Could Allergies be Causing your Sinus Migraines?
Migraine headaches are the worst… and it seems like many primary care providers sympathize as long as your headache is easy to control. But as soon as it gets tougher its straight to sub-optimal care or a referral to neurology (which, if you’re in Colorado, means about a 3-6 month wait)!
Now, I’m not a migraine expert (I had my first migraine recently – thanks, Ikea)! But I know when my wife had migraines I wanted to do anything possible to help her feel better… and even for a doctor, the healthcare system was frustrating to navigate to get her help.
Luckily, my wife’s migraines are not chronic but more hormone related.
But if you’re reading this, I’m willing to guess that your migraines are more chronic issues and nobody has found a great solution yet (or maybe they have… but you want to reduce your migraine medications).
Today, I will give you something new to think about: could allergies be causing your sinus migraines?
This may seem silly at first, but there are some interesting studies that will show you this is more common than you think. Plus, if it is true, then I can help you with migraines and with allergies!
Who should read this article?
This article might not be for everyone, but you should read through the major points (or jump down to the summary) if you:
- Have migraine headaches and also a history of allergies
- Get “sinus headaches” with allergies
- Have a history of migraine headaches without a known cause (even if you don’t have allergies)
- Want better control of your headaches (or want to reduce medications)
If these don’t sound like you, then you need not read this any further.
But… about 13% of your friends (20% women and 6% men) suffer from migraines and 10-30% also suffer from allergies.1 You can be their hero by SHARING this article. That way, together we can help more people feel better.
Wait… migraines? Isn’t it a sinus headache?
If you have allergies, it is common to have a sinus headache… and you know what it feels like. But sinus headaches are usually self-diagnosed.
- In one study, researchers took 100 people who had a self-diagnosed sinus headache, the cause was due to migraines in 52% of the people.2
- In a different study of 2991 patients with a history of physician- or self-diagnosed sinus headaches, 88% had a migraine-variant, 8% had a tension-headache and only 4% had an underlying sinus problem causing their symptoms.3
Part of the problem is that a sinus allergy headaches doesn’t have a definition (I’m surprised at this too!)4 Physicians and patients alike group sinus pain or pressure as a sinus headache and if you have allergies… bam, sinus allergy headache.
Put another way, up to 8 out of 10 people with “allergy sinus headaches” actually have migraines.
What I want you to consider is that maybe you’re having a sinus migraine (or allergy migraine)… which is causing your symptoms.
I like the term sinus migraines (or allergy migraine) because I think it does a good job describing your headache’s location, its severity and the recurrent nature of the headache, and also gives the pathway for treatment.
I think you’re experiencing sinus migraines and that, to a degree, allergies cause headaches (or at least cause them to be worse).
The Connection between Sinus Migraines, Allergies and Headaches
Even though your symptoms might be classified as a sinus migraine, there is a strong connection with allergies (allergy migraines).
Allergies and Sinus Migraines
Here are studies on allergies and migraines:
- In one cross sectional comparison, sinus migraines were 8.27x more likely if you have allergies.5
- Frequency of experiencing migraines was 400% higher if you have allergies.6
- 50% of people with allergies had migraines (compared to 18.75% in people without allergies).6
Allergies, migraines and age
In addition, there seems to be a connection between allergies, migraines and age.
- In the study showing there is an 8-fold increase in migraines with allergies, the correlation was strongest if you were over 40.5
- A different study showed treatment variation between allergy migraines with age < 40 and age > 40 (see treatment section below).
Allergies, migraines and severity
There is a great study that correlated the severity of allergies with the severity of sinus migraines. They found:
- Allergy migraines can happen at any degree of allergy sensitization7
- But sinus migraines are more frequent and cause more disability if you have more allergies! 7
Correlation =/ Causation
Now, I know correlation does not equal causation.
But if your allergies cause headaches, then I would strongly consider you might have a sinus migraine (or allergy migraine).
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So I might have a sinus migraine (allergy migraine) – How does this help me feel better?
The purpose of this article is not just to say “gee whiz, that’s neat, I have a sinus migraine and allergies cause headaches.” The point is to help you feel better.
There are 3 ways knowing the connection between allergies, migraines and headaches can help:
- We can treat you allergies and migraines at the same time
- Treating allergy headaches as sinus migraines opens up migraine treatments
- It also allows for a new treatment pathway instead of ENT sinus surgery
1. Treat allergies and migraines at the same time
If you have never been tested or treated for allergies and have a history of migraines, this is a great place to start. Same if you have a history of recurrent sinus headaches and want to help your allergies and headaches at the same time.
The goal in any treatment is to help you feel better without adding too many medications. If your allergy headaches are sinus migraines, then good allergy control might help improve your allergy migraines as well!
Sinus migraines and allergy medications
The first step would be to ensure you have optimal allergy control (now is not the time to say your allergies are “minor” or are “treated well enough.” Now is the time to ensure your allergies are fully treated!)
- First, start the best nasal steroid for you
- Consider adding a sinus rinse (here are sinus rinse tips and tricks)
- Then add the best over the counter antihistamine
Overall, there is no correlation with the amount of allergies and sinus migraines. This means improving allergy control will help everyone… regardless of if you were really allergic or mildly allergic.
