Is there such a thing as “sinus headache?”
Many media sites note that a ‘sinus headache’ is characterized as pain or pressure within the sinuses associated with fevers, chills, runny nose and fullness in the ears. However, many of my patients state that they have sinus pressure without associated symptoms of fever, chills or runny nose. Furthermore, the official International Classification of Headache Disorders does not include a diagnosis of sinus headache. The fact is, many patients with migraines are misdiagnosed with sinusitis or ‘sinus headaches.
Studies have shown that sinusitis is the most common misdiagnosis given to people who actually have migraine. A study by Al-Hashel and colleagues showed that out of 130 patients with migraine, 106 (81.5%) were previously misdiagnosed as sinusitis. As a result of misdiagnosis, migraine diagnosis was delayed by several years and many patients had their migraines worsen from episodic migraine to severe chronic migraine due to a lack of appropriate treatment. On average, patients diagnosed with ‘sinusitis’ had to wait an average of 7 years before they were properly diagnosed.
This is accurate based on my personal experience. Over the past decade, I have seen patients take medications and have procedures performed after being misdiagnosed. Other common misdiagnoses include temporomandibular dysfunction, allergies and cervical spine disorders. While it is important to consider secondary causes for headache before diagnosing a primary headache disorder such as migraine, it is also important to quickly start treatment once other causes have been ruled out. Due to direct connections of facial nerves with the migraine generator in the neck, migraines can present with:
- sinus pain and pressure
- jaw pain
- neck discomfort
Early treatment of migraine with appropriate preventive and abortive treatments can stop the progression of disease and in turn reduce disability. Dr. Al-Hashel’s study showed that migraine improved in almost 70% of people after receiving a correct diagnosis and treatment.
As we enter a New Year, I wish you a healthy and prosperous 2021! – Dr. K