Story by: Norton Healthcare on April 16, 2021
You live in Louisville or Southern Indiana, so you get sinus headaches, right? Well, maybe not. They very well could be migraine attacks, and the way you’ve been treating them actually may be giving you more headaches.
As many as 86% of those who thought they had sinus headaches were actually experiencing migraine, according to a study published in Headache: The Journal of Head and Face Pain. Just 3% had headaches related to their sinuses.
“We’ll often see patients who say, ‘I’ve had sinus headaches for years. I live in Kentucky,’ but once they describe their symptoms it becomes clear they’ve been getting migraine attacks around the fall and spring every year,” said Mandy J. Whitt, M.D., a headache specialist with Norton Neuroscience Institute.
Talk to a primary care provider about whether your sinus headaches are really migraine attacks and what’s the best treatment option
Common over-the-counter treatments for sinus headaches actually can cause more issues for those who experience migraine.
Taking acetaminophen, ibuprofen, aspirin or naproxen more than 10 days a month can trigger medication overuse headaches. Prescription drugs such as opiates, triptans, dihydroergotamine and butalbital — a barbiturate sometimes combined with other medications for headache treatment — all can trigger medication overuse headaches even faster.
“It can make the headaches worse. Then, after you stop the medicine, the headache reverts to its previous pattern within two months,” Dr. Whitt said.
The first course of treatment for many who experience migraine headaches is to eliminate medication overuse.
A new treatment for migraine, gepants, block CGRP — a protein in the brain that has been identified as a migraine trigger. The treatments have a relatively low risk of serious side effects and a low risk of medication overuse headaches.
Currently there are two gepants available by prescription and two more on the way, according to Dr. Whitt. Ubrogepant and rimegepant are only for acute migraine treatments. Both can be taken orally as needed. After two hours, about 20% of patients are free of pain. The drugs are not recommended during breastfeeding or pregnancy.
Of the other two, one is planned as a migraine preventer and the other is a nasal spray for acute migraine treatment.
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