What are the key differences between sinus headaches and migraines. How can you accurately diagnose and treat sinus-related head pain. What are the risk factors and warning signs associated with severe headaches.

The Misconception of Sinus Headaches: Unraveling the Truth

Many people believe they’re experiencing a sinus headache when they feel pain and pressure in their forehead and nasal area. However, this common assumption often leads to misdiagnosis and improper treatment. Research indicates that a staggering 90% of individuals who think they have a sinus headache are actually suffering from migraine headaches.

Why does this misconception persist? The symptoms of sinus-related pain and migraine headaches can be remarkably similar, making it challenging for individuals to differentiate between the two. This confusion often results in unnecessary antibiotic prescriptions, which can be ineffective and potentially harmful when the underlying cause is a migraine.

Key Differences Between Sinus Infections and Migraine Headaches

• Sinus infections typically follow a cold or upper respiratory infection
• Migraine headaches are not associated with a recent cold
• Sinus infections produce thick, colored nasal mucus
• Migraine-related nasal discharge is usually clear
• Sinus infections impair the sense of smell
• Migraines generally do not affect olfactory function
• Migraine symptoms often worsen with physical activity
• Sinus infection symptoms usually remain constant regardless of activity

Identifying True Sinus Headaches: Signs and Symptoms

Genuine sinus headaches, while less common than migraines, do occur and are typically associated with sinusitis. These headaches are characterized by specific symptoms that set them apart from other types of head pain.

How can you recognize a true sinus headache? Look for these telltale signs:

• Pain and pressure localized to one cheek or upper teeth
• Thick, discolored nasal mucus
• Decreased sense of smell
• Symptoms persisting for several days or longer
• Recent history of a viral upper respiratory infection or cold

It’s important to note that sinus headaches are not typically aggravated by noise or bright light, nor are they usually accompanied by nausea or vomiting – symptoms commonly associated with migraines.

The Migraine Masquerade: When Headaches Mimic Sinus Pain

Migraine headaches are notorious for their ability to mimic other conditions, including sinus infections. This chameleon-like nature often leads to confusion and misdiagnosis. Understanding the unique characteristics of migraines can help differentiate them from true sinus headaches.

Hallmarks of Migraine Headaches

• Pulsating or throbbing pain, often on one side of the head
• Sensitivity to light and sound
• Nausea and/or vomiting
• Visual disturbances (aura) in some cases
• Pain exacerbated by physical activity
• Relief after lying down or sleeping

Are migraines always easy to identify? Not necessarily. Migraine symptoms can vary significantly from person to person and may even change over time in the same individual. This variability contributes to the frequent misdiagnosis of migraines as sinus headaches.

Risk Factors and Prevalence: Who’s Most Likely to Experience Headaches?

Understanding the risk factors associated with different types of headaches can help individuals better assess their symptoms and seek appropriate treatment. While headaches can affect anyone, certain demographic groups are more susceptible to specific types.

Migraine Risk Factors

• Age: Most common between 20 and 50 years old
• Gender: Women are more than twice as likely to experience migraines
• Family history: 75% of migraine sufferers have a family history of the condition
• Hormonal changes: Women may experience changes in migraine patterns during menopause

Do sinus headaches have specific risk factors? While anyone can develop sinusitis, certain conditions may increase the likelihood of experiencing sinus-related headaches:

• Allergies
• Structural abnormalities in the nasal passages
• Weakened immune system
• Frequent upper respiratory infections

Diagnostic Challenges: Navigating the Complexities of Headache Evaluation

Accurately diagnosing the cause of headaches can be a complex process, requiring a comprehensive approach from healthcare providers. The similarities between different types of headaches often necessitate a thorough evaluation to determine the underlying cause and appropriate treatment plan.

Steps in the Diagnostic Process

1. Detailed medical history and symptom assessment
2. Physical examination, including evaluation of the sinuses and neurological function
3. Imaging studies (CT scan or MRI) in some cases
4. Consideration of other potential causes, such as tension headaches or cluster headaches

Why is proper diagnosis crucial? Misdiagnosis can lead to ineffective treatments, unnecessary medication use, and prolonged suffering for patients. A correct diagnosis is the foundation for developing an effective treatment strategy tailored to the individual’s specific condition.

