Dear Doctor: Is it a migraine or a sinus headache?

Many people self-diagnose migraines headaches as sinus headaches.

One way to tell the difference is by blowing your nose. If you have clear nasal drainage, you may have a migraine or other type of headache, which may cause pain and pressure in your face. If it is a migraine, the pain will usually stop within 72 hours.

A true sinus headache often accompanies a sinus infection.

If you have a sinus headache, you will also have yellow-green or blood-tinged nasal discharge accompanied by pain, pressure and fullness in your cheeks, brow or forehead. You may also have a fever along with cough and sore throat.

Your sinuses are the air-filled spaces found in the bones of your face. You have four pairs of sinuses located on both sides and at the back of your nose, behind your eyes, in your forehead. Each sinus cavity acts as an air filter. The mucous membranes and microscopic cilia trap dust and germs to clean the air you breathe.

When the linings of your sinuses become irritated by a cold or allergies, they generate more mucus, which may become infected and cause sinus-like headache pain.

A sinus infection may clear on its own, but if you’ve experienced symptoms for a week or more or if you have a temperature, you should visit your primary care provider. He or she may prescribe an antibiotic to help your body fight the infection.

However, if you treat a migraine as a sinus headache, you could be making matters worse. Pain relievers may provide temporary relief, but overusing analgesics could also cause rebound migraine headaches.

If you are having recurring migraines that are accompanied with itchy, watery eyes and clear nasal drainage, there are many treatments and preventative measures you can pursue.

Migraine Prevention

  • Avoid triggers. Often foods, odors and activities or the combination of these may trigger a migraine attack. Keeping a food diary may help you identify what types of stimuli trigger your migraines. While there are some common triggers, your migraine triggers will probably be unique to you.
  • Establish daily routines including sleep times and meal times. Scheduled changes and daily stress might be the cause of your migraine pain.
  • Exercise regularly to relieve tension and maintain or lose weight. However, sudden rigorous exercise is thought to be a migraine trigger, so be sure to warm up slowly.
  • Look at the prescriptions and over-the-counter medications in your medicine cabinet, especially if you’re a woman. Medications with hormones including birth control pills might be triggering your migraines or making the pain worse.

Migraine Treatments:

  • Your doctor may prescribe pain relieving medication or preventative medicines that may include prescriptions such as cardiovascular drugs, antidepressants, anti-seizure drugs, or even botox.
  • Muscle relaxation exercises may relieve migraine pain.
  • Rest and relaxation in a dark, quiet place as soon as a migraine starts may help you lessen the severity of the pain and the duration of a migraine headache.
  • Natural or homeopathic remedies including feverfew, ginger, butterbur, magnesium and omega 3s are other formulations may offer relief without a prescription.
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