Sinus Headache vs. Migraine: How to Tell the Difference
- Madeleine Herman
- 5 days ago
- 3 min read
A Guide from SCENT Houston – Sinus Center & ENT Specialists of Houston
Many people assume that any headache with facial pressure is a “sinus headache.” But here’s the surprising truth: most sinus headaches are actually migraines.In fact, research shows that up to 80% of people who think they have sinus headaches actually have migraine symptoms.
At SCENT Houston, our ENT specialists help patients determine whether their pain is truly sinus-related — or something else.
What Is a Sinus Headache?
A sinus headache occurs when the sinuses become inflamed or blocked. This can happen during a sinus infection, allergies, or chronic sinusitis.
Typical Sinus Headache Symptoms:
Pressure in the cheeks, forehead, or between the eyes
Pain that worsens when bending forward
Stuffy or blocked nose
Thick nasal drainage (often yellow or green)
Reduced sense of smell
Fever or fatigue
Tenderness to touch over the sinuses
A key detail: true sinus headaches almost always come with nasal symptoms.
What Is a Migraine?
Migraines are neurological headaches, not sinus-related. But because they can cause facial pain and pressure, many people confuse them with sinus problems.
Common Migraine Symptoms:
Throbbing or pounding pain
Sensitivity to light or sound
Nausea or dizziness
Pain on one side of the head
Visual symptoms (flashing lights, blurry vision)
Facial pressure without congestion
Clear, watery nasal drainage (not thick mucus)
Migraine pain often worsens with movement, stress, hormonal changes, or certain foods.
The Key Differences
Here’s a quick comparison to help you understand your symptoms:
Symptom | Sinus Headache | Migraine |
Nasal congestion | Yes (common) | Sometimes (usually mild) |
Thick nasal drainage | Yes | No |
Fever | Possible | Rare |
Light/sound sensitivity | Rare | Common |
Nausea/vomiting | No | Common |
Symptoms worsen with movement | Mildly | Significantly |
Response to sinus treatments | Good | Poor |
Seasonal allergies link | Common | Sometimes |
If your “sinus headache” doesn’t improve with allergy meds, decongestants, or sinus treatment, it may be a migraine.
When It Is Sinus-Related
True sinus headaches typically occur with a sinus infection or chronic sinus inflammation.
You may have sinus disease if you experience:
Congestion that lasts more than 10 days
Repeated sinus infections
Facial pressure + thick drainage
Pain when pressing the cheeks/forehead
Symptoms that worsen with allergies
Loss of smell
Post-nasal drip
Sleep disruption due to nasal blockage
In these cases, ENT evaluation is essential.
How SCENT Houston Helps
At SCENT Houston, we specialize in diagnosing both sinus-related headaches and headaches that mimic sinus pain, such as migraines.
Your visit may include:
Nasal endoscopy
Sinus CT imaging
Allergy testing
Detailed history of your symptoms
Evaluation of nasal obstruction
Discussion of migraine-like features
Once we identify the cause, we create a clear, personalized treatment plan.
Treatment Options
If the headache is sinus-related:
Nasal steroid sprays
Antibiotics (if bacterial infection is present)
Allergy management
Saline rinses
Short-term decongestants
In-office procedures such as turbinate reduction or Balloon Sinuplasty (for chronic sinusitis)
If the headache is migraine:
Migraine-specific medications (triptans, CGRP blockers)
Lifestyle and trigger evaluation
Coordination with a neurologist if needed
Treating underlying nasal obstruction to improve airflow and sleep quality
Get the Right Diagnosis — and the Right Treatment
Misdiagnosed sinus headaches can lead to years of unnecessary treatments.Getting evaluated by an ENT is the first step to finally understanding your symptoms.
At SCENT Houston, we help patients breathe better, sleep better, and live without chronic facial pain.
📍 Ready for Answers?
If you’re dealing with frequent sinus pressure or headaches, schedule a comprehensive evaluation with our ENT specialists.
🔵 SCENT Houston – Sinus Center & ENT Specialists of Houston
Serving Memorial • Tanglewood • Greater Houston
📞 Call today to schedule your visit.