Migraine vs sinus headache?

Last updated September 3, 2026.

Most self-diagnosed sinus headaches are migraines. A true sinus headache is rare and rides on an active infection: thick colored discharge, face pressure, fever, after a cold. Migraine: throbbing, often one-sided, worse with movement, with nausea and light sensitivity, recurring without any infection. Migraine's dirty trick is autonomic: it can water an eye and stuff a nostril on the headache side, which feels sinus-y. The sorting questions: repeated attacks with clear sinuses between (migraine) versus only-when-sick (maybe sinus); colored discharge plus fever (infection) versus nausea plus dark-room-seeking (migraine); bending-forward pressure (sinus) versus movement-worsened throb (migraine). The label matters because the treatments do not overlap: antibiotics do nothing for migraine, and triptans taken early do. Red flags hold regardless of label: thunderclap onset, fever with stiff neck, new weakness or vision change, all ER. And if you have treated "chronic sinus" for years without infection findings, ask about migraine; that question regularly ends years of wrong treatment.

Find answers about headaches

Start a free AI doctor consult →

What to do

Related questions

Sources

Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment.

Free AI doctor, 24/7 by textStart a free AI doctor consult