What Are Sinus Headaches?

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Sinus headaches are those that occur due to inflammation and congestion of the sinuses, the cavities (empty spaces) formed by the facial bones of your skull. 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 Headache Symptoms

Sinus headaches usually produce many symptoms. They come on fairly quickly and can be relieved quickly, too.

Sinus headaches are characterized by dull pain, pressure, and a sensation of fullness around the forehead, cheekbones, and behind the nose and/or eyes.

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.

Sinus headaches are usually accompanied by other symptoms, which can include any combination of the following:

  • 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

When to See a Doctor

When symptoms of a sinus infection do not quickly resolve or recur, it's important to see your doctor.

Notably, you should not delay in seeing your physician if you have any of the following signs, which could indicate a superimposed bacterial infection:

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

Causes

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 as well.

Risk Factors

Sinus headaches can develop for a variety of reasons and are common among healthy people of all ages.

A simple cold or flu can cause sinusitis, giving way to 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 are triggered.

Medical conditions that impair breathing, including asthma and cystic fibrosis, 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. This may show narrowing of these passageways due to swelling, as well as the presence of nasal discharges. Polyps or septal deviation may be notes and can be a predisposing factor for recurrent sinus headaches.

Tests

Most of the time, specialized diagnostic examinations are not necessary for evaluation of sinus headaches. If there is a concern that the cause is serious or that you could have another condition entirely, however, some tests may be ordered depending on the suspected diagnosis.

For example, your doctor may send mucus samples to the lab to test for bacteria, or order an X-ray, ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) to look for a mass or other obstruction.

Differential Diagnoses

Usually, there is nothing more to a sinus headache than sinusitis. But sometimes there can be other concerning illnesses that need to be ruled out. It's also possible that you indeed have a headache, but a different type.

Mimicking Conditions

A few conditions can mimic sinus headaches:

Like sinus headaches, these conditions may cause head pressure, but there are often symptoms and signs that can help with the diagnosis. Imaging can be used to differentiate some of these conditions.

Other Headache Types

Sinus headaches can have some features that are similar to those of tension headaches, medication overuse headaches, and migraine headaches, but there are some differences as well.

Migraine vs. Sinus Infection
Verywell / Cindy Chung

Your doctor will consider these when determining if you, indeed, have a sinus headache or another type.

For example, tension headaches—which are very common—tend to improve with sleep, worsen with emotional stress and muscle strain, and are not associated with congestion.

Migraines are also very common and at times can feel similar to sinus headaches. However, in migraines, the pain is often throbbing, involves one side of the head, and is associated with nausea, vomiting, sensitivity to light, sