Sinus headache vs migraine? Probably a migraine | Norton Healthcare Louisville, Ky.

Those headaches you’ve been blaming on your sinuses? They may be migraine attacks

What you’ve been calling sinus headaches very well may be migraine attacks, and the way you’ve been seeking relief may be making things worse.

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.

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.

Headache School On Demand

Headache School, presented by the Norton Neuroscience Institute Headache Center, is an on-demand virtual series of five video presentations by NNI Headache Center specialists designed to inform new and existing patients about their headaches, why they should see a specialist and what treatments are available.

Register to learn more

New migraine treatments

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.

Frequent symptoms of a migraine

  • At least five attacks lasting four to 72 hours
  • At least two of the following characteristics:
    • One side of the head
    • Pounding pain
    • Moderate to severe pain
    • Gets worse with activity
  • During the headache, at least one of the following:
    • Nausea and/or vomiting
    • Intolerance to light and sound
  • No other explanation


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