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Sinus Headache or Migraine?

I've been having sinus pressure and pain for going on 5 months now. It's located around my nose, behind my cheeks, behind my eyes/eyebrows, and in my temples. It is a constant pain about a 3/10, and I feel relief when I push on my sinuses, use heat, or massage my face. It's been a constant pain for about 5 months, with no big change. I believe it has been causing me to clench my jaw, leading to some TMJ issues re-surfacing. After getting a decent mouth guard, my TMJ issues have subsided.

Sinus issues causing migraine

I also believe it has been causing migraines -or at least dizziness- and sometimes other head pain that does feel like a migraine. But that goes away; the sinus pain does not. When all other symptoms are gone, the dull ache of my sinuses is still there. I sometimes have a post nasal drip that irritates my throat, or even what feels like irritated lymph nodes, but I do not have congestion that is typical with sinus issues. Doctors continue to tell me it's migraines. I have had migraines with vertigo since I was 15 years old, and this is different. I keep telling them IT'S DIFFERENT. When I only have this sinus pressure/pain, I feel clear-headed, not dizzy, no head pain, not nauseous. But the doctors keep saying "migraines".

Lingering sinus pain

When I research "sinus pain with no congestion", even the internet says it's a migraine. I'm not sure what to do. Sumatriptan, Ubrevly, Nurtec, all don't help the sinus pain. I've stopped drinking alcohol and I keep a migraine diary for triggers (I’ve discovered soy is probably one) - but soy will cause dizziness, nausea, and headache... not this sinus pressure/pain.

Communicating with my doctor
I guess I'm looking for help on how to get the message across to my doctors. I've asked for an MRI and allergy test, but they dismiss it based on "sinus pain with NO congestion". I’ve seen a neurologist, ENT, had a barium swallow test, blood work, and a vertigo test.

Anyone else have this issue?

Although it's manageable, I'm going crazy with constant pain, especially when I feel like it could be handled better.

  1. Hi ,

    Thank you for reaching out to our community with your question. I hear how frustrated you are, I don't blame you!

    Good to hear you're investigating this and are keeping a migraine diary - a great way to identify any triggers and patterns our attacks have. I wanted to let you know migraine attack patterns, triggers and symptoms can change over time, mine sure have, and that in itself is frustrating.

    Sinus and migraine can be confusing. Almost 80% of people who think they have a sinus issue really have migraine! The thing is facial pain, pain in teeth, gums, sinus pressure (with and/or without congestion) can all be part of a migraine attack. Let me share this article with you on this topic; As the article mentions, there is not an official diagnosis of "sinus migraine".

    By any chance did the ENT do a nasal endoscopy and/or x-ray to see if your sinus cavities were full? If not, that may be one direction to take. I have my own ongoing issues with chronic sinusitis, which is visible on x-ray.

    Is there any chance you are taking something every day, or near daily to help relieve the pain? Another issue we can unwittingly create is something called rebound headache. This occurs when we take over-the-counter pain relievers and/or migraine medications, more than two to three days a week. If we are in a rebound cycle our migraine attacks may be more difficult to treat and we can end up in a daily cycle of pain that is hard to break.

    Having said all that, try not to lose hope! I understand how frustrating this is, and we're here for you.
    Will you let me know how you are doing?
    Nancy Harris Bonk, Patient Advocate/Moderator

    1. Oh wow, I could have written this. I have TMJ issues that have not been relieved by a dentist made mouth guard as I clench and grind too fiercely while I sleep. I thought it was causing neuralgia as of late because of electricity all over my face, but primarily across the jaw and sides of cheeks - as well as the bridge of the nose. Basically anything below the eyes is fair game. Mine isn’t pain, it’s zapping. Neuralgia however is intense pain on one side, which isn’t what you or I describe. So it’s possible it’s still migraine related. Like you, the zapping is daily even if the migraines are not. In fact, when I have an attack, often times I don’t even have a headache. My limbs go weak, I have fatigue, nausea, dizziness and a feeling of being seriously ill without a reason. This lasts for days at a time. The neurologist is convinced it’s migraines. I’m presently trying to learn more about the connection with the Trigeminal nerve and why the face feels pain or electricity. I was prescribed a Triptan drug and Naproxen which I take when an attack comes on but it doesn’t feel like it does anything. The new CGRP blockers may work better... not sure. I have an MRI in July to rule out MS and a tumour.

      1. , thanks for chiming in again. Good luck with your MRI in July. That seems like a long ways off though, is there a reason for the wait? ~Liz, Moderator

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