Your sinusitis may be a migraine

This article explains that many sinusitis diagnoses may actually be misdiagnosed migraine headaches.

Many people with migraine headaches are first misdiagnosed with, and treated for, sinusitis problems leading to an impaired quality of life, according to migraine expert and surgeon Elliot Shevel from the Headache Clinic, a group of private treatment facilities across the country.

New research has been published in recent years confirming the trend, said Shevel, and showing “the importance of clinicians making a proper and correct diagnosis”.

Painful effects
According to United States-based medical research organisation Mayo Clinic, migraines are chronic headaches commonly accompanied by symptoms such as nausea and sensitivity to light and sound. They are caused by the “activation of a mechanism deep in the brain that leads to the release of pain-producing inflammatory substances around the nerves and blood vessels of the head”, according to the World Health Organisation’s website. 

Sinusitis is inflammation of the cavities around the nasal passages and can be caused by having a cold, allergies and bacterial or fungal infections, according to Mayo Clinic. 

In a 2013 study published in the Journal of Headache and Pain, 130 migraine patients in Kuwait were asked about their headache history. More than 80% had been initially misdiagnosed as having sinusitis, with the correct migraine diagnosis taking anywhere from one to 38 years of seeking treatment.

Most of the 80% of patients who had been misdiagnosed previously were treated with medication, but 12% underwent surgery to help alleviate sinusitis.

The reason for the high rate of misdiagnosis, according to the researchers, is that “symptoms suggestive of sinusitis are frequently seen in migraine patients”, including congestion in the nasal passageways prompting them to call for general practitioners to be more aware of the diagnostic criteria for migraine.  

Medication overuse
An inaccurate migraine diagnosis can lead to further problems such as medication overuse headaches, said Headache Clinic managing director Daniel Shevel.

Medication overuse headaches occur when chronic use of painkillers begins to cause head pain. Migraine sufferers who receive little relief from sinusitis medication may begin to self-medicate in this way, according to Shevel. 

“Sufferers are between a rock and a hard place – if they resist the pain medication they suffer the pain, but if they take it they make future pain more likely.”

Migraines can be debilitating and some last for up to 72 hours, but there are effective treatments available, said Shevel. “The first step, however, is being accurately diagnosed.”

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How to tell if your headache is a migraine

This article discusses how to tell if your headache is truly a migraine or not. Also, it discusses good ways to try and alleviate migraines.

Have you ever wondered why your headache just won’t go away? It could be because you’re not treating it correctly. There are several types of headaches, which we often confuse with one another. Each is marked by different symptoms and characteristics. In order to properly treat a headache, you must be able to identify which type of headache you’re experiencing.

Tension Headache: Tension headaches are the most common type of headache, and as many as 30 to 78 percent of the general population experience them during their lifetime. This type of headache appears periodically and can last from 30 minutes to several days. The pain is a mild to moderate pressure or tightness, which typically doesn’t interfere with daily activities. Over-the-counter pain medications can be used to treat tension headaches.

Sinus Headache: This type of headache consists of constant pressure or tenderness over the sinus areas including the cheekbones, forehead and nose. The defining factor of a sinus headache is the presence of nasal discharge, congestion, facial swelling, ear sensations or fullness and in many cases a fever. Treatments for sinus headaches can include decongestions, pain relievers or antibiotics in the case of an infection.

Cluster Headaches: This type of headache is the least common type of “headache” and its cause is unknown. Cluster headaches reoccur over a period of time. Periods can last for several weeks to months then disappear. Each attack is short lasting, severely painful and typically localized to one side of the head. There are no warning signs for a cluster headache. Treatments are available through your health care professional.

Migraines: Migraines are less common than tension headaches. Migraines can last from four to 72 hours on average. Symptoms of a migraine include moderate to severe pain affecting daily activities, nausea, vomiting, light and sound sensitivity and aura. Aura is a warning symptom that can occur before, during or after the onset of a migraine, consisting of blurred vision, blind spots, flashing dots or lights and other visual disturbances. Aura’s typically last 20 to 30 minutes.

More than 29.5 million Americans suffer from migraines, with women being affected three times more often than men. One of the reasons women are affected more by migraines is because hormone changes serve as a migraine trigger. Many women experience migraines before or during their menstrual cycle.

Identifying a Migraine

The ID Migraine Questionnaire, developed by Dr. Richard Lipton, is a simple three question test used to determine if you’re suffering from migraines or another type of headache. According to his research, if two of the three criteria are present, a migraine is likely 93 percent of the time, and if all three are present a migraine diagnosis is 98 percent likely.

• In the last three months, how disabling are your headaches; do they interfere with your ability to function? (Are you missing work, school and family activities?)
• Are your headaches ever associated with nausea?
• Are your headaches ever associated with sensitivity to light?

Migraines are often misdiagnosed as sinus headaches since they have similar symptoms. According to the American Headache Society Committee on Headache Education, 90 percent of the time a self-diagnosed sinus headache is a migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their health care provider. If you have headaches that continuously interfere with your daily life and that don’t respond to over-the-counter medicines, you may be suffering from migraines. Visit your health care professional to get the proper treatment.

Strategies for Living with Migraines

Migraine sufferers vary in their sensitivity to specific foods, and triggers to foods may take anywhere from 30 minutes to 72 hours to develop, making them often very difficult to pinpoint, says the National Headache Foundation. Experts recommend keeping a daily journal of food intake and activity can help pinpoint specific triggers. By doing this you may be able to determine a pattern and prevent future migraines. This can be time consuming, but is helpful to both you and your health care professional when determining the right course of treatment for you.

The second strategy is preventing and coping with your headaches through lifestyle change. Several triggers are out of your control including the weather, travel and odors such as cigarette smoke, but many common triggers can be controlled by adapting certain habits. Long Beach Memorial encourages you to focus on the common triggers, such as, sleep, diet, exercise, hydration and stress management.

Sleep – Feeling well-rested may keep a headache at bay. It is ideal to get eight hours of sleep each night. Try not to sleep in too late on the weekends and sleep too little on the weekdays. Make it a habit to go to bed and wake up at regular times all week long.

Diet – Keeping your meals routine also can help you avoid headaches. Delaying or skipping meals can cause your blood sugar to dip, causing the “hungry headache.” To avoid this, you should eat balanced meals throughout the day. The best diet consists of as many fresh foods as possible. You should include a good protein source at each meal/snack (i.e., milk, meat, fish) and should avoid eating high sugar foods by themselves, says the American Headache Society Committee on Headache Education. Alcohol and caffeine both can be triggers for headaches; each should be used in moderation.

Exercise - Exercise can help you fight other headache triggers such as anxiety, poor sleep, sadness, stress, and waist and weight gain. Aerobic level activity leads to an increase in natural body joy and pain control chemicals according to the American Headache Society Committee on Headache Education. However, too strenuous of exercise also can lead to a headache. Moderation is the key. For proper walking techniques visit MemorialCare.org/LiveHealthy.

Hydration - Dehydration is a risk for a headache. Weather is a headache trigger, so hydration is especially important on hot days. Prevent dehydration by drinking plenty of water.

Stress - Stress is the most commonly recognized trigger of headaches says the National Headache Foundation. Anything that increases your emotional and physical stress level can trigger a headache. Factors related to stress include anxiety, worry, shock, depression, excitement and mental fatigue. You can’t always avoid stress, but you can alter the way you respond to it. For more tips on stress management visit MemorialCare.org/LiveHealthy.

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Study: Sinus headache vs. Migraine headache

This study looks at the differences between a sinus headache and a migraine.

Headache disruptions in our daily routine and work productivity are common; the occasional headache plagues us all. But those who suffer from chronic headaches are desperate for relief from their frequent and disabling headache symptoms. Americans spend countless hours and dollars seeking migraine headache relief from over-the-counter pain medication, natural remedies, migraine prescription drugs, and trips to doctors and emergency rooms. Understanding sinus vs. migraine headaches can be very challenging, according to Dr. Brian Rotskoff, Chicago asthma, allergic rhinitis (hay fever), and adult sleep apnea expert.

However, those who believe they suffer from chronic sinus headaches may actually be experiencing migraines. Clarity Allergy Center's Dr. Rotskoff is an adult and pediatric allergy, asthma, and immunology specialist who teaches his patients that lasting headache relief can only be achieved through proper diagnosis. "Studies show almost 90% of patients with sinus headaches are misdiagnosed by their physician," he said, "Many patients are treated with frequent courses of antibiotics, anti-histamines/decongestants, allergy shots, and even sinus surgery. But the majority of these patients could actually have migraine headaches and not sinus problems. It can be very confusing and difficult to distinguish between a sinus headache and a migraine headache."

What's more, patients with allergies may be up to 10 times more likely to have migraines.

What Causes Headaches?

"Sinus headaches create such a buzz that when people suffer from frequent headaches over their forehead and cheeks, they're quick to blame their sinuses," says Dr. Rotskoff, "But before we can assume the headache is caused by a sinus or allergy problem, we have to dig deeper and look for the possibility of a migraine headache. For lasting relief, we have to address the source of the headache."

Migraine headaches, considered primary headaches, are typically caused by neurogenic or vascular changes that affect blood vessels or changes in serotonin levels. A family history of migraines can significantly increase your likelihood of suffering from them.

A sinus headache, on the other hand, is actually caused by a bacterial infection of the sinuses. "This may occur on a chronic basis or as an acute problem, simply arising from a cold or acute bacterial sinus infection," Dr. Rotskoff explains. Head pain caused by a sinus infection will respond to a course of antibiotics and treatment for any underlying allergies, if present.

Dr. Rotskoff stresses that professional diagnosis is key to not only unlocking your headaches, but also applying the right mix of prevention and treatment strategies.

Symptoms of a Migraine

• Pulsating, throbbing headaches often on one side of head
• Sensitivity to light and sound
• Nausea, possibly with vomiting
• Blurred vision
• 
  

Symptoms of a Sinus Headache

• Discolored (greenish/yellow) nasal discharge
• Decreased sense of smell and nasal stuffiness/congestion
• Accompanying sore throat or cough
• Fever (only during an acute infection)
• Pain and/or pressure over cheeks and forehead

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