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Migraine vs Sinus vs Tension Headaches: A Doctor Explains the Difference

Migraine vs Sinus vs Tension Headaches: A Doctor Explains the Difference

Can a headache kill you? What are primary, secondary or emergency headaches? Here are all the answers you've been looking for!

Ever felt a throbbing pain in your head so bad that you couldn’t differentiate whether it was a tension headache, sinusitis or a migraine?

Are they all the same? What causes them? How do the symptoms differ? Could migraines be deadly? How to treat or avoid them?

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To answer the barrage of questions, The Better India got in touch with Mumbai-based expert neurologist Dr Rahul Chakor. He also heads the Department of Neurology TN Medical College & BYL Nair Hospital.

1. Understanding what is a tension headache

Migraine vs Sinus vs Tension Headaches_ What's the Difference_ - Final
Representational Image. Source: PXHERE

Dr Chakor says, “Migraine and tension headaches are primary headaches, while sinus is a secondary headache. Simply put, in primary headaches, the pain in your head itself is the problem. Whereas, in sinusitis, the headache is secondary to another condition, in this case, sinusitis.”

Tension headaches are the most common types of headaches, capable of causing mild, moderate, to intense pain in your head, neck, and sometimes even behind your eyes. One of the easiest analogies of this headache is like someone forcing you to wear a very tight and uncomfortable band around your forehead. It can be episodic (frequent or infrequent) or chronic.


  • Throbbing in either or both sides of your head.
  • A dull headache, pressure around the forehead or tenderness around the forehead and scalp.
  • The pain is usually mild to moderate. But it can be severe in chronic cases.
  • Can they be confused with migraine? Yes. How do you differentiate? The neurologist answers, “Tension headaches, unlike migraines, are not accompanied by nausea and vomiting.”


These are muscle contractions which can be caused due to certain foods, activities, physical or emotional stress.

Are you working on a computer screen for too long? Reading in the dark? Driving continuously for extended periods without breaks? Or the temperature around you has suddenly dropped?

Some other triggers include excess alcohol intake, dry eyes, exhaustion or fatigue, smoking, flu, caffeine or even poor posture.


Can tension headaches be life-threatening? “Tension headaches are common and can be treated with simple paracetamol. But if they continue for extended periods, become more frequent and severe, consult a doctor,” says Dr Chakor.

Some other relaxation techniques include heat therapy (warm compresses), taking a warm shower, massage, meditation, neck stretching, and other relaxation exercises.

2. What is a migraine?

Representative image. Source: Pixabay

Migraines are not life-threatening. But that being said, Dr Chakor adds how severe migraines that persist for longer durations and can affect your quality of life.

Migraine can be broadly divided into two categories—migraine with aura and migraine without aura. Aura refers to the experiences a person undergoes 10-30 minutes before a migraine attack. A lack of mental alertness; difficulty in thinking; seeing flashing lights; numbness in the face or hands; an unusual sense of smell, taste, or touch, are some examples.


Migraines range between moderate to severe and are accompanied by other symptoms like nausea, vomiting, eye or earache, throbbing temple, and sensitivity to light or sound.

In comparison to other headaches, migraines typically affect only one side of the head but may affect both sides as well. If your migraines are severe and frequent (more than once a week) or accompanied by nausea and vomiting, where you cannot partake in your daily activities smoothly, it can be a cause of concern.

Dr Chakor says, “Patients suffering from migraine are prescribed prophylactic medicine, as the aches may not completely go away. For some, taking prophylactic medication at an early stage can help them live a migraine-free life. But others continue to live with the condition throughout their lives, despite regular treatment.”


A variety of factors ranging from emotional anxiety, use of contraceptives, excess alcohol intake, hormonal changes, or menopause can trigger migraines.

Is there a way to prevent or control them? Migraines are complex, but a change in your lifestyle can help reduce their occurrence.

Dr Chakor suggests getting to the source of the trigger and avoiding it. Are there certain foods or odours that you think have triggered your headaches in the past? Avoid them. Reduce excess caffeine, alcohol and tobacco intake.


  • Establish a routine. Have consistent sleeping patterns and fixed meal times. Control your stress.
  • Exercise regularly. Partake in activities like walking, swimming and cycling that keep you fit.
  • Does estrogen trigger or escalate headaches? Try to avoid or reduce any medication you consume that contains estrogen. Some examples are birth control pills and hormone replacement therapy. Get in touch with your doctor for suitable alternatives or dosage changes.

3. What is a Sinus headache?

Representative image. Source: Pixabay

Sinus headaches are secondary headaches. These may occur when you suffer from common sinusitis or sinus infections, which means that your sinuses or nasal passages have become inflamed or blocked. Sinus-induced headaches stop once the infection is treated.


Sinusitis is accompanied by pain, pressure and fullness in the cheeks, brows or forehead. The headache worsens when you bend forward or lie down. Other symptoms include a stuffed nose, fatigue, and ache in your upper teeth.

Even though a few symptoms between sinus and migraines overlap, sinusitis occurs after a respiratory infection or cold. Headaches due to sinus persist longer than migraines, which last for a few hours or a day.

But if your headache is severe and persists longer than 15 days, and even over-the-counter pain medication doesn’t help, it is time to see a doctor.

You may wonder if there is any headache that can be dangerous and require immediate medical intervention? “These refer to headache emergencies, where the headache is a symptom of an underlying serious disease,” says Dr Chakor.

He lists a few such instances:

Having a headache for the first time? And it is severe? It raises flags. “When a person with no history of headache, suffers from a condition as mentioned above, they need to be rushed to the emergency room. Such headaches can occur due to the rupture of a brain vessel and even cause haemorrhage.”

If the pain escalates, builds up rapidly, and becomes very severe within a short period, seek medical help.

Dr Chakor says, “Headache that is accompanied by symptoms like difficulty in speaking or slurring of speech, facial distortion, limbs losing function—could be a sign of underlying brain disease. Seek immediate help.”

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He adds, “Headache that is associated with fever, neck pain, vomiting, drowsiness, fatigue and slurring speech, is an alarm too. It could be a symptom for meningitis. Consult a doctor.”

Headaches in patients of cancer, HIV, or after organ transplants can be a cause of concern. They could arise from an infection, and the patient may need to be rushed to the emergency unit.

Dr Chakor’s tips for urban workaholics and corporate workers:

Representative image. Source: Pixabay
  • Your lifestyle affects your health. So make smaller and healthier changes not only to avoid headaches, migraines and sinusitis but also to improve general well-being.
  • Sleep for consistent and fixed durations.
  • Have meals at fixed times. Do not skip meals or have them irregularly. Avoid consuming junk food that has high sugar and carbohydrate content.
  • Are you working on the computer for long durations? Take periodic breaks every 30-45 minutes. This prevents eye-strain and photo-phobias where bright light from the screen can trigger headaches.
  • Establish a dincharya or schedule and stick to it.

“Recent studies have found that people who overwork, (more than ten hours a day) are at a higher risk of getting a stroke, let alone having headaches. A migraine only affects the quality of life, but a stroke can be life-threatening. So don’t overwork. Have a longer working year than long working hours each day,” he signs off.

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(Edited by Shruti Singhal)

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