Rhinitis Common Among Migraine Patients

Research about the association between rhinitis and Migraine was recently presented at the 2013 American Headache Society Scottsdale Headache Symposium by Dawn C. Buse, a researcher and psychologist who practices behavioral medicine.

Clinic-based studies had suggested rhinitis is associated with high Migraine attack frequency and severity. Therefore, researchers wanted to utilize the 2008 patient survey for the ongoing, groundbreaking American Migraine Prevalence and Prevention (AMPP) Study to ask about rhinitis status to learn more about the possible connection between rhinitis and Migraine attack frequency and severity.

toc09An explanation of the definition of rhinitis used in this study is extremely important for understanding the research. Patients participating in the AMPP Study survey were considered to be living with rhinitis if they answered “yes” to both of these questions:

1. Do you have nasal allergies, seasonal allergies or hayfever?
2. Do you have more than two rhinitis symptoms: Runny nose, stuffy nose, sneezing, itchy nose or post nasal drip?

Through analysis of survey participant responses, researchers learned 67% of patients experience both rhinitis and Migraine. Patients living with mixed rhinitis (a combination of allergic and non-allergic) and Migraine were more likely to be living with chronic Migraine (15 or more days per month of headache) and to experience more attack-related disability in all areas of their lives.

“An attack of either of these conditions can be debilitating on its own and together they are even more impairing,” said Buse, PhD, Associate Professor, Albert Einstein College of Medicine, and Director of Behavioral Medicine at the Montefiore Headache Center in Bronx, NY.

“People who experience either of these conditions should talk with their doctor to design a personalized, optimal treatment plan for each condition. This may include acute and preventive medications as well as behavioral interventions, such as relaxation exercises and trigger avoidance.”

Buse also suggests that even patients who live with rhinitis and Migraine but experience infrequent attacks speak with their doctors to determine which treatments can help reduce impairment and discomfort.

Researchers believe the finding that patients with mixed rhinitis were more likely to live with chronic Migraine and to experience greater attack-related disability may suggest these patients live with a more severe version of Migraine Disease than some other Migraine patients.

Although the ability to determine any cause and effect relationship is beyond the scope of this study, researchers believe rhinitis might decrease a patient’s threshold for Migraine attacks due to inflammation or other phenomena that have been linked with Migraine by researchers.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
1. Vince T. Martin, et al. "Allergy and immunotherapy: Are they related to migraine headache?" Headache. 2011;51(1):8-20. 2. Headache Classification Subcommittee of the International Headache Society. "The International Classification of Headache Disorders 3rd edition (beta version)." Cephalalgia 2013;33(9):629-808. 3. Dawn C. Buse and Richard B. Lipton. "Chronic Migraine: Update from the American Migraine Prevalence and Prevention (AMPP) Study." American Headache Society Scottsdale Headache Symposium. November 2013.

Comments

View Comments (29)
  • K_ot
    5 years ago

    Thank you so much for this article, I will be bringing it to my next appointment for sure!

    I had migraines and throbbing sinus pain for the better part of 2013. I finally found TREMENDOUS relief when I cut out gluten (if you’re like me and would try anything at this point, I recommend giving it a shot!) Now I’m weaning off of Elavil (aka the darklord of heavy slumber) and finding the sinus pressure is returning… It’s as though I need to sneeze but I cant and it just builds and builds. Finding it discouraging but hoping the link between the rhinitis and migraines can narrow down some treatment options, just wish it was as simple as a drug-free controlled diet :S

    I find so much comfort in this forum and look forward to your articles, thank you so much Diana!

  • kimberlyflick
    5 years ago

    Unbelievable. No one ever told me there could be a connection. This article is me all over the place. I have post-nasal drip every day and have fought with sinus infections and rhinitis yearly. My migraines are terrible. Now I just don’t know who to turn to because my doctor is obviously not catching it. Thank you soooo much for this article!

  • Dee
    5 years ago

    Finally doctor’s discover what, I for one, have always suspected. I love reading about latest findings into migraine as it gives me hope that we are getting steps closer to unveiling this mysterious disease.

    Probably not everyone has a nasal link to their migraines, but this can be very helpful for those that are found to.

    Thanks Diana! Much appreciated.

  • AnnH
    5 years ago

    I have had allergic rhinitis for quite a few years and take daily medication for it. Since October last year I have been diagnosed with Episodic migraine and now have daily headache/migraine which I believe is moving more towards chronic having now done my own research on the subject. I have just stumbled across the above and everything fits!