I would expect these steps to help improve your allergies and they should improve your sinus migraines. But if you need more help, there is another option: allergy shots.
Sinus migraines and allergy shots
Allergy shots (allergy immunotherapy) is a treatment where an allergist gives you an injection of the various pets, pollen, mold or other allergens that cause your symptoms. The process improves your allergy symptoms.
In a study of patients with sinus migraines, allergies treated with allergy shots helped:
- Decrease the number of people with sinus migraines
- Decrease the frequency of allergy migraines
- Reduce the disability associated with sinus migraine headaches
But there was a nuance with this study:
- When giving allergy shots for allergies, migraine headaches were improved the most if you were less than 40.
- That doesn’t mean they won’t help if you’re over 40. It means I’d start medications first and consider shots second.
So… treat your allergies and migraines should improve
I think the best take away point from this section is: treat your allergies to their fullest and it might help improve sinus migraines (at a minimum, it will help your allergies).
If you want a more detailed or personalized plan, just fill out this form and I will work with you to make sure you have the best allergy plan.
2. Treating allergy headaches as sinus migraines opens up migraine treatments
If you have a history of recurrent sinus headaches and allergy treatment has not helped, then your next step might be a trial of migraine medication.
This is exciting because I know many people have optimized allergies but still get chronic sinus headaches. And I know how frustrating this can be for you.
But if your sinus headaches are allergy migraines, then you can consider adding migraine treatment or even migraine prevention!
Most migraine treatment is done by using rescue treatment for a current migraine and preventative treatment. To help, I found this website, migrainepal, which does a great job as a resource if you have chronic migraines.
3. It also allows for a new treatment pathway instead of ENT sinus surgery
This one is a HUGE benefit.
Normally, if you have chronic allergy headaches, your primary care provider will send you to an allergist who will treat your allergies (like I mentioned above).
But sometimes, whether it is due to your primary care’s plan or if treating allergies doesn’t help, your doctor will then send you to an ENT surgeon for possible chronic sinusitis (here’s a chronic sinusitis guide for you to review).
Although I covered allergists vs ENT in a prior article, the biggest concern is the ENT will say you need a sinus surgery for “chronic sinus disease” when you need migraine treatment!
The way I would now approach your symptoms:
- If you have chronic sinusitis symptoms, treat allergies and consider ENT
- If you have chronic sinus migraines, treat allergies and consider migraine treatment
Want more personalized help?
There comes a point where an internet article is awesome (or at least mine is ) but you need a little more help to figure out the connection between allergies and headaches, reassurance you’re on the right path for treatment, or guidance for your next step in solving your allergy migraines.
Well, that’s where I can help you even more. If you want more personalized help, simply fill out this form and I will try to guide you as much as possible to treat your sinus migraines.
Allergies cause headaches which are often called sinus headaches (by patients and providers alike). But in actuality, these sinus headaches might actually be sinus migraines (or allergy migraines).
- 52-88% of patients physician- or self-diagnosed with sinus headaches have sinus migraines.
- Sinus migraines occur 8.27 times more often if you have allergies
- Allergy migraines are also 400% more frequent if you have allergies
If this made you a little anxious, here’s a positive way to view allergies and migraines:
- If you have sinus migraines and haven’t found a good treatment yet… treating allergies might help
- If treating allergies hasn’t helped your headaches, perhaps treating for allergy migraines will help
- If you are being told you need surgery for chronic sinusitis, you might need migraine treatment
Has this article got you thinking of a new way to help your migraines?
If you have questions, you can either email me OR see your primary care provider to discuss whether sinus migraines might cause your symptoms.
And if you haven’t already done so, please SHARE this post on Facebook, Pinterest, or Google+. You sharing this article will help it reach more people and help them start to feel better… just like you will be soon enough!
- Saberi A, Nemati S, Shakib RJ, Kazemnejad E, Maleki M. Association between allergic rhinitis and migraine. J Res Med Sci. 2012 Jun;17(6):508-12.
- Eross E, Dodick D, Eross M. The Sinus, Allergy and Migraine Study (SAMS). Headache. 2007 Feb;47(2):213-24.
- Schreiber CP, Hutchinson S, Webster CJ, Ames M, Richardson MS, Powers C. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed “sinus” headache. Arch Intern Med. 2004;164(16):1769.
- Anna Gryglas. Allergic Rhinitis and Chronic Daily Headaches: Is There a Link? Curr Neurol Neurosci Rep. 2016; 16: 33.
- Ayhan Ozturk, Yildiz Degirmenci, Burcu Tokmak, and Abdurrahman Tokmak. Frequency of migraine in patients with allergic rhinitis. Pak J Med Sci. 2013 Apr; 29(2): 528–531.
- Mehle ME. Allergy and migraine: is there a connection? Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):265-9.
- Martin VT, Taylor F, Gebhardt B, Tomaszewski M, Ellison JS, Martin GV, Levin L, Al-Shaikh E, Nicolas J, Bernstein JA. Allergy and immunotherapy: are they related to migraine headache? Headache. 2011 Jan;51(1):8-20.