Sinus Headaches
Sinus Headache or Migraine?
Many people with migraines go for years without being properly diagnosed because they continue their erroneous assumption that what they are experiencing is merely a common sinus headache. One study found that a whopping 97% of people who described their headaches as sinus headaches were actually experiencing symptoms associated with migraines.
The problem is that the symptoms of migraine headaches and sinus headaches often overlap, leading to confusion that can be very serious if your migraine goes undiagnosed. One reason behind this confusion may lie in the fact that the same nerves that carry migraine pain also travel to the sinuses. Pain in the sinuses, face or around the eyes can be felt during a migraine on one or both sides of the head. In addition, the nerves that cause stuffy or runny nose and watery eyes can be also be activated during a migraine.
Sinus headaches
Sinus headaches usually result from a sinus infection or allergies, or else follow hard upon the heels of a cold or the flu. The cause of sinus headaches are an inflammation of the sinus passages, which are the air cavities located behind and above your nose. The increased pressure that results from the closing of infection of the sinuses is what causes the headache. The pain is involved with a sinus headache can be quite severe and last for an extended period of time. They tend to begin in the morning after waking.
The usual treatment for sinus headaches is antibiotics but physicians are beginning to question the validity of this approach because of the building up of resistance to the drug when it taken repeatedly. Common sinus headache symptoms include pain and pressure around the eyes, an ache in the upper teeth, fever or chills and swelling about the face.
Heat and ice can be used to relieve the facial pain of sinus headaches with many doctors recommending hot compresses, hot drinks such as tea or broth, and even a steamy shower. A cool-mist humidifier can also be of tremendous help in keeping your sinuses moist.
Migraine headaches
So how do migraines differ from sinus headaches, then, and how do you determine which one you’ve got. To begin with, there isn’t just one migraine headache, but two. Migraines with aura and migraines without aura. Common migraine symptoms include pain that is prefaced by visual disturbances, a throbbing on just one side of the head that ranges from mild to extreme, nausea, vomiting, an increased sensitivity to both light and noise.
Migraines require a trigger to get your head to hurting. These triggers are wide in scope and can very significantly from person to person. Most migraines seem to be triggered by food. The most common food triggers seem to be wine, chocolate, aged cheese, processed meats, Chinese food and caffeine. Other triggers include flashing lights, loud noises, menstruation, intense exercise, weather changes, exposure to smoke or perfumes, lack of sleep, stress, or sex In addition, some medications such as birth control pills and estrogen replacement therapy have been proven migraine triggers.
So what’s the big deal with misdiagnosing a migraine headache as a sinus headache? Well, for one thing all that money you’re shelling out on medicine specifically marketed it not actually designed to treat sinus headaches will do you no good whatever if you are suffering migraines. In addition, if you are under the delusion that you are experiencing sinus headaches you may be unduly extending the life of your migraines by continuing to eat food triggers, or continuing to experience environmental triggers that you could and should otherwise avoid.
Basically, treating a migraine headache as it were a sinus headache is really no different from treating a toothache as it were a sinus headache. The problems are completely different, regardless of how similar they may seem and how much they may have in common physiologically. A sinus headache is a headache; a migraine is a disease that has as one its symptoms excruciating head pain. Do yourself a favor. If you are absolutely convinced you are suffering sinus headaches, go see a doctor who knows the difference.
Headaches
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are extremely rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and occasionally by taking medications.
Causes
The most common headaches are probably caused by tight, contracted muscles in your shoulders, neck, scalp, and jaw. These are called tension headaches. They are often related to stress, depression, or anxiety.
Overworking, not getting enough sleep, missing meals, and using alcohol or street drugs can make you more susceptible to them. Headaches can be triggered by chocolate, cheese, and monosodium glutamate (MSG). People who drink caffeine can have headaches when they don't get their usual daily amount.
Other common causes include:
- Holding your head in one position for a long time, like at a computer, microscope, or typewriter
- Poor sleep position
- Overexerting yourself
- Clenching or grinding your teeth
Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight and sore. The pain is usually persistent, but does not get worse with activity.
Migraine headaches are severe headaches that usually occur with other symptoms such as visual disturbances or nausea. The pain may be described as throbbing, pounding, or pulsating. It tends to begin on one side of your head, although it may spread to both sides. You may have an "aura" (a group of warning symptoms that start before your headache). The pain usually gets worse as you try to move around.
Other types of headaches:
- Cluster headaches are sharp, extremely painful headaches that tend to occur several times per day for months and then go away for a similar period. They are far less common.
- Sinus headaches cause pain in the front of your head and face. They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches.
Headaches may occur if you have a cold, the flu, fever, or premenstrual syndrome.
