What Is a Sinus Headache?

Diagnosis is key, as sinus pain may actually be part of a migraine attack

Sometimes that dull, throbbing pain in your face is a sign that you’ve caught the dreaded common cold, and your sinuses are now inflamed. It's tricky though to differentiate between sinus pain and a migraine or tension headache, since all three can produce similar types of pain.

Let's learn more about sinus headaches and what you can do to ease your pain and accompanying symptoms.

How Do I Know if my Headache is from my Sinuses?

A sinus headache is typically felt in the cheekbones, forehead, and behind the bridge of the nose. The pain is usually constant and throbbing. Typically a sinus headache worsens when you move your head or bend over. The pain may also intensify when you lie down. Sinus headaches may be worse in the morning and improve during the day as mucus drains. Some individuals are also more likely to experience sinus headaches in colder, rainy weather.

A sinus headache is usually caused by a viral infection and may be accompanied by other symptoms including a sore throat, cough, fatigue, and a nasal discharge. A feeling of fullness in the ears and facial swelling may also occur. Sometimes, the sinuses will be tender when you press on them—like on the forehead or cheeks. If the sinus headache is caused by a bacterial infection, a high fever or tooth pain may also be present.

How is a Sinus Headache Diagnosed?

Most sinus headaches are caused by allergens, environmental irritant, or infections, especially viral infections, like the common cold. In order to determine the cause of your sinus headache, your doctor may conduct a few tests.

The first thing your doctor will do is examine your sinuses. Your doctor may use her finger to tap on your sinuses to determine if they are tender. She might also use a small light to look inside your sinuses through your nose for swelling and drainage.

If your doctor suspects a sinus infection, she may take a sample of your mucus in order to test it for bacteria or rarely, a fungus. A sinus infection that is caused by a bacteria will typically be treated with antibiotics, while an infection caused by a virus does not require antibiotics. If you suffer from chronic sinus headaches, your doctor may also send you for a CT or MRI of the sinuses.

If a sinus infection is ruled out, your doctor may wish to examine you for other symptoms. Sometimes it's discovered that a tension headache is the likely culprit, especially if a person also has a feeling of tightness around their head. A migraine can also cause sinus-type symptoms, but tends to be more intense and occur with other symptoms, such as nausea, vomiting, and sensitivity to light and sound. 

Allergies, such as hay fever, may also cause a headache due to nasal congestion. If allergies are suspected, your physician may send you for allergy testing. Treating allergies often helps alleviates sinus headache symptoms.

In rare instances, symptoms of a sinus headache can signal a tumor or cluster headache. This is why with any sort of headache or facial pain, your doctor will likely also do a neurological examination.

Finally, other mimickers of sinus headache are:

How is a Sinus Headache Treated?

For mild sinus headaches that last a few days, at-home remedies can be effective at easing the pain. Remedies, like taking a hot, steamy shower, can help ease a person's congestion by facilitating drainage of the nasal passages. Your doctor will also recommend rest and lots of fluids. Some doctors recommend using a saline-based nasal irrigation system like a neti pot. Over-the-counter medications, like decongestants, antihistamines and pain relievers, may also help. Sometimes your doctor will prescribe a corticosteroid nasal spray, especially if you have a history of allergies.

If your doctor suspects a bacterial sinus infection, she will prescribe you an antibiotic, in addition to recommending the above remedies. Sinus surgery by an ENT, or ear, nose, and throat doctor is a last resort option for people with chronic sinusitis.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. De Corso E, Kar M, Cantone E, et al. Facial pain: sinus or not?Acta Otorhinolaryngol Ital. 2018;38(6):485–496. doi:10.14639/0392-100X-1721

  2. Maheshwari PK, Pandey A. Unusual headachesAnn Neurosci. 2012;19(4):172–176. doi:10.5214/ans.0972.7531.190409

  3. Masood A, Moumoulidis I, Panesar J. Acute rhinosinusitis in adults: an update on current managementPostgrad Med J. 2007;83(980):402–408. doi:10.1136/pgmj.2006.054767

  4. Macy E. A rhinitis primer for family medicinePerm J. 2012;16(4):61–66. doi:10.7812/tpp/12-053

  5. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Sinusitis: Overview. 2009 Feb 9 [Updated 2018 Oct 18]. 

  6. Soler ZM, Schlosser RJ. The role of fungi in diseases of the nose and sinusesAm J Rhinol Allergy. 2012;26(5):351–358. doi:10.2500/ajra.2012.26.3807

  7. Barshak MB, Durand ML. The role of infection and antibiotics in chronic rhinosinusitisLaryngoscope Investig Otolaryngol. 2017;2(1):36–42. Published 2017 Jan 23. doi:10.1002/lio2.61

  8. Chowdhury D. Tension type headacheAnn Indian Acad Neurol. 2012;15(Suppl 1):S83–S88. doi:10.4103/0972-2327.100023

  9. Weatherall MW. The diagnosis and treatment of chronic migraine. Ther Adv Chronic Dis. 2015;6(3):115–123. doi:10.1177/2040622315579627

  10. Sussman G, Sussman D, Sussman A. Intermittent allergic rhinitisCMAJ. 2010;182(9):935–937. doi:10.1503/cmaj.091490

  11. Edvardsson B. Cluster headache associated with acute maxillary sinusitisSpringerplus. 2013;2:509. Published 2013 Oct 5. doi:10.1186/2193-1801-2-509

  12. Sullivan SJ, Hammond-tooke GD, Schneiders AG, Gray AR, Mccrory P. The diagnostic accuracy of selected neurological tests. J Clin Neurosci. 2012;19(3):423-7. doi:10.1016/j.jocn.2011.09.011

  13. Jones NS. Sinus headaches: avoiding over- and misdiagnosis. Expert Rev Neurother. 2009;9(4):439-44. doi:10.1586/ern.09.8

  14. Little P, Stuart B, Mullee M, et al. Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trialCMAJ. 2016;188(13):940–949. doi:10.1503/cmaj.160362

  15. Small P, Keith PK, Kim H. Allergic rhinitisAllergy Asthma Clin Immunol. 2018;14(Suppl 2):51. Published 2018 Sep 12. doi:10.1186/s13223-018-0280-7

  16. Vennik J, Eyles C, Thomas M, et al. Management strategies for chronic rhinosinusitis: a qualitative study of GP and ENT specialist views of current practice in the UKBMJ Open. 2018;8(12):e022643. Published 2018 Dec 19. doi:10.1136/bmjopen-2018-022643

Additional Reading