Sinus Migraine

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

Sinus migraine is not an official name for a type of migraine, but it is used by people to describe where they feel pain during a migraine attack.

Sinus headache vs. sinus migraine

Also, many people (and doctors) confuse sinus headaches and migraines because the two share many of the same symptoms, including pain around the nose and forehead. This can make it hard to tell the difference between a sinus headache caused by congestion or allergies and migraine.

Is it a sinus infection?

Adding to the confusion, many people have nasal symptoms during their migraine attacks. Many doctors now believe that people who think they have a sinus infection actually have a migraine without aura and with sinus symptoms.

Sinus infection standards

Standards from the International Headache Society say that head pain is likely caused by a sinus infection (rhinosinusitis or inflammation of the sinuses) if:1

  • There is head pain the front of the head
  • Test results show evidence of rhinosinusitis
  • The head or facial pain goes away after antibiotic treatment

Without this evidence, it is more likely to be a migraine. In fact, a large study found that only half of people who were diagnosed with migraine knew they had migraine before the study. Most had been misdiagnosed with sinus headache.2

What is the difference between a sinus headache and a migraine?

A migraine will not cause fever, heavy, pus-like nasal discharge, post-nasal drip, and sore throat. Migraines also tend to recur and get in the way of normal activities. On the other hand, a sinus headache will not cause nausea, vomiting, or sensitivity to light.2


Both conditions may include symptoms such as:2

Treating a sinus headache

A sinus headache is caused by inflammation of the sinus cavities due to an infection. This is treated with antibiotics. The pain is treated with over-the-counter painkillers like ibuprofen or acetaminophen.2,3

Treating a migraine

Many types of migraine can be treated with a combination of medicine and lifestyle changes. The treatments include:3

  • Preventive drugs that help reduce how often you have migraines and how severe the attacks are
  • Acute drugs taken at the beginning of an attack to try and reduce its severity
  • Complementary treatments to reduce stress, such as biofeedback and cognitive behavioral therapy
  • Learning your triggers and avoiding the ones you can, such as certain foods and drinks, not eating, or not getting enough sleep
  • Taking care of other health conditions that can trigger migraines or make them worse, such as depression, anxiety, insomnia, sleep apnea, or obesity

A migraine journal is a good way to keep track of your migraine symptoms, triggers, what happened before the migraine attack, and how long symptoms lasted.

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