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Sinus Headaches May Acutally Be Migraine

Throbbing and tenderness in your nose, cheeks and/or eyebrows seem to be clear indicators of a sinus headache. Most likely they aren’t. 90% of what patients think are sinus headaches are actually untreated migraines.

[Headache specialist Eric] Eross and colleagues advertised a free evaluation to people suffering from “sinus headaches.” They signed up the first 100 people, and gave them a rigorous 1.5-hour evaluation. It turned out 90 of the 100 patients were really suffering from migraines.

Sinus headaches do exist, but they are much rarer than people believe.

If you have an active sinus infection, your head hurts. Typical symptoms include fever, swollen lymph nodes, and a green or yellow nasal discharge. But most people who think they have sinus headaches don’t have these symptoms — just pain high in their cheeks. They likely have migraines, Eross says.

Following the study, about half the participants who thought they had sinus headaches became Dr. Eross’s patients. Most of them improved dramatically with migraine treatment.

Sinus headache was one of my early self-diagnoses. I can’t tell you how many allergists, ENTs and ENT surgeons I saw. I underwent numerous tests and scans and tried meds and allergy shots, but nothing showed that I had sinus headaches. That didn’t stop me from having nasal surgery for my headaches, which was completely ineffective.

My migraines don’t fit the symptoms of what most people think of as migraine: I didn’t have a visual aura, one-sided pain, nausea or sensitivity to light. Turns out that this describes “classic migraine” (or migraine with aura) which about 40% of people with migraine have symptoms of. Much more common is migraine without aura, often called “common migraine.”

Because of this, getting the right diagnosis was difficult for me. My experience makes me want to tell everyone who has “sinus headaches” that they could have another kind of headache disorder. Since this is my blog, I will. Please consider that your headaches aren’t sinus-related.

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Allergies & Migraine

People with nasal allergies may have a greater incidence of migraine, according to a recent study. The study, which had 294 participants, found that 34% of people with hay fever (aka allergic rhinitis) had migraine symptoms; only 4% of participants without hay fever had such symptoms.

But don’t jump to conclusions!

This study doesn’t prove that migraines are caused by allergies. Instead it’s that people who have migraine might have the condition triggered by hay fever. These folks already have headache disorders, but the allergies may be what triggers them to come out of the woodwork. (This is how all triggers work — they don’t cause migraine, but put an already present condition into action.)

These findings also do not contradict research that says that 90% of what patients and doctors classify as sinus headache is actually migraine. That’s not necessarily true. The results may in fact reinforce the previous studies. People with allergies may be more likely to have migraine-like symptoms than those without. That doesn’t mean that those in the 34% were suffering from sinus headaches. They could be having migraines that are triggered by the allergies.

Debates about allergies and headaches are likely to go on forever. In addition to the research that I’ve read, my obvious bias is also influenced by anecdotal “evidence.” I spent a long time treating allergies and visiting allergists to treat my headaches. After two allergists in one practice said I didn’t have allergies, I found another one who did. I did this before I was diagnosed with migraine, but, migraine or not, allergy treatments didn’t help. Many people tell me similar stories. Again, stories aren’t enough to make something medical fact, but they may help you not waste precious time in treating your headaches.

Tanks, Pam for bringing this important article to my attention!