Can you get a sinus infection on one side? Sinus headache is often mistaken for a sinus infection, but it’s actually a migraine headache. Learn how to tell the difference and when to see a doctor.

Understanding Sinus Headaches and Migraines

Nearly everyone experiences a headache at some point, with the pain ranging from mild to debilitating. Sometimes, headaches are accompanied by pain and pressure in the brow and forehead, as well as nasal symptoms. Many people associate these sinus and nasal symptoms with a sinus infection, also called sinusitis, or with an upper respiratory infection, a cold. They may say they are experiencing a “sinus headache.” However, sinus and nasal symptoms often can signal something else: a migraine headache.

The term “sinus headache” is not an actual medical diagnosis. Studies show that 90% of people with symptoms of a sinus headache are experiencing migraine headaches instead.

Distinguishing Sinusitis from Migraine

Migraines and headaches from sinusitis are easy to confuse because the signs and symptoms of the two types of headaches may overlap. Migraines can affect people differently, and symptoms can change over time, which is why many who have had migraine headaches in the past are surprised when they begin having sinus and nasal symptoms with a migraine.

However, there are some key differences. Sinusitis usually isn’t associated with nausea or vomiting, nor is it aggravated by noise or bright light — all common features of migraines. Sinusitis usually occurs after a viral upper respiratory infection or cold, and includes thick, discolored nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth. Headaches due to sinus disease often last days or longer, while migraines most commonly last hours to a day or two.

Misdiagnosis and Risks

Many people who assume they have headaches from sinusitis have been misdiagnosed and prescribed an antibiotic for sinusitis. In these cases, the antibiotics are not necessary and could be harmful. Some people may feel better after they take the antibiotic because it may decrease inflammation in the sinuses caused by the migraine headache or because of the placebo effect. Despite this, an antibiotic is not the correct treatment for a migraine headache.

Identifying Sinus Infection vs. Migraine

How can you tell whether your sinus and nasal symptoms are part of a sinus infection or part of a migraine headache? Here are some key differences:

When you have a sinus infection:

• You likely just had or have a cold.
• You have thick, colored nasal mucus.
• You usually need to blow your nose and cannot smell well.
• You usually can function.

When you have a migraine headache:

• You do not have a cold.
• Any drainage from your nose is clear.
• Your sense of smell is not affected.
• Your symptoms tend to get worse with physical activity, such as walking or bending over.
• You may feel better after you lie down or sleep.

Risk Factors for Migraine

Migraine headaches can affect anyone, but they are more common in people between age 20 and 50. More than twice as many women as men have migraine headaches. Women over 50 often have fewer and less severe migraine headaches than they had earlier in life, and sometimes migraines stop after menopause. Migraine headaches also tend to run in families, with 75% of people with migraines having a family history of the condition.

Seeking Proper Diagnosis

The cause of headaches can be difficult to determine. Your healthcare provider will ask you questions about your headaches and perform a physical exam. You may also have a CT scan or MRI to help determine the cause of your headache. There are several ways to treat headaches, and your care team will work with you to determine the best option for you.

If your headache symptoms happen more than 15 days a month, over-the-counter pain medication doesn’t work, or you miss school or work because of frequent headaches, talk with your primary care provider. Call 911 if you have the worst headache of your life or a sudden, severe headache accompanied by confusion, fainting, high fever, numbness, weakness, paralysis, or trouble seeing, speaking or walking.