How do you know if you have sinus headaches?

Imaging: True "sinus" headaches are much less common than other types of headache, such as migraine, tension, medication rebound headache, TMJ issues, etc. To complicate matters, migraines may cause nasal congestion, and some sinus issues may trigger migraines. In most cases, the only definitive way to identify a probable "sinus" headache is to get a ct or mri. See a neurologist or ENT doctor.