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QUESTION: WHAT IS THE DIFFERENCE BETWEEN MIGRAINE, SINUS AND TENSION HEADACHE?

Migraine headache is one of the most common and misunderstood medical conditions. People with headache disorders are usually under the wrong impression that they have "sinus" or "tension" headaches. This usually leads to ineffective treatment and frustration.

There are 28 million migraine sufferers in the USA and half of them are not aware that they have migraines. Of all the headaches that cause people to seek medical attention, migraine is by far the most common. One in 4 households has a migraine sufferer and women outnumber men 3 to 1.

According to several studies, migraine headaches are most commonly misdiagnosed as "tension" or "sinus" headaches. "Tension" headache is misdiagnosed because half of people who have migraine will also have neck pain or tightness in the back of their head during or at the onset of their migraine. These migraines may even respond to heat and massage, giving the impression that they are caused by muscle tension. They also respond to the migraine-specific medications known as triptans.

When groups of people with "sinus" headaches are systematically evaluated in headache clinics, over 90% of them are really misdiagnosed migraine sufferers. The misdiagnosis of "sinus" headache occurs for a number of reasons. First, it is very common for migraine attacks to produce clear nasal drainage, nasal congestion, and facial pain, leading sufferers to think that they have a sinus problem. Additionally, migraine is often triggered or worsened by weather changes. Misdiagnosed migraine sufferers often attribute sinus pressure and pain to barometric changes, but this is actually a low-grade migraine attack.

The myth of "tension" headache and "sinus" headache is perpetuated by the mass marketing of over-the-counter headache medications targeted at the large number of headache sufferers. These successful ads promote products that all contain either aspirin or acetaminophen and sometimes caffeine, which can help mild migraines. In fact, frequent use of over-the-counter headache medications actually may worsen a person's headache condition. "Rebound headaches," which are caused by the overuse of medications, may occur when over-the-counter pain medicines are used more often than two days per week to treat headaches.

The published standards and educational materials developed by the International Headache Society, the American Headache Society and the American Academy of Neurology show that the criteria for migraine are quite simple. Headaches that get worse with head movement or exertion, are accompanied by nausea, light sensitivity, or sound sensitivity may be migraine and need to be properly diagnosed in order to allow effective treatment. Migraine is a common condition and is treatable by the primary physician or dedicated headache clinics using lifestyle changes and appropriate medications.

Edmund Messina MD
Neurologist and Headache Specialist

Christina Calabrese MD
Family Practitioner specializing in Headache Disorders

Dr.Messina is the Medical Director of the Michigan Headache Treatment Network in Lansing, a clinic dedicated to the outpatient treatment of painful disorders of the head, neck and face. More information about headaches can be found on their websites www.michiganheadache.com and www.headachecentral.com

article provided by: Lansing State Journal