Could your sinusitis actually be a migraine?

Many people with migraine headaches are first misdiagnosed with, and treated for, sinusitis problems leading to an impaired quality of life, according to migraine expert and surgeon Elliot Shevel from the Headache Clinic, a group of private treatment facilities across the country.

New research has been published in recent years confirming the trend, said Shevel, and showing “the importance of clinicians making a proper and correct diagnosis”.

Painful effects
According to United States-based medical research organisation Mayo Clinic, migraines are chronic headaches commonly accompanied by symptoms such as nausea and sensitivity to light and sound. They are caused by the “activation of a mechanism deep in the brain that leads to the release of pain-producing inflammatory substances around the nerves and blood vessels of the head”, according to the World Health Organisation’s website. 

Sinusitis is inflammation of the cavities around the nasal passages and can be caused by having a cold, allergies and bacterial or fungal infections, according to Mayo Clinic. 

In a 2013 study published in the Journal of Headache and Pain, 130 migraine patients in Kuwait were asked about their headache history. More than 80% had been initially misdiagnosed as having sinusitis, with the correct migraine diagnosis taking anywhere from one to 38 years of seeking treatment.

Most of the 80% of patients who had been misdiagnosed previously were treated with medication, but 12% underwent surgery to help alleviate sinusitis.

The reason for the high rate of misdiagnosis, according to the researchers, is that “symptoms suggestive of sinusitis are frequently seen in migraine patients”, including congestion in the nasal passageways prompting them to call for general practitioners to be more aware of the diagnostic criteria for migraine.  

Medication overuse
An inaccurate migraine diagnosis can lead to further problems such as medication overuse headaches, said Headache Clinic managing director Daniel Shevel.

Medication overuse headaches occur when chronic use of painkillers begins to cause head pain. Migraine sufferers who receive little relief from sinusitis medication may begin to self-medicate in this way, according to Shevel. 

“Sufferers are between a rock and a hard place – if they resist the pain medication they suffer the pain, but if they take it they make future pain more likely.”

Migraines can be debilitating and some last for up to 72 hours, but there are effective treatments available, said Shevel. “The first step, however, is being accurately diagnosed.”

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