Overview of Sinus Headaches

Are you having a sinus headache or something else?

Saline nasal spray may ease sinus congestion and pain
Saline nasal spray may ease sinus congestion and pain. Glow Wellness/Getty Images

Sinus headaches are common among healthy people of all ages. These headaches are characterized by head pain and pressure, as well as a number of other symptoms, including congestion and watery eyes. You may develop a sinus headache when you have a common cold, when your allergies flare up, or if you develop a major respiratory illness.

Sinus headaches are often relieved with mild pain medication or with decongestants. Some people are prone to sinus headaches and may benefit from taking preventative medication, especially if allergies frequently act up and trigger these headaches. In some cases, surgery can help prevent frequent sinus headaches.

Symptoms

Sinus headaches usually produce many symptoms. They come on fairly quickly and can be relieved quickly too. Sinus headaches are characterized by dull, throbbing pain, pressure, and a sensation of fullness around the forehead, cheekbones, and behind the nose and/or eyes.

Sinus headaches are usually accompanied by other symptoms, including:

  • Congestion, stuffy nose
  • Runny nose
  • Thick nasal discharge
  • Watery eyes
  • Sore throat
  • Post nasal drip
  • Fatigue
  • Coughing
  • A sense that you have to clear your throat
  • Sneezing
  • Ear pressure

With a sinus headache, you may feel slight tenderness when you gently press on your cheeks. The symptoms typically worsen when you lower your head or lie down.

Complications

Sometimes you may want to take medication at the first sign of a sinus headache. If you are prone to sinus headaches you can eventually develop medication overuse headaches. These headaches worsen when the medication wears off, prompting you to take more medication, and then a cycle of pain continues.

Be sure to talk to your doctor if you experience recurrent sinus headaches so that you won't develop this problem—which can be really hard to shake.

Concerning Symptoms

When sinus headaches are caused by a major infection, other effects can develop. You should see a doctor if you have signs of a bacterial infection, including:

  • Fever higher than 100.3 degrees Fahrenheit
  • Pain that is not relieved with over-the-counter remedies
  • Symptoms lasting longer than seven days
  • Ear pain
  • Trouble breathing
  • Dizziness or lightheadedness
  • Loss of appetite
  • Nausea or vomiting
  • Trouble concentrating
  • Neck pain or stiffness

Cause

Your sinuses are cavities (empty spaces) formed by the facial bones of your skull. Normally, sinuses provide space for mucus drainage. When your sinuses become fuller, due to a buildup of mucus or inflammatory cells, the pressure can cause sinus headache pain.

Sinus headaches generally develop due to sinusitis, which is inflammation of the sinuses. And structural variations in your sinus cavities can make you more prone to sinus headaches too.

Risk Factors

Sinus headaches can develop for a variety of reasons. A simple cold or flu can cause sinusitis, triggering the pain of a sinus headache. Most people experience this type of sinus headache a few times per year.

If you are prone to allergies from pollen, mold, dust, or smoke, you can develop sinus headaches when your allergies act up. Medical conditions that impair breathing, including asthma, cystic fibrosis or other chronic conditions, can also make your sinuses congested, causing sinus headaches.

Mild anatomical alterations in your facial bones can lead to a fullness in your sinuses, which causes sinus headaches. Structural abnormalities can alter the flow of mucus and inflammation, trapping it and making you more prone to sinus headaches.

The most common structural abnormality that causes sinus headaches is a narrowing of the nasal cavity, such as a nasal valve collapse or a deviated septum. Structural narrowing of the nasal passage can cause you to feel pressure and fullness from just slight inflammation and mucus build up, resulting in a sinus headache.

Diagnosis

A sinus headache is diagnosed based on a clinical examination. While a sinus headache can be treated fairly easily and is not dangerous, your doctor may also want to rule out serious illnesses, such as meningitis.

Physical Examination

During your physical examination, your doctor may check to see if you have tenderness of your sinuses by tapping on your cheekbones and forehead to observe whether this worsens your sensation of pain and pressure.

Your doctor may check your ears with an otoscope and your nasal passages with an endoscope. You may have some fullness of these passageways, but redness, blood, swelling, or pus are evidence of an infection or trauma, not just a sinus headache.

Diagnostic Tests

Most of the time, specialized diagnostic examinations are not necessary for evaluation of sinus headaches. If there is a concern that you may have another condition or a serious cause of your headaches, however, you may need to have some tests. For example, your doctor may send mucus samples to the lab to test for bacteria.

If there is a concern that you could have an abscess or a tumor causing sinus pressure, then you may need an x-ray, ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) examination.

Differential Diagnosis

Usually, there is nothing more to sinus headaches than sinusitis. But sometimes, there can be other concerning illnesses that need to be ruled out. This would be more likely if you have symptoms that are not typical of sinus headaches, including fevers, persistent head pain, nose bleeds, hearing loss, or ulcers of your nose or mouth.

Conditions that can mimic sinus headaches include:

Other Headache Types

There are several types of headaches, and they are all treated differently. Sinus headaches can have features similar to those of tension headaches, medication overuse headaches, and migraine headaches. Tension headaches tend to improve with sleep, worsen with emotional stress and muscle strain, and are not associated with congestion.

Migraines can feel similar to sinus headaches, with pain behind your eyes that worsen if you bend forward. But there are some major differences. For example, pain and pressure are the most prominent symptoms of sinus headaches, while migraines are usually accompanied by neck and shoulder pain, photophobia (sensitivity to light), phonophobia (sensitivity to sound), and mood changes, such as anxiety or depression. Also, sinus headaches usually affect both sides of the face and head equally, while migraines often affect only one side.

Treatment

In the case of a sinus headache, at-home treatments and over-the-counter (OTC) pain relief, such as aspirin, Tylenol (acetaminophen), or Motrin or Advil (ibuprofen), can usually help relieve symptoms. OTC nasal sprays and decongestants can help relieve the sinus pressure that often leads to sinusitis.

If you are using OTC treatments, be sure to use as directed and to call your doctor if you don't experience an improvement of your symptoms within a few days.

At-Home Treatments

There are also simple and safe strategies you can use to reduce sinus inflammation and congestion. When it comes to these at-home treatments, use what works best for you.

  • Room humidifiers—be sure to clean them out as directed
  • Steam bath or shower—adjust the temperature to your comfort level
  • Ice packs—use on your cheeks or nose and don't leave on for more than a few minutes
  • A saline-based nasal irrigation system like a neti pot can reduce congestion

Prescriptions

In some cases, your doctor may prescribe an antihistamine for short term use to reduce inflammation. The most effective treatment for bacterial sinus infections is antibiotics, which need to be taken for the full duration to ensure that all the bacteria is eradicated. Eliminating the bacterial infection should also put an end to the sinus headaches.

If the sinusitis is caused by irritants such as smoke, pollen or dust, your doctor may prescribe a corticosteroid nasal spray, which is designed to reduce the sinus swelling that is responsible for the headache pain.

Surgery

When sinus headaches keep recurring due to an anatomical variation, corrective surgery can help prevent the headaches. Different procedures are used, including endoscopic (minimally invasive) surgery, tumor removal, treatment for a deviated septum, and turbinate reduction.

A Word From Verywell

Sinus headaches may mimic other headaches and some medical illnesses. Once you get a diagnosis of sinus headaches, you can rest assured that the treatment is generally successful. If you continue to experience recurrent discomfort, however, you may need to see an allergist or an ear, nose, and throat (ENT) specialist so that you can get a diagnosis regarding the cause of your sinus headaches and begin a preventative treatment plan.

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