If you are over age 50 and are experiencing headaches for the first time, a condition called temporal arteritis may prove to be the cause. Symptoms of this condition include impaired vision and pain aggravated by chewing. There is a risk of becoming blind with this condition. Therefore, it must be treated by your doctor right away.
Rare causes of headache include:
- Brain aneurysm -- a weakening of the wall of a blood vessel that can rupture and bleed into the brain
- Brain tumor
- Stroke or TIA
- Brain infection like meningitis or encephalitis
Home Care
Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches. When a headache occurs, write down the date and time the headache began, what you ate for the past 24 hours, how long you slept the night before, what you were doing and thinking about just before the headache started, any stress in your life, how long the headache lasts, and what you did to make it stop. After a period of time, you may begin to see a pattern.
A headache may be relieved by resting with your eyes closed and head supported. Relaxation techniques can help. A massage or heat applied to the back of the upper neck can be effective in relieving tension headaches.
Try acetaminophen, aspirin, or ibuprofen for tension headaches. Do NOT give aspirin to children because of the risk of Reyes syndrome.
Migraine headaches may respond to nonsteroidal anti-inflammatory drugs (NSAIDs), or migraine medications that contain a combination of drugs.
If over-the-counter remedies do not control your pain, talk to your doctor about possible prescription medications.
Prescription medications used for migraine headaches include ergotamine, dihydroergotamine, ergotamine with caffeine (Cafergot), isometheptene (Midrin), and triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), eletriptan (Relpax), almotriptan (Axert), and zolmitriptan (Zomig). Sometimes medications to relieve nausea and vomiting are helpful for other migraine symptoms.
If you get headaches often, your doctor may prescribe medication to prevent headaches before they occur. It is important to take these medicines every day as prescribed, even when you are not having a headache.
People who take pain medications regularly for 3 or more days a week may develop medication overuse, or rebound, headaches. All types of pain pills (including over-the-counter drugs) can cause rebound headaches. If you think this may be a problem for you, talk to your health care provider.
When to Contact a Medical Professional
Take the following symptoms seriously. If you cannot see your health care provider immediately, go to the emergency room or call 911 if:
- This is the first headache you have ever had in your life and it interferes with your daily activities
- Your headache comes on suddenly and is explosive or violent
- You would describe your headache as "your worst ever" even if you are prone to headaches
- Your headache is associated with slurred speech, change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss
- Your headache gets progressively worse over a 24-hour period
- Your headache is accompanied by fever, stiff neck, nausea, and vomiting
- Your headache occurs with a head injury
- Your headache is severe and localized to one eye with redness in that eye
- You are over age 50 and your headaches just began, especially with impaired vision and pain while chewing
- You have cancer and develop a new headache
See your provider soon if:
- Your headaches wake you up from sleep
- A headache lasts more than a few days
- Headaches are worse in the morning
- You have a history of headaches but they have changed in pattern or intensity
- You have headaches frequently, and there is no known cause
What to Expect at Your Office Visit
Your health care provider will obtain your medical history and will perform an examination of your head, eyes, ears, nose, throat, neck, and nervous system.
The diagnosis is usually based on your history of symptoms. A "headache diary" may be helpful for recording information about headaches over a period of time. Your doctor may ask questions such as the following:
- Is the headache located in the forehead, around the eyes, in the back of the head, near the temples, behind the eyeball, or all over?
- Is the headache on one side only?
- Is this a new type of headache for you?
- Would you describe the headache as throbbing?
- Is there a pressure or band-like sensation?
- When does the headache occur? How long have you had headaches? How long does each headache last?
- Does the headache awaken you from sleep? Are the headaches worse during the day and better at night?
- Did other symptoms begin shortly after the headaches began? Do headaches occur repeatedly?
- Does the headache reach maximum intensity over 1 to 2 hours?
- Are the headaches worse when you are lying down? Standing up?
- Are the headaches worse when you cough or strain?
- Do they occur at a specific time related to your menstrual period?
- What home treatment have you tried? How effective was it?
Diagnostic tests that may be performed include the following:
- Head CT scan
- Head MRI
- Sinus x-rays
- Temporal artery biopsy
- Lumbar puncture
If a migraine is diagnosed, medications that contain ergot may be prescribed. Temporal arteritis must be treated with steroids to help prevent blindness. Other disorders are treated as is appropriate.
Prevention
The following healthy habits can lessen stress and reduce your chance of getting headaches:
- Getting adequate sleep
- Eating a healthy diet
- Exercising regularly
- Stretching your neck and upper body, especially if your work involves typing or using a computer
- Learning proper posture
- Quitting smoking
- Learning to relax using meditation, deep breathing, yoga, or other techniques
- Wearing proper eyeglasses, if needed
Alternative Names
Pain - head; Rebound headaches; Medication overuse headaches
