Pressure around the forehead, cheeks, or eyes is often described as a sinus headache, but facial pain alone does not prove that the sinuses are infected. Migraine and other headache disorders can produce facial pressure, nasal symptoms, and sensitivity that feel similar. The pattern of symptoms and the overall clinical history are more useful than pain location alone.
Clues that help distinguish causes
Sinusitis commonly includes nasal blockage or discharge and may reduce the sense of smell; acute sinus symptoms often follow a respiratory infection. Migraine can cause moderate or severe head pain, nausea, sensitivity to light or sound, and worsening with routine activity. Some people with migraine also have nasal congestion or watery eyes, which can confuse the picture.
The colour of mucus is not enough to identify bacterial sinusitis, and a headache without convincing nasal symptoms should not automatically be treated as a sinus infection. Recurrent attacks with similar triggers, nausea, or light sensitivity may be worth discussing as a possible headache disorder with a clinician.
Why diagnosis changes treatment
Treatment for sinus inflammation and treatment for migraine are different. Unnecessary antibiotics do not treat migraine and can cause side effects. Conversely, persistent sinus symptoms may need nasal treatment or further assessment. A clinician will ask about duration, frequency, fever, nasal discharge, smell changes, neurological symptoms, and prior headache history.
A simple symptom diary can record where pain starts, how long it lasts, associated nausea or light sensitivity, nasal symptoms, sleep, menstrual or other patterns, and medicines used. This helps avoid repeatedly treating every facial pain episode as the same condition.
Warning signs that need urgent care
Seek emergency attention for a sudden severe headache that reaches maximum intensity quickly, new weakness or numbness, confusion, fainting, seizure, double vision, stiff neck with fever, or a new headache after major head injury. These signs are not typical of uncomplicated sinus pressure or migraine.
Prompt assessment is also important for swelling or redness around an eye, vision changes, severe facial swelling, or severe symptoms with high fever. Persistent or recurrent headaches deserve review when their pattern changes or usual measures stop helping.
Common questions
Can migraine cause a blocked nose? Yes, nasal symptoms can occur with migraine in some people, so congestion does not establish sinus infection by itself.
Do I need antibiotics for green mucus and facial pain? Not automatically. A clinician considers the duration, severity, fever, overall pattern, and other findings before deciding whether antibiotics are appropriate.
Explore our nasal endoscopy page for more information about this care option. A clinician can advise based on the individual history and examination findings.