Treatment Approaches: Tailoring Solutions to the True Cause

Once the underlying cause of headache pain has been identified, healthcare providers can recommend appropriate treatment options. The approach to managing sinus headaches differs significantly from that of migraines, underscoring the importance of accurate diagnosis.

Treating True Sinus Headaches

• Antibiotics (if bacterial sinusitis is confirmed)
• Nasal corticosteroid sprays
• Decongestants
• Saline nasal irrigation
• Pain relievers

Managing Migraine Headaches

• Over-the-counter or prescription pain medications
• Triptans or other migraine-specific medications
• Preventive medications for frequent migraines
• Lifestyle modifications (e.g., stress management, dietary changes)
• Alternative therapies (e.g., acupuncture, biofeedback)

How can patients ensure they receive the most effective treatment? Open communication with healthcare providers about symptoms, triggers, and response to treatments is essential for optimizing headache management.

When to Seek Immediate Medical Attention: Recognizing Red Flags

While most headaches are not life-threatening, certain symptoms warrant immediate medical evaluation. Recognizing these red flags can help individuals distinguish between routine headaches and potentially serious conditions requiring urgent care.

Warning Signs Requiring Emergency Medical Attention

• Sudden, severe headache described as the “worst headache of your life”
• Headache accompanied by confusion or trouble understanding speech
• Fainting in conjunction with headache pain
• High fever and severe headache
• Numbness, weakness, or paralysis
• Vision changes, difficulty speaking, or trouble walking

Why is prompt evaluation crucial in these cases? These symptoms may indicate serious conditions such as stroke, meningitis, or intracranial bleeding, which require immediate medical intervention to prevent severe complications or life-threatening outcomes.

Living with Chronic Headaches: Strategies for Long-Term Management

For individuals experiencing frequent headaches, developing a comprehensive management strategy is essential for improving quality of life and reducing the impact of pain on daily activities. Long-term headache management often involves a multifaceted approach that extends beyond medication alone.

Key Components of Chronic Headache Management

• Identifying and avoiding triggers
• Maintaining a consistent sleep schedule
• Practicing stress-reduction techniques
• Regular exercise and physical activity
• Dietary modifications and hydration
• Keeping a headache diary to track patterns and effectiveness of treatments

How can patients work effectively with their healthcare providers to manage chronic headaches? Regular follow-up appointments, open communication about symptom changes, and willingness to try different treatment approaches are crucial for optimizing long-term headache management.

By understanding the complexities of headache diagnosis and treatment, individuals can take a more active role in their healthcare, leading to improved outcomes and better quality of life. Whether dealing with sinus-related pain, migraines, or other types of headaches, accurate diagnosis and tailored treatment plans are key to finding relief and regaining control over daily life.

Sinus headache: Not what you think

Speaking of Health

Wednesday, August 18, 2021

Topics in this Post

• Headache
• Ear, Nose and Throat (ENT)

Nearly everyone experiences a headache at some point, and the pain can range from mild to debilitating.

Sometimes, headaches are accompanied by pain and pressure in your brow and forehead, and cause nasal symptoms. Many people associate sinus and nasal symptoms with a sinus infection, also called sinusitis, or with an upper respiratory infection, a cold. They may say that they are experiencing a sinus headache. But 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.

Sinusitis or migraine?

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

Sinusitis, however, 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, and migraines most commonly last hours to a day or two.

Previous misdiagnosis

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 they think the antibiotic is helping, known as the placebo effect. Despite this, an antibiotic is not the correct treatment for a migraine headache.

These are a few ways you can tell whether your sinus and nasal symptoms are part of a sinus infection or part of a migraine headache:

When you have a sinus infection	When you have a migraine headache
You likely just had or have a cold.	You do not have a cold.
You have thick, colored nasal mucus.	Any drainage from your nose is clear.
You usually need to blow your nose and cannot smell well.	Your sense of smell is not affected.
You usually can function.	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

Migraine headaches can affect anyone. However, 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. Sometimes, migraine headaches stop after menopause.

Migraine headaches tend to run in families. Seventy-five percent of people with migraine headaches have a family history of migraine headaches.

Proper diagnosis

The cause of headaches can be difficult to determine. Your health care provider will ask you questions about your headaches and do a physical exam. You may 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.