    Thanks to everyone who has shared their stories too

  • Ellen Schnakenberg
    5 years ago

    Annh,

    Another thing to keep in mind, is that the side effects of the medications you may be taking for your allergic rhinitis may also be a trigger for Migraines as well as cause other headache disorders. Did you know there are over 300 different headache disorders? No wonder they are so hard to control. If only the rest of the public understood that they can be so terribly disabling.

    ~Ellen

  • Julie
    5 years ago

    I did not put 2+2 together until I had a severe case of sinusitis and bronchitis this past Christmas to present day (1-17-14) which yet has not been resolved. My PCP doesn’t understand the correlation and I did not until now. But my Pain Management Dr. did. My ENT cannot seem to fit me into his busy schedule until the 27th and I cannot wait any longer as this is triggering many migraines despite my Pain Management Doctors hard work. I had a CT scan in Nov 2013. I had an MRI in 2006 to show a sinus cyst in the LH side. Now I have one in my RH side. Diagnosis Sinus Disease. Now it’s all messed up & causing a lot of trouble. I’ve never had sinus problems this bad before. Is there any way to get this as a PDF to print to take to my doctor??

    I follow all your work and want to also Thank You for all your tireless and excellent effort as a Migraine Advocate. I don’t know what all off us thousands of Migraine Sufferers would do without wonderful people like you and Teri Robert. Keep up the great work. Kudo’s and Blessings. Julie

  • Nina Rose
    5 years ago

    wow this is great to hear, i have a lot of allergies and can’t manage without taking an anti-histamine everyday…i had already suspected they were probably related to my chronic migraines in some way but it’s good i’m not the only one who thinks so 🙂

  • Diana-Lee author
    5 years ago

    It can be surprisingly reassuring when research supports your experience.

  • DJ-Hill
    5 years ago

    When I was diagnosed with migraines, I thought it was a sinus infection. The weather and sinus problems are one of my main migraine triggers.

  • Diana-Lee author
    5 years ago

    That’s how it was for my mom for many, many years. I finally had to push and prod and question for us to get her a Migraine diagnosis after many years. Your experience is incredibly common.

  • vrabelrj
    5 years ago

    This is good to know, however, what is the treatment for the Rhinitis. I am an RN who still works at age 59. I just went to my migraine specialist and told him this has benn happening the last year( rhinitis withj congestion and postnasal drip. It is embarrassing at work. My PCP started me on Zyrtec for allergies and Flonase for the rhinitis. Sometimes it helps but this winter has been awful. Would it help to go to an allergist? I have anywhere from 12-16 migraines a month. I can not understand why my migraines are not considered chronic. My Doctor tell me that botox would not help me. I am getting to the point where I would like another opinion. If anyonen out there has any suggestions for what they do for this it would be greatly appreciated. Thank-you

  • Marjieoc
    5 years ago

    This is the first time I’ve seen any data about a correlation between migraine and upper respiratory problems. I have battled chronic migraine all my life and chronic sinusitis for at least 19 years. Tests for allergies were negative, however. I had sinus surgery a year ago, but I can’t tell that it made any difference.

    One of my most common warning signs of an impending migraine is nasal congestion on the same side of my nose as the imminent migraine. In fact, a nasal decongestant is usually my first line of defense against a headache, and it is very often effective.

    I’ve discovered that if I use a cotton swab soaked with oxymetazoline HCL (Afrin) to apply the Afrin to the exact spot in my nose that is congested, I can often abort the migraine. The congestion is uncomfortable enough that I can tell exactly where to put the Afrin, and I know I’ve got the right spot because it stings enough to make my eyes water when the Afrin touches it. BTW, using nasal spray in the usual way makes no difference. The magic seems to be a concentrated dose applied to the exact spot.

    My doc at the Diamond Headache Clinic had never heard of this home remedy before, but it works for me. I often take Tylenol and some caffeine along with the Afrin, but those aren’t always necessary. A long nap often reboots my brain and thwarts the migraine, too.

    I read somewhere years ago (I think it was in Oliver Sacks’ book Migraine, which I wholeheartedly recommend to all migraineurs) that some researchers suspect that migraines start in the back of the nose. That seems to be the case with me, at least.

    Anyway, because the congestion is as frequent as the migraines, I hypothesize that the chronic congestion associated with the chronic migraine is the cause of my chronic sinusitis. I was praying that the sinus surgery would at least reduce the number of migraines, but it appears to have had no effect. I don’t know which condition — the congestion or the migraine — is the chicken and which is the egg, but there is very definitely a relationship, at least in my case.

    Just as I take nadolol, gabapentin, magnesium and riboflavin daily in hope of preventing or minimizing migraines, I take extended-release guaifenesin (Mucinex) twice a day to control the sinusitis as much as possible. I keep a sample-size box of swabs and Afrin in my purse, my desk, and my nightstand, and I use this weird treatment at the first sign of nasal discomfort.

    In fact, it appears I need to do it right now! Off to the medicine cabinet …

  • Jillian
    5 years ago

    I also have allergies and migraines. My allergies get also get worse in the winter so I recently figured out that it isn’t primarily pollen I react to but dust. If that might the case for you, allergy/dust covers for pillows and mattress made a huge difference for me.

  • Diana-Lee author
    5 years ago

    Yes, seeing an allergist would be a great idea. That has been incredibly helpful for my brother, who deals with frequent, though not chronic Migraine and rhinitis. One thing that helps him the most is nasal irrigation every single morning, as well as oral medications for allergies. I hope this helps.

  • Elle2
    5 years ago

    I knew there was a connection but my migraine nurse (yes,our well-known group plan doesn’t have a migraine doctor) didn’t believe it. I have an appointment later this month and I’m taking her a copy of this report.

  • Diana-Lee author
    5 years ago

    Boom! Nothing quite like the feeling of some support for what you suspect when you’ve been dismissed by a health care professional. 🙂 Make sure you take the citation information for the study, too, which is available under the References link.

  • Jan Piller
    5 years ago

    It’s interesting that I’ve never had a problem with allergies or rhinitis or anything like that but when I get a migraine, I would be soooo stuffed up!! Since going on the verapamil, that has ceased.

  • Diana-Lee author
    5 years ago

    Although that’s not something I deal with, it’s pretty common. And a big part of the reason people have trouble differentiating sinus issues and congestion from Migraine attacks.

  • Susan K.
    5 years ago

    What a relief to learn this connection has finally begun to be investigated. I have lived with migraine for 42+ years, chronic for about 8. I also have severe seasonal allergies, post nasal drip, watery eyes, stuffiness, sneezing, etc. Right now my migraines are peaking again because of the pollens in the air – I live in a rural area in Southern California, so we have very little down time from pollens and mold spores. I have tried numerous preventative medications and also triptans, etc. Either meds don’t work or my body won’t tolerate them. I had my second round of Botox in mid-December and have an appointment with my headache clinic next week for another round of trigeminal nerve block injections. We are blessed to have a migraine specialist only 10 miles away. All of this to say thank you, Diana, for your work and caring for fellow migraineurs.

  • Diana-Lee author
    5 years ago

    You’re most welcome. It’s truly my pleasure to share what I’m lucky enough to learn from these amazing experts.

  • Janet Michaud
    5 years ago

    my sinus surgery did relive some migraines. I have increased Rhinitis during migraine attacks and can tell from the decrease in runny nose and increase in stuffy sinus things are changing.

  • Diana-Lee author
    5 years ago

    That’s awesome! I hope the progress continues.

  • Elizabeth Roberts-Zibbel moderator
    5 years ago

    Diana, you are amazing. I have been suffering with migraine disease for 30 years, chronic / transformed for 15, and have been following your work for at least 5 on Twitter, Facebook and here at Migraine.com. I have applied for Disability for the first time and am barely able to take care of my kids, much less do the research, attend the seminars, and write the articles you do. Thank you for advocating for us. You have more silent fans than you will ever know.

  • Diana-Lee author
    5 years ago

    Thank you so much for saying that. I really love what I do and being able to bring this information to everyone, but I must admit it feels great when someone like you expresses your appreciation. Take care!

  • gailpearce
    5 years ago

    I had 5 sinus surgery’s, never had headaches before these surgeries. After the 5th is when the migraines started and now I deal with them daily for the last 17 years. I feel doctors don’t understand the correlation and only try to treat the migraine not the sinus issue. Very frustrating!

  • Diana-Lee author
    5 years ago

    Ugh, frustrating indeed. 🙁

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