Is it a Migraine?

Migraines versus sinus and tension headaches

/ Author:  / Reviewed by: Robert Carlson, M.D

You’ve got a headache, and it’s a bad one. Your head hurts and you're in pain –  that’s all you know. So how to know when it crosses the line into migraine?

Migraines have different causes, treatments and triggers than their still-painful counterparts (like sinus or tension headaches) so it’s important to know when a migraine is at play so that they can be cared for effectively.

Paying attention to symptoms and visiting the doctor can help determine the nature of the beast.

Migraine Versus Tension-Type Headache

Symptom Breakdown

Womenshealth.gov (a website managed by the US Department on Health and Human Services Office on Women’s Health) provides a number of ways to tell the difference between a migraine or a bad tension-type headache.

Migraine headaches often are accompanied by intense, pounding pain, while tension-type headaches are more likely to be qualified as “distracting, but not debilitating,” reports Women’s Health.

Tension headaches are unlikely to occur on only one side of the head, which may be the case for some migraines.

Migraines may be accompanied by symptoms like nausea or vomiting, which is not true for tension-type headaches, and while sensitivity to light or sounds happens to many migraine sufferers, this a rare occurrence with tension headaches.

Patients who experience aura (sensory symptoms that can include seeing lights or feeling tingling sensations) before a headache are likely to be suffering from migraines and not tension headaches.

Overall, Women’s Health advises that a “tension-type headache is generally less severe and rarely disabling,” than their migraine counterparts. While migraines can sometimes be mild, tension-type headaches are unlikely to be severe.

Triggers and Treatments

The causes or triggers of a headache can also provide clues to help determine its nature.

Both tension-type headaches and migraines can be brought on by stress or fatigue. However, migraines have been linked to a variety of other triggers including hormone changes, certain foods and weather shifts.

According to Woman’s Health, treatment differences also exist, and, “Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.”

Migraine Versus Sinus Headache

Sinus and migraine headaches are often confused due to the fact that watering eyes, sinus pain and pressure and congestion can occur with both migraines and sinus headaches.

However, if a patient has two or more of the following symptoms: nausea, sensitivity to light or moderate to severe pain, they probably have a migraine headache.

According to a report from the American Headache Society Committee on Headache Education (ACHE) written by Susan Hutchinson, MD and Director of the Orange County Migraine & Headache Center in Irvine, California, “self-diagnosed sinus headache is nearly always migraine.”

Women’s Health agrees, saying, “A true sinus headache is rare and usually occurs due to sinus infection.”

Symptoms like fever and thick nasal drainage are likely to accompany these viral infections. Treating the sinus infection should, in turn, solve the headache problem.

Dr. Hutchinson writes that though there are various over-the-counter medications available to treat sinus headaches and many may believe that this is a common condition, it is really not as commonplace as most may think.

Migraine headaches with sinus-related symptoms are more likely to be the culprit in these cases.

“Go beyond the nasal and sinus congestion; the facial pain and pressure,” recommends Dr. Hutchinson, “and look for a headache associated with inability to function normally at work, school, home or social functions; nausea; sensitivity to light and triggers such as weather change; menses; and stress (all common provokers for migraine).”

Right Headache, Right Treatment

Doctors can help patients confirm exactly what type of headache is at play so that it can be treated effectively.

Medications can help treat migraines, and lifestyle changes can help prevent them before they occur. Before these important steps can be taken, however, patients need to know what they are coping with and trying to treat.

Treating migraines like tension-type headaches or sinus headaches or vice versa won’t effectively bring the relief that patients need. Women’s Health suggests that patients talk to their doctor if “headaches disrupt your home, work, or school life.”

It is important to note that severe headaches should be taken seriously, as they can be a sign of serious problems. Sudden, severe headache that causes nausea, vomiting, vision, or other sensory problems needs emergency treatment. Stiff neck, convulsions, or confusion/loss of alertness also need emergent treatment.

Women's Health recommends seeking medical help if the headache occurs with pain around the ear or eye, a stiff neck, confusion, convulsions, sensory problems like numbness, vomiting, nausea or occurs after hitting the head.

If headaches start to become a more frequent problem, occur in major ways several times per month, or if a first-time headache is accompanied by any of the above symptoms, it is best to visit a doctor to make sure that no urgent and serious problem is at play.

With proper diagnosis and treatments, patients and doctors can work together to make these unpleasant pains as infrequent and disrupting as possible.

Reviewed by: 
Review Date: 
December 19, 2012