How to tell the difference between a migraine and a sinus headache

Your head is killing you. There's pain, pressure and throbbing. So, is it a sinus headache, or a migraine?

This is where a lot of us get confused, and for good reason, says neurologist Nithi Anand with Wellstar Neurology and Headache Center.

"Most people think if you have congestion and pain in your cheeks, it's automatically sinusitis,” says Dr. Anand.

But , Anand says, many migraine sufferers have sinusitis-like symptoms.

One study showed up to 80% of people with migraine headaches experience facial pain, watery eyes or congestion.  And, migraines are a lot more common than sinusitis.

"1 in 5 women have migraines,” Dr. Anand says. “1 in 10 men have migraines. It's the most common reason we see headache patients in our clinic and practice."

Anand says with migraines, you have certain telltale symptoms:

The headaches are recurring, meaning they come and go.  The pain is usually and one side of the head, and it’s often throbbing. It can last anywhere from 4 to 72 hours.

"There's commonly light sensitivity and noise sensitivity and nausea,” Dr. Anand says.

With acute sinusitis, Anand the pain typically hits, then lingers.

"It's a headache that lasts over many days,” he says. “And you can have discharge in your nose, you can have some congestion. You can run a fever."

So, if the pain gets better, then returns, the culprit is typically migraine.

"Very likely, more than 90% chance, they have migraines rather than sinusitis,” says Dr. Anand.

If you're still not sure what's causing your pain, see a neurologist and get a diagnosis.

Migraines are thought to be caused by a neurochemical reaction in the body.  So, many migraine drugs are designed to shut down that reaction and block the pain.

If the problem is a sinus infection, you may need antibiotics or steroids to reduce the inflammation.

But, those drugs won’t help fight migraine.  So, Anand says, get some answers.  You don't want to be playing a guessing game with your pain.

"Commonly people start on antibiotics and steroids before they even think about migraines,” he says. “So, one thing I tell my friends or patients or families is to think about migraines before you think about sinusitis."