The Sinus Headache Myth
There is a growing body of research that suggests that recurrent, episodic headaches that are accompanied by allergy or sinus symptoms are actually migraine headaches. Symptoms of migraine that may mimic sinus disease include:
How can this be?
What does the trigeminal nerve have to do with allergy or sinus symptoms?
Activation of this trigeminal system results in parasympathetic nervous system involvement, causing nasal congestion and watery, itchy eyes. (Visit the American Migraine Foundation website for more information on sinus and migraine.)
has this been thoroughly studied?
The short answer is, “yes.” The idea that sinus headache is actually migraine has been borne out in multiple thorough, credible scientific studies. For example:
American Migraine Prevalence and Prevention Study
According to the American Migraine Foundation, at least 36,000,000 Americans have migraine. This would indicate that almost 8 million migraine sufferers believe they have sinus headache, and thus, are not getting appropriate treatment for migraine.
A much larger study, conducted in 2004 and involving 452 primary care clinics in North America, screened almost 3000 patients who had either self-diagnosed or physician-diagnosed sinus headache. 97% of the patients reported moderate to severe head pain, plus some autonomic symptoms (sinus pressure or pain, nasal congestion, rhinorrhea, watery eyes, and itchy nose). Of the 2991 patients in the study, 88% of the patients were found to have migraine or probable migraine headaches according to the IHS criteria* for diagnosing migraine.
In yet another study, conducted in 2002 by Barbanti, et al, researchers looked at the percentage of migraine patients with autonomic features including: eye watering, eye redness, eyelid drooping, eyelid swelling, nasal congestion and nasal running. 127 consecutive migraine patients were interviewed, revealing that 45% of these patients had at least one autonomic feature with their migraine headaches.
Weather is known to be a significant trigger for migraine headaches. Coupled with the autonomic features that can accompany migraine, it is easy to see why there is so much confusion about sinus and migraine. According to a paper published in the Journal of Neurology, Neurosurgery and Psychiatry on the comorbidities of chronic migraine in 2010, the two top comorbities are allergy (60%) and sinusitis (45%).