Let's Talk About Pain

Migraine or Sinus Headache?

 Although I'm always eager to leave the cold months of winter, spring does not excite me. The growing warmth of the days also means a lot of wind. 

 And in New Mexico, March winds do not bring April showers. April means more wind. And wind makes my allergies worse. Like a lot of you, I get sinus pain.

Sinus pain includes facial pain and pressure, congestion, and sometimes, headache. But sinus headaches are a lot more unusual than most people think. In fact, migraine are often commonly misdiagnosed as sinus pain. 

A study of over 30,000 participants found that over 88 percent of self-diagnosed sinus headaches were really migraines. A substantial number of these patients claimed to have never experienced a migraine.

So that means that there are a lot of you out there experiencing migraines that you are treating as sinus headaches. In fact, sinus headaches are rare and usually secondary to a bacterial infection. 

How do you tell the difference?

If you headache originates in your sinuses, you will have some or all of the following symptoms:

thick, discolored nasal discharge,

facial pain or pressure


decreased smell or no smell

foul smelling breath

Migraine symptoms may include some symptoms commonly associated with a sinus headache, such as nasal congestion or watery eyes. They may also include the following: 


sensitivity to light and/or noise

moderate to severe headaches

headache worsened by activity

pulsing throbbing pain

vision disturbances

How do you differentiate between the two?  Ask yourself the following questions from the ID Migraine Questionnaire:

1. In the last 3 months, how disabling are your headaches; do they interfere with your ability to function? 

2. Are your headaches every associated with nausea?

3. Are your headaches ever associated with sensitivity to light?

If you answer yes to two of the above questions, there is a 93% probability that you have a migraine. If you answer affirmatively to all three, then you are 98% percent likely to have a migraine. 

If you are experiencing symptoms more commonly associated with migraine pain than sinus pain. Talk to your doctor. Don't try to treat your headache with over-the-counter sinus pain medications. It won't help.

In the meantime, April winds do bring May flowers. We just have to wait. (sigh). 

Pain in Your Hip May Not Be What You Think

You've been experiencing pain in your hip. Because you are (ahem) of a certain age, you have assumed that it must be arthritis. Not so fast.

Hip pain may be caused by many things. While it is true that arthritis can be a common cause of hip pain. Many also experience hip pain as a result of bursitis. They have similar symptoms but different sourches.

Osteoarthritis occurs when the protective cartilage between joints wears down through ordinary use. As the joints deteriorate, bony growths may form. This can aggravate the problem. 

Bursitis occurs when the hip joint bursa, a thin sac on the outside of the joint, becomes inflamed. The inflammation may occur as a result of a hip injury or alternatively by trauma to a nerve, such as a pinched nerve in your back. 

While treatments for the two types of pain can be similar, there are also some differences. Osteoarthritis is commonly treated with anti-inflammatory drugs or NSAIDS. Sometimes steroid injections or other types of new injections, such as PRP, can help. 

Bursitis also responds to these treatments but there are also additional treatments that may be warranted. Modifying strenuous activity and rest and is essential for those with bursitis. Sometimes a physician will recommend aspirating fluid from the bursa. Occasionally the bursa will become septic and the patient will need antibiotic.

Most important, do not self-diagnose your pain. Depending on the source of your pain, you may have options you have not considered. Talk to your doctor about your pain. Don't assume that there is an immediate link between your pain and your age. 

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