Talk with your primary care provider 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.

Call 911 if you have the worst headache of your life or a sudden, severe headache accompanied by any or all of these:

• Confusion or trouble understanding speech
• Fainting
• High fever
• Numbness, weakness or paralysis
• Trouble seeing, speaking or walking

Quintin Cappelle, M.D., is an otorhinolaryngologist and head and neck surgeon in La Crosse and Onalaska, Wisconsin. Scott Spritzer, D.O., is a neurologist in Eau Claire, Wisconsin.

Topics in this Post

• Headache
• Ear, Nose and Throat (ENT)

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Nosebleeds: From minor annoyance to serious situation

Does caffeine treat or trigger headaches?

6 Tips to Help You Get Relief from Your Head Cold

Oh, your aching head! If you’re suffering from unbearable nasal congestion and headache, you probably have a head cold. The reason you’re so stuffed up? When you have a head cold, the membranes lining your nasal passages become swollen and produce excess mucus to flush out whatever is causing the irritation, whether it’s a virus or an allergen. You might experience pain in your forehead, under your eyes or in your upper teeth.

The key to getting rid of a head cold is to reduce sinus swelling and help mucus drain from your sinuses. Although it might seem counterintuitive, keeping your nasal passages moist is the best way to clear out congestion—dry sinuses will only result in further irritation.

Try these simple tips to clear up a head cold and help relieve headache and sinus pressure.

1. Use a humidifier.

Since breathing in dry air will dry out your sinuses, it’s best to add moisture back into your environment by using a cool-mist humidifier or steam vaporizer. You can also try breathing in steam from a hot shower. Doing so can help soothe the irritated membranes lining your nasal passages.

2. Reach for a warm compress.

A great way to ease a headache and sinus pressure is to place a warm compress on your forehead and nose. If you don’t have a compress, try moistening a washcloth with warm water and applying it to your face several times a day. This will help relieve nasal congestion and relieve your head cold symptoms.

3. Irrigate your sinuses.

Flushing out your sinuses with salt water can help clear out mucus and other irritants (like pollen, dust and bacteria) and reduce inflammation of the mucous membrane, resulting in better drainage. This can be done with a neti pot, syringe or various other products that can be found in drug stores. When using a nasal rinse, be sure to use sterile or previously boiled water, and rinse and dry the device thoroughly after each use.

4. Try a nasal spray.

If a nasal wash isn’t for you, try using a nasal saline spray. Similar to a nasal wash, it can help add moisture to your sinuses and flush out irritants and infectious agents. Look for a mist formula and apply it up to six times a day.

5. Drink plenty of fluids.

There’s a reason chicken soup tastes so good when you have a cold: Sipping lots of liquids can help thin out your mucus and promote nasal drainage. Try drinking water, tea and warm milk.

6. Take a decongestant.

Over-the-counter nasal decongestants reduce blood flow to the nasal membranes, which decreases swelling and congestion. They can help open up your nasal passages and decrease the pain and pressure in your sinuses and head. For fast relief, try Sinex Severe All-In-One Sinus liquicaps—the non-drowsy formula contains a powerful pain reliever and phenylephrine, a safe and effective decongestant.

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How to diagnose sinus headache with a runny nose: Sinus headache is pain that can feel like an infection in your sinuses. There may be a feeling of pressure around the eyes, on the cheeks and on the forehead, and pain in the head. But in fact, this pain can be caused by a migraine. Primary diagnosis of sinus headache with a runny nose will require computed tomography of the brain, magnetic resonance imaging of the brain and subsequent consultation with a neurologist. As an additional examination, the doctor may prescribe an MRI of the sinuses.

Which doctor treats sinus headache with a runny nose: If you have symptoms of sinus headache with a runny nose, you should first consult a neurologist, based on the results of the initial examination, the doctor may prescribe an additional consultation with an otolaryngologist.

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Headache symptoms of a runny nose

Headache symptoms of sinusitis include:

• pain, pressure, and a feeling of fullness in the cheeks, eyebrows, or forehead
• Increased pain when bending forward or lying down
• nasal congestion
• fatigue
• Sensation of pain in the upper teeth.

Differential diagnosis between common cold headache and migraine headache

Migraine and sinus headache are easy to confuse because the symptoms of these 2 types of headache may overlap. In both migraine and sinusitis, the headache is often aggravated by leaning forward. Migraines can also be accompanied by a variety of symptoms, including nasal congestion, facial pressure, and a clear, watery discharge from the nose. This is due to the involvement of the autonomic nervous system in a migraine attack. In fact, studies have shown that most patients who see a neurologist for sinus headaches have migraines instead. However, sinusitis is usually not accompanied by nausea or vomiting, and is not aggravated by noise or bright lights – all of which are characteristic of migraine Headache with a common cold is usually:

• occurs after a viral infection of the upper respiratory tract or a cold
• appears as thick, discolored nasal mucus
• associated with decreased sense of smell
• causes pain in one cheek or upper teeth.

Sinus headaches often last a few days or longer, and migraines most often last from a few hours to 1-2 days.

Which doctor diagnoses a headache with a runny nose

Consult a neurologist if:

• headache symptoms occur more than 15 days per month or require frequent over-the-counter pain medications
• severe headache and over-the-counter pain medications are not helping.

If you suspect a headache with a runny nose, a neurologist will give you a referral for a consultation with an otolaryngologist.

Diagnosing the cause of a headache with a runny nose

Sinus headache is usually associated with migraine or other forms of headache. Headaches in the common cold are associated with pain and pressure in the face and sinuses, and can also cause nasal symptoms. In most cases, these headaches are not caused by sinus infections and generally should not be treated with antibiotics.

Risk factors

Sinus headaches can affect anyone, but may be more likely to occur if present:

• previous history of migraine or headaches
• family history of migraines or headaches
• hormonal changes associated with headaches.

Differential diagnosis of headache in the common cold

The cause of headaches is sometimes difficult to determine. At the initial examination, the neurologist will conduct a physical examination and interview the patient. Imaging tests may be done to determine the cause of the headache, including:

• computed tomography of the brain
• magnetic resonance imaging of the brain
• MRI of the sinuses.

Author: Bogatov Nikita Dmitrievich

Specialization: Manual Therapy, Osteopath

Place of appointment: MRI Center and RIORIT Clinic, Incentro Clinic

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• Toxic headache. It develops with excessive ingestion of alcohol, nicotine, intoxication (chemicals), taking medications (side effect).

Causes of headaches

There are a lot of causes that provoke headaches and they all have different etiologies. Headache can torment a person due to “jumps” in blood pressure, disturbances in the functioning of internal organs and systems; due to pain along the nerve, head injuries, brain tumors; due to poisoning, stress, infectious pathologies, etc. The list is really extensive and in each case this ailment must be considered individually. Often recurring pains indicate malfunctions in the work of some specific organs and latently developing pathologies.

Diseases associated with headaches

What diseases can be accompanied by headaches? We list several pathologies, one of the main symptoms of which is headache . This is – hypertension, eye diseases, such as glaucoma or myopia, which “give” pain in the head. The most formidable diseases with symptoms of severe headaches are a brain tumor, Horton’s disease (acute inflammation of the temporal and carotid arteries), trigeminal neuritis, inflammation of the brain, acute cerebrovascular accident, aneurysm rupture (expansion of the lumen of the cerebral artery), meningitis (inflammation meninges), etc.

Infectious and viral manifestations such as sinusitis, sinusitis, influenza are also accompanied by headache.

Examinations for headaches

Methods of examination of modern medicine for headaches give an almost 100% correct picture of the processes occurring in the brain. A large number of different examinations contributes to error-free diagnosis and allows you to choose the most effective therapy. Unfortunately, the vast majority of people who have experienced a headache prefer to eliminate it with fast-acting pills (the symptoms “go away”, but temporarily, since the true cause of the pain remains unidentified).

Headache is not an autonomous disease, but a symptom that can help to correctly diagnose and avoid complications.

Let us inform you about the examinations recommended for headaches:

• An encephalogram captures electrical impulses, on the basis of which the activity of brain cells is evaluated. This method is used for arterial pressure, cervical osteochondrosis, insomnia and other pathologies associated with headache.
• Computed tomography (CT) provides information about damage to parts of the brain, vascular atherosclerosis, abnormal brain disorders in children, pathological neoplasms, damage to the bones of the skull, etc.
• Magnetic resonance imaging (MRI) examines the condition of internal organs and tissues.
• Angiography inspects human vessels for their pathological changes and damage, narrowing of vascular lumens.
• Blood pressure monitoring reveals arterial hypertension, manifested by headaches.
• Lumbar puncture is a manipulation with the extraction of fluid from the spinal cord, which is performed in complex diseases (meningitis, encephalitis, etc.). A puncture is done with severe headaches in cases of urgent need due to increased intracranial pressure.

Methods for treating headaches

There are certainly a lot of methods for treating headaches, but the most common among them are:

• Physiotherapy. One of the most effective treatments for headaches. It includes laser and magnetic therapy, massages, acupuncture.
• Medical treatment. Proponents of pills “know” how to deal with a headache and, at the slightest manifestation of discomfort, use them without delay and hesitation, but qualified doctors prescribe drug therapy for such a symptom, making sure that the pathology is identified accurately and the diagnosis is confirmed by examinations. And only in this case, the question of how to cure a headache can be removed from the agenda.

Classical treatments

Drug treatment of headache

Only a professional doctor who has studied all the complaints, symptoms and nuances of a patient’s headache can correctly diagnose and prescribe therapeutic drugs. However, many of us want to know which pills help with headaches. We list some of the most popular remedies:

• Analgin eliminates spasms, migraine attacks.
• Citramon increases blood flow, eliminates headaches, drowsiness and fatigue.
• Pentalgin has a tonic effect on the vessels of the brain.
• Tempalgin is a well-known analogue of analgin.
• Solpadeine stimulates the psychomotor centers of the brain.

Non-traditional methods of treatment

Oriental medicine believes that various pathologies can be the cause of headaches, but among the main ones it calls problems with the spine, “a column of gold coins”, as Tibetan doctors call it.

Also, according to the doctors of the Sagan Dali clinic, the causes of headaches are disorders in the work of the intestines, constipation, accumulation of a liquid substance in the paranasal sinuses, tension in the muscles of the head, provoking vasoconstriction and lack of oxygen, muscle tension in the cervical-collar zone ( can pinch a nerve).

Tibetan healers have long known how to relieve headaches without medication. And to the burning question of how to get rid of a headache without pills, they would have answered briefly: pulse diagnostics, acupuncture, acupressure and herbal medicine, combined with additional methods of Tibetan medicine.

Tibetan medicine distinguishes people according to the basic constitutions of “wind” (sanguine), “bile” (choleric), “phlegm” (phlegmatic). They are different in physique, temperament, “set” of diseases, temperament, food preferences, reactions to events, etc. “Wind” people have a thin and fragile physique, “bile” people are denser, “strong”, “mucus” people are large, with a wide bone.

Doctors of the Sagan Dali clinic recommend that representatives of these three basic constitutions:

• For those with a “wind” constitution, it is advisable to drink hot ginger tea with lemon and honey or sweet tea in case of headaches and get a good night’s sleep. Avoid cold food and drink.
• Representatives of the constitution “bile” with headaches, it is desirable to exclude fatty and spicy foods, alcohol and smoking from the diet. Cool compresses work well for them.
• For headaches, slime constitutions are advised to practice a short fast for about a day and drink hot ginger tea. There is also a somewhat “exotic” way to eliminate a headache as rubbing warm vegetable (or ghee) oil on the head with a small amount of red pepper. This method promotes a good outflow of blood from the head.

And in addition, if you have a desire to learn how to quickly get rid of a headache, then you need to find and massage: It eliminates headaches, tinnitus, helps with eye fatigue. Calms and normalizes sleep.

Pressure for headaches

What pressure can be used for headaches? With headaches, high blood pressure is often observed (from 140/90 mm Hg or more), in which the pain is permanent and localized mainly in the back of the head.

Headache during pregnancy

The causes of headache during pregnancy can be different. Most often, the malaise is associated with hormonal changes occurring in the body of a woman. Eating cold foods and foods that adversely affect blood vessels, long intervals between meals can trigger headaches. Bright irritating lighting, noises, unpleasant odors, weather conditions, stress, emotional overload, sleep disturbances, worries are the causes of headaches.

How to get rid of a headache during pregnancy

When a woman in “position” has a headache, it is necessary to consult a doctor and identify the true cause of the disease.