Is It Sinus or Migraine? How to Identify, Treat, and Prevent Misdiagnosis

Written and verified by Holly Hazen

If you've ever experienced pressure in your sinuses, a pounding headache, or a runny nose, you might wonder: Is it sinus or migraine? These two conditions share overlapping symptoms but treating them effectively depends on getting the diagnosis right. Let's clear up the confusion.

Research shows that nearly 42% of people with migraines are misdiagnosed as having sinus headaches. This confusion can lead to ineffective treatments and prolonged suffering. Let’s break down the differences, symptoms, and best treatments for each so you can find the relief you deserve.

Is It Sinus or Migraine: Understanding the Key Differences

Sinus Headache:
Sinus headaches are commonly caused by sinusitis, which is the swelling or inflammation of the sinus tissues. When your sinuses fill with fluid instead of air, they can become a breeding ground for bacteria, viruses, or fungi, leading to infection.

Symptoms of a Sinus Headache:

• Sinus pressure and pain, especially around the eyes, nose, and cheeks.

• Headache and localized pain or pulsating pain.

• Nasal congestion or discharge (runny nose).

• Puffy eyelids or teary eyes.

• Post-nasal drip, sore throat, or even a mild fever.
  
  

Migraine:
Migraine is a neurological condition that often gets mistaken for sinus issues because they can include sinus-like symptoms, such as a runny nose or watery eyes. However, migraines have distinct characteristics, including sensory sensitivities.

Symptoms of a Migraine: 

• Intense, throbbing head pain (often on one side).

• Sensitivity to light, sound, or smells.

• Nausea or vomiting.

• Aura (in some cases) – visual disturbances like flashes or zigzag lines.
  
  

Key Takeaway:
If your headache is accompanied by nausea, vomiting, or sensory sensitivities, it’s more likely a migraine. Sinus headaches rarely cause these symptoms.

Why Getting the Right Diagnosis Matters

Using the wrong treatment can lead to frustration and worsening symptoms. For instance:

• Over-the-counter sinus medications won’t work for a migraine.

• Migraine medications, like triptans, are ineffective against sinus infections.
  
  

Keeping a symptom journal can help your physician identify patterns and make an accurate diagnosis. Note triggers, duration, severity, and accompanying symptoms to narrow down the possibilities.

Treating Sinus Headaches vs. Migraines

To treat sinus headaches, focus on addressing the underlying inflammation or infection:

1. Medications:

• Antihistamines for allergies.

• Decongestants to relieve nasal pressure.

• Antibiotics if a bacterial infection is confirmed.
  
  

2. Home Remedies:

• Steam Therapy: Inhale steam 2–4 times daily to clear nasal passages.

• Saline Nasal Spray or Irrigation: Flush out allergens and mucus.

• Humidifiers: Keep the air moist to prevent sinus dryness and irritation.
  
  

3. Lifestyle Adjustments:

• Stay hydrated to thin mucus.

• Avoid allergens like dust or pollen during peak seasons.

• Use herbal supplements like olive leaf extract to boost immunity (consult your doctor first).

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Migraine Treatments:

A migraine often requires abortive medications to stop symptoms or preventatives to reduce frequency:

1. Medications:

• Triptans: Highly effective when taken at the onset of symptoms.

• Preventative medications for chronic cases (e.g., beta-blockers, anticonvulsants).

• Over-the-counter NSAIDs for a mild migraine attack (use sparingly).

2. Lifestyle Changes:

• Maintain a consistent sleep schedule.

• Avoid known triggers like caffeine, certain foods, or stress.

• Practice relaxation techniques, such as yoga or meditation.
  
  

3. Alternative Therapies:

• Acupressure or Acupuncture: May relieve tension and reduce migraine intensity.

• Aromatherapy: If they don't trigger an attack, lavender and peppermint oils can help soothe symptoms.
  
  

Pro Tip: Always consult your physician to tailor a treatment plan that works best for your unique needs.

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Seasonal Triggers: Are Your Sinus or Migraine Symptoms Worse in Certain Weather?

Both sinus headaches and migraines can be influenced by environmental factors:

• Spring and Fall Allergies: High pollen counts can trigger sinus issues and migraines in sensitive individuals.

• Winter Dryness: Cold, dry air can irritate sinuses and make migraines worse.

• Summer Heat and Humidity: Barometric pressure changes and dehydration can set off an attack.
  
  

Tips for Managing Seasonal Triggers:

• Use air purifiers and allergen filters during allergy seasons.

• Stay hydrated and avoid outdoor activities during extreme weather.

• Try saline rinses and humidifiers to counteract dry air.
  
  

How to Tell If It’s Sinus or Migraine: A Quick Checklist

Bottom line: if your symptoms include sensory sensitivities or nausea, you're likely dealing with a migraine.

What You Can Do Now

1. Start a symptom journal to track your headaches.
   
   
2. Use treatments tailored to your diagnosis (migraine vs. sinus).
   
   
3. Consult a physician for persistent or severe symptoms.
   
   

For sinus headaches, focus on reducing inflammation and improving sinus health. For migraines, prioritize abortive medications and preventive measures.

Need help keeping track of your headaches? Download the free migraine diary and symptom tracker to share with your doctor. Join our mailing list here!

The Right Diagnosis = Better Relief

Understanding whether your pain is sinus or migraine can make all the difference. Proper treatment minimizes symptoms, improves quality of life, and prevents unnecessary suffering. If you’re unsure, consult your doctor for an accurate diagnosis.

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<sub>Is It Sinus or Migraine References:
1. International Headache Society (2024) ICHD-3 Classification of Headache Disorders. Available [online] at: https://ichd.org
2. American Migraine Foundation (2024) Understanding Migraine and Headache Types. Available [online] at: https://americanmigrainefoundation.org
3. University of Maryland Medical Center (2022) Sinus Headache Causes and Treatments. Available [online] at: https://www.umms.org/ummc/health/medical/altmed/condition/sinus-headache</sub>

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