You may not realize that two kinds of headaches — sinus headaches and migraines — are linked to allergies.
Are Migraines and Allergies Related?
Yes. Individuals with migraines are more likely to have allergies, and individuals with allergies are more likely to have migraines.
In fact, migraines will often follow a seasonal pattern. There is a shared mechanism between migraines and allergies: migraines are triggered by a protein called CGRP (calcitonin gene-related peptide), which has been found to be elevated in the nasal secretions of allergy patients. Finally, histamines, which are chemicals in the body released by immune cells during an allergic reaction, have also been found to be elevated in migraine patients. Because of this, optimal treatment of migraines involves treatment of both the migraine and allergy symptoms, if they are present.
How Do Allergies and Sinusitis Cause Headaches?
The sinuses are four paired cavities in the head that are connected by narrow channels to the nose. They create mucus that drains out of the channels of the nose. This mucus drainage helps to keep the nose clean and free of bacteria, and in a healthy patient, the sinuses are mainly filled with air.
When the sinuses or nasal passages become inflamed due to sinusitis or allergies, patients can experience pain and pressure and headache in the areas that are infected or inflamed. This is referred to as a rhinogenic headache.
How Can Migraines Mimic Sinus Headaches?
Not all headaches that feel like they are in the sinuses are due to nasal issues. In fact, some patients that experience headaches localized to the sinuses may actually be experiencing a type of migraine. Because of the way the nervous system is wired in the brain, often, a migraine can make patients feel like they are having a sinus infection even when there is no inflammation in the sinuses.
In a study of 2991 patients with sinus headaches, researchers actually found that 88% actually had a migraine. Indeed, while many of these patients experienced sinus pressure, congestion, and headache, they actually met criteria for having a migraine. These results were also supported in another study, where once again, many patients who thought they were having sinus headaches were actually more likely to be having migraines.
How Can I Tell the Difference Between a Migraine, Sinus Headache and Allergy Headache?
To help doctors and patients differentiate between sinus headaches and migraines, we will often use diagnostic criteria or specific definitions of what each disease is. A migraine is an episodic, recurrent headache, meaning that patients tend to experience relatively brief episodes of headache, lasting 4-72 hours, that recur. For a migraine diagnosis, patients need 2 out of 4 criteria (unilateral pain, throbbing pain, pain worsened by movement, and moderate to severe pain) + any 1 associated symptoms (nausea, vomiting, sensitivity to light, or sensitivity to sound). In contrast, a sinus infection or chronic sinusitis is typically associated with nasal congestion, nasal drainage, purulence, or facial pain and pressure. Lastly, allergies can also cause inflammation of the nasal passages and cause a feeling of facial pain and pressure, but these are typically associated with exposure to your allergens and are often seasonal and improve with taking antihistamines or allergy medications.
What Can I Do About My Symptoms?
Physicians can work with you to determine if your symptoms are more likely to be allergy related or migraine related. Often, patients will suffer from both. By treating your allergy symptoms it can improve your headaches and potentially decrease your migraine episodes.
Talk to our allergy doctors today to learn how to fix your allergies for life, and finally live without allergy-triggered migraines.