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Sinus headache or migraine?


Hunter's Moon
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For the last 5 years or so, I've been getting headaches that I always attributed to my allergies and sinusitis, but after the headache I had last night, I'm beginning to wonder.

 

My headaches usually occur in the evening/night. They're usually on my right side, directly above my eye. When I get them, I usually also get head 'nausea.' I can tell the nausea isn't based in my stomach, but it travels there if that makes sense. The head nausea usually travels to both sides of my head, not just the right, but the majority of the pain is focused in the right side.

 

For the most part, sleep will get rid of the headache, but I always wake up with the head nausea. It's as if the headache is threatening to return. If sleep doesn't get rid of the throbbing/waves of pain, it lessens it.

 

I can still be around lights and sounds, but it definitely helps not to be. If I need to look at my phone for example during one of these headaches, I need to hold it farther from my face to avoid the squinting or my headache gets worse.

 

Do these sound like migraines or sinus headaches? Sometimes the headaches occur because I didn't take my allergy prescription for a few days and my head gets stuffed, but sometimes there's no obvious stuffiness.

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I get those too and attribute it to sinuses. I can get sinus infections with NO other symptoms; that is, no congestion, no cold, etc. The only thing that helps--both in prevention during allergy season and as cure when I feel one coming on--is a nasal steroid spray. It's a lifesaver for me.

 

Fwiw I get migraines and pressure headaches (due to weather) too, but they feel different to me.

Edited by MEmama
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I actually don't have any decongestants on hand, but I'll definitely be picking some up to test out the theory. I usually take Ibuprofen, which definitely takes the edge off. 

 

I'm currently taking Zertec (10 mg daily) and Flonase. I'm going to talk to my doctor about switching up my meds, since I've been on both for years now, to see if there may be something better suited to my needs. 

 

Thanks!

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The one side and nausea make me think migraine. A decongestant may help because migraines can be triggered by pressure changes and swelling, and decongestants relieve some of the pressure. IOW, if the decongestant helps, that doesn't rule out migraine.

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An option you may not have considered is you might be grinding your teeth. For decades I used to wake up with terrible headaches that might slowly improve throughout the day, but they were awful and often I saw no improvement at all. I mentioned it to doctors and they said things like "it could be that you sleep on your stomach" which I did, but that wasn't helpful.

 

I should have been talking to my dentist instead! I got a mouth guard a few years ago and I almost never get those headaches any more. It's wonderful!

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My neurologist said sinus headaches do not exist.  They were made up by drug marketing departments.  If there is pressure not pain, it might be allergies or a sinus infection.  If there is actual pain (above 2 or 3 on a 10 point scale), it is a migraine.  Especially if it is only on one side & involves vision changes or nausea, it is absolutely a migraine.

 

My mom has suffered from "sinus headaches" her entire life until one day I forced her to take some Excedrin and iced coffee instead of sudafed.  Magically, the pain went away in 20 minutes and was much more effective.

 

The difference is that those with disabling migraines have an issue with substance P that changes their pain tolerance.  If you don't have that issue a little Excedrin and caffeine will be extremely effective.

 

Nope. Definitely sinuses for me. Pain killers don't touch it. But medicated nasal spray will; as soon as the drainage starts I'll feel better.

 

It's weird though, I don't have to feel congested to be congested. I'd never had the problem until I got my first sinus infection some 10 years ago. Since then it's been an issue.

 

eta: when I mentioned it to a doctor friend, she wasn't surprised. She said sinuses are different in everyone and I could have narrow ones that get clogged easily, causing the pain.

 

My migraines are a different beast and not treated with nasal spray.

Edited by MEmama
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I've always assumed they were sinus related because I have chronic sinusitis - the walls of my sinuses are chronically enflamed.

 

They do seem to become more frequent if I stop my allergy medications for a few days (not done purposely), but they also seem to happen out of the blue. No stuffy nose, just pressure/pain that alternates between a throb and a dull ache.

 

I woke up today feeling much better than last night - it brought me to tears last night, which isn't usual. I've had the 'head nausea' all day, and a dull ache has now moved above my left eye, so I have no idea what to think.

 

I'm hoping my doctor has some answers. I work on computers, so avoiding screens when I feel it coming on isn't always possible.

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An option you may not have considered is you might be grinding your teeth. For decades I used to wake up with terrible headaches that might slowly improve throughout the day, but they were awful and often I saw no improvement at all. I mentioned it to doctors and they said things like "it could be that you sleep on your stomach" which I did, but that wasn't helpful.

 

I should have been talking to my dentist instead! I got a mouth guard a few years ago and I almost never get those headaches any more. It's wonderful!

They usually wind up during the evening/night and are gone when I wake up, so I don't think it's grinding.

 

I'm glad you got yours sorted - I would hate to constantly start my days with a headache.

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