Sinus Headache or Migraine? How to Tell

Why the mix-up happens

Facial pressure and stuffy nose can occur in both sinus inflammation and migraine. Correct diagnosis prevents months of wrong treatment.

Quick comparison

Points toward migraine

• Throbbing/pulsating pain, usually moderate–severe

• Nausea, light/sound sensitivity

• Worsened by activity; may have aura or neck pain

• Minimal nasal discharge; normal temperature

Points toward sinus headache

• Facial pressure over cheeks/forehead with thick nasal discharge

• Often follows a cold/allergy flare

• Fever, dental pain, or smell reduction

• Improves with saline + intranasal steroids; may show sinus changes on CT

Smart first steps at home

• For suspected migraine: hydration, rest in a dark room, NSAID/acetaminophen early; track triggers (sleep, caffeine, foods).

• For suspected sinus: saline rinses, steroid spray, humidifier; short course decongestant spray only for 3 days max.

When to see a clinician

• Headaches with fever >101°F, severe neck stiffness, or neurologic symptoms

• “Sinus” symptoms >10 days or worsening after initial improvement

• Frequent headaches impacting work/school

• Smell loss or recurrent infections

How Vitale ENT can help

Targeted exam, allergy evaluation, and—when appropriate—sinus CT to confirm inflammation. If migraine is likely, we coordinate with your PCP/neurology for evidence-based therapy while managing any nasal triggers.

Tampa Bay Area care

Vitale ENT —  Wesley Chapel • Lutz• Zephyrhills

Appointments: (813) 406-4400 | VitaleENT.com