraine episode strikes, the sufferer may experience throbbing pain on one side of the head or both sides, nausea, vomiting, a feeling of pressure in the face, sensitivity to sound and light, and occasionally sensitivity to smell and touch.

Pain and soreness in the cheeks, forehead, or brow; pain upon leaning forward; stuffy nose; pain and discomfort in the upper teeth; exhaustion; fever; chills; are all signs of a sinus headache.


Analgesics, NSAIDs, ergotamine derivatives, and antiemetics are some of the medications used to treat migraine pain and nausea and vomiting.

Beta-blockers, calcium antagonists, etc., are used for drug prophylaxis.

Analgesics, decongestants, mucolytics, antibiotics (if a bacterial infection is present), antihistamines, and corticosteroids are all useful medications for treating a sinus headache (in case of allergies).


In conclusion, migraines and sinus headaches are two distinct conditions that have different causes and symptoms. While they may share some similarities, it is important to understand the differences in order to accurately diagnose and treat each condition. If you are experiencing chronic headaches, it is important to consult with a healthcare professional to determine the cause and appropriate treatment.

Updated on: 21-Apr-2023


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