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Stuffy head or migraine?

I’m not sure if it’s my freshly diagnosed autoimmune issue, my mucositis (yech), or just bad luck, but I’ve gotten lots more colds in the last couple of years than I ever had before. I don’t mind them so much–sometimes I enjoy the scratchy, sultry voice (it allows me sing in lower registers as I belt along with the radio in my car–I’m amazing).

Perhaps it’s not the frequency of colds but their duration that has changed in recent years. I used to get a cold for 2-3 days and then have little to no trace of it left. Nowadays it seems my cold develops slowly and takes a long time to leave. This one’s been around for at least a week and a half. It started with sneezing and stuffy-headed-ness. Then it moved into my throat, where it settled in and made it hard for me to speak loudly enough for people to understand me well. After my voice started coming back early last week, I figured the cold was on its way out. WRONG. It moved back into my head, focusing mainly on the left side of my sinus cavity.

Here’s the rub: I can’t always tell the difference between the beginning stages of a migraine and sinus congestion. From what I understand, a lot of migraineurs confuse the two. (Let’s not rehash the sinus headache issue here, though.) This past Wednesday, I went to bed early with a congested head; I woke in the middle of the night a couple of times because my head was so heavy and it was hard to breathe. After awaking Thursday and walking around the house a bit, I realized I was not suffering from just sinus congestion: I had a migraine that was rapidly progressing. I kicked myself for not having taken a triptan in the middle of the night.

But it had been so hard to tell the difference between sinus pressure & the early stages of migraine!

This morning I awoke with so much sinus congestion on the left that I immediately opened my bedside table drawer to get a Maxalt tab. There was no such tab in the drawer, so, favoring another hour in bed over getting up to look for my triptan pill, I took a nasal decongestent (I have an emergency drug arsenal next to my bed, of course). Upon waking in earnest, I dared to try my neti pot again. (Months ago I had a strange experience wherein using my neti pot led to an immediate and severe migraine–not sure how I screwed up, but I did and it HURT. I’ve been scared to try the pot again ever since despite its having worked wonders pre-pain-incident.) I can’t claim that any one thing cured today’s head issues, but the decongestent + neti pot flush rid me of the migrainey feeling I had. Interesting.

Do any migraineurs (or folks with sinus problems like me) have any tips as to how to know when to use a triptan and when to focus on the sinuses? How do you tell the difference between the beginning of a migraine and a side effect of sinus problems?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • wendy nikkel
    5 years ago

    Hi I take a sinus tablet called Zertec/ Razine (generic) at night before I go to bed and don’t usually have the sinus migraine in the morning. Also when i have a migraine i cannot sneeze, which suggests nasel interference. My other migraines from my neck are from lifting something heavy ie 10 ltre paint bucket,or pram out of the boot, etc. also oven cleaner and toxic smelling stuff brings on a bad one.

  • themigrainegirl
    9 years ago

    Knitch, did you end up buying a mini-barometer?

    My yoga teacher knows that the saline Neti pot treatment sometimes aggravates my sinuses, and she suggested I use an herbal mixture like the one you describe. Thanks for the tip!

  • knitch
    10 years ago

    I'm thinking about purchasing a miniature barometer to carry in my "arsenal" so that I can keep up with the changes in barometric pressures in my headache diary. I'm also currently going through some kind of sinus something something and using the sinus flush bottle. I put 1/4 tsp salt, 1/4 tsp baking soda, and a couple of tbsp of Alkalol into my bottle. (Alkalol is an old-timey liquid consisting of Menthol, Eucalyptol, Thymol, Camphor, Benzoin, Oils of Wintergreen, Spearmint, Pine, and Cinnamon, Potassium Alum; Potassium Chlorate; Sodium Bicarbonate; Sodium Chloride; Alcohol (2/100 of 1%); Caramel Color.) It really helps clear up that passageway between the nose and throat.

  • themigrainegirl
    10 years ago

    ModernMom, thanks for the tip! I'll have to try that next time I'm trying to differentiate between migraine and stuffy head.

    Nikki, I experience dizziness more often than most, but it's not always associated with a migraine attack. I can tell you that MAV (migraine-associated vertigo) is relatively common in the migraine community–I have a few friends with this disorder. Do a google search and/or look here to see if this might be what you're experiencing (but of course you have to have a doctor diagnose you if applicable!).

  • Nikki
    10 years ago

    I just came across your blog. I'm 21, and doctors seem to think I have migraines and a mix of something else (which they're still trying to figure out..) I was just wondering, with your migraines, have you ever had bad dizziness? Mine seems to be almost constant for the past few months. Can migraines really do that for so long without any let up?

  • Brandy
    10 years ago

    I have a free item to add to your site. I just got a link to then go to the middle of the page and it says to receive a free prescription for treximet. It asks you about 10 questions then allows you to print a coupon for 9 free tablets! Its basically imitrex at 85mg plus naproxen sodium (which is Aleve). I take imitrex now so it may help some of your follwers that take that as well. PS you still need a prescription from your doctor too.

  • ModernMom
    10 years ago

    Hi just found your blog! Migraine sufferer for about 9 years here!
    I too have a difficult time telling the difference between the incoming sinus infection and migraine issue. Sometimes (yes sometimes) if I stand up and quickly put my head down to my knees the pressure is felt more in my face then my head? You know what I mean? This has proven to be sinus over migraine.
    It is not an exact sinus!

  • themigrainegirl
    10 years ago

    L.B., I have heard good things about Irlen. Google them and you'll find their site. They can guide you to opticians that specialize in fancy filters for reading, glasses, etc. I went with the cheaper method: I just had the generic glasses place put a rose tint and anti-glare coating on my glasses. The rose color supposedly cancels out the blue of the fluorescents; the anti-glare helps with…well…glare!

    Christine E., I'm with you on the barometric pressure migraines! Eek. I think from now on I'm going to try the Sudafed route when I first feel the sinusy-migraine swelling.

  • Christine E
    10 years ago

    I find that changes in barometric pressure will often bring on migraines; if I am paying attention and start to feel pressure behind my eyes I can take a sudafed and often stave off a migraine (I know this because when I choose not to do it, I usually regret it).

  • L. B.
    10 years ago

    Hi there. I just found your blog and it could pretty much be me writing it. Also a twenty-something with chronic migraines! Had them for 10 years now.

    Apologies if you've answered this question somewhere else previously, but I noticed in an earlier post you mentioned tinted, "anti-fluorescent" glasses… I've never heard of these and I'd love to know where you get them! I have real trouble with fluorescent light.

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