Sinus headache vs. migraine: A quick guide to tell the difference

If you've ever wondered whether the headache you’re experiencing is a sinus headache vs. a migraine, you're not alone. The two share surprisingly similar symptoms, making it challenging to identify which one is causing your discomfort.

And here’s something that might surprise you: many people who think they have sinus headaches actually have migraines. Studies suggest that up to 90% of self-diagnosed "sinus headaches" are actually migraines. This happens because migraines can cause nasal congestion and facial pressure, mimicking sinus headache symptoms.

Understanding the difference between a sinus headache vs. migraine isn't just about satisfying your curiosity. It's about getting the right treatment, finding effective relief and knowing when it's time to seek care.

Sinus headache vs. migraine: What you’re really dealing with

Here’s what to know about sinus headaches and migraines, so you can get to the bottom of what’s causing your discomfort.

Sinus headache: It’s all about the pressure

When you have a sinus headache, you're experiencing pain caused by inflammation and congestion in your sinus cavities—the air-filled spaces around your forehead, cheeks and behind your nose.

This inflammation typically occurs when you have a sinus infection (sinusitis), allergies or a cold that blocks your sinuses and prevents proper drainage.

When your sinuses get blocked, pressure builds up, creating that characteristic deep, aching sensation you feel in your face and head.

Migraines: It’s all about the brain

Migraines, on the other hand, are complex neurological events that involve changes in brain activity and blood flow. And what you’re experiencing is far more than just a "bad headache."

During a migraine, your brain experiences a cascade of electrical and chemical changes that can affect not just pain perception, but also your sensitivity to light, sound and even smell.

Unlike the localized pressure of sinus issues, migraines involve your entire nervous system, which explains why you might experience symptoms like nausea, visual disturbances or even tingling in your hands and feet.

Spotting the differences: Sinus headache symptoms vs. migraine symptoms

To make it easier to compare the signs of a sinus headache vs. migraine, here are the symptoms to look for and where they might occur.

What's triggering your headache pain?

From allergies and weather to hormonal changes and dehydration, there are many triggers for headaches—but you may be surprised to learn that they’re different for a sinus headache vs. migraine. Here are some common triggers for each.

Common sinus headache triggers

• Seasonal allergies (pollen, dust mites, pet dander)
• Upper respiratory infections
• Environmental irritants (smoke, strong perfumes, pollution)
• Weather changes and barometric pressure shifts 
• Structural issues like deviated septum

Common migraine triggers

• Hormonal changes (particularly in women during menstruation)
• Certain foods (aged cheese, processed meats, chocolate, alcohol)
• Stress and changes in sleep patterns
• Bright lights, loud sounds or strong smells
• Weather changes
• Dehydration
• Skipping meals

Headache treatment approaches that work

Depending on the type of headache you have, there are, in fact, different approaches to relieve the pain. With sinus headaches, it’s all about reducing inflammation and improving drainage; with migraines, sometimes a multi-faceted approach is needed, due to the specific causes.

Here are some headache treatment options to help you find relief.

Sinus headache treatment

• Decongestants (oral or nasal sprays) for short-term relief
• Saline nasal rinses to flush out irritants and thin mucus
• Warm compresses applied to affected areas
• Steam inhalation from a hot shower or bowl of hot water
• Antihistamines if allergies are the culprit
• Pain relievers like ibuprofen to reduce inflammation

Migraine treatment

• Over-the-counter pain relievers (taken early in the attack)
• Prescription triptans for moderate to severe migraines
• Anti-nausea medications for accompanying stomach upset
• Dark, quiet environment for symptom relief
• Cold or heat therapy (varies by personal preference)
• Preventive medications for frequent migraines
• Lifestyle modifications to avoid known triggers

When to seek help for your sinus headache or migraine

While many headaches can be managed at home, certain situations need professional medical attention. You should speak to your doctor if you experience:

• Headaches that are getting worse or more frequent
• Sudden, severe headache unlike any you've had before
• Headache with fever, stiff neck, confusion or vision changes
• Headache after a head injury
• Persistent sinus symptoms lasting more than 10 days

Additionally, if you find yourself using over-the-counter pain medications more than twice a week for headaches, it's time to seek medical guidance. Overuse of pain medications can actually cause rebound headaches, creating a cycle that's difficult to break without medical supervision.

It can also be helpful to keep a headache diary noting your symptoms, potential triggers and what treatments work best. This information will be invaluable whether you're managing symptoms at home or working with a healthcare provider.

Ready to take the next step in managing your headaches? Our Virtual Headache Care program connects you with specialists who can provide personalized treatment plans from the comfort of your home.