Migraine vs sinus headache

Migraine and sinus headache can feel similar because both can cause facial pressure, forehead pain, and pain that worsens when bending forward. Mayo Clinic notes that many people who think they have sinus headaches actually have migraine or tension-type headache.

What points toward migraine?

Migraine often includes nausea, vomiting, light sensitivity, sound sensitivity, smell sensitivity, throbbing pain, activity worsening symptoms, aura, or attacks that return in a pattern. Migraine can also cause nasal symptoms, which is one reason it is confused with sinus headache.

Migraine-related nasal symptoms can include congestion, runny nose, or watery eyes. Those symptoms do not automatically mean the sinuses are the root cause.

What points toward a sinus problem?

A true sinus headache is usually linked to sinus infection or inflammation. Signs can include thick discolored nasal discharge, fever, reduced smell, and facial pain with other sinusitis symptoms. A clinician may need to examine you if the pattern is new or unclear.

Why mislabeling matters

If migraine is repeatedly treated as a sinus problem, the person may miss migraine-specific treatment and prevention. If sinus infection is treated as migraine, infection symptoms may be missed. Repeated "sinus headaches" with nausea, light sensitivity, and normal nasal findings are worth discussing as possible migraine.

What to track before an appointment

• Facial pressure location
• Nasal discharge color and fever
• Light, sound, or smell sensitivity
• Nausea or vomiting
• Whether attacks recur in a pattern
• Medication response
• Allergy or infection symptoms

When to get help

Seek urgent care for sudden severe headache, new neurologic symptoms, fever with stiff neck, confusion, seizure, head injury, or a headache that is clearly different from your usual pattern.

Sources

• Mayo Clinic: Sinus headaches symptoms and causes
• Mayo Clinic: Sinus headaches diagnosis and treatment
• Mayo Clinic: Migraine symptoms and causes