Ask the doctor: Mistaken migraines
Q. I have suffered from sinus headaches for years and have tried over-the-counter allergy medications without any improvement. Is there something else I can do?
A. Seasonal allergies can cause sinus congestion, sneezing, and a runny nose, but when you experience pain and pressure in your head it may be time to consider other causes. Headache is an unusual symptom for pure sinus problems, unless you also have an acute infection with yellow-green nasal discharge and fever. A daily headache over the eyes and cheeks, along with nasal congestion, is often labeled a "sinus headache," but it is much more likely to be a migraine headache.
I have often seen people with migraine headaches misdiagnosed with sinus problems and treated for sinus infections that do not exist. Many people do not recognize that sinus pain and pressure are reported by more than 80% of migraine sufferers, and about half of them also experience nasal congestion or a runny nose. In addition, weather changes are common migraine triggers and may lead to seasonal variation in the headaches. Clues that the sinus pain is related to migraines include nausea or vomiting and sensitivity to light or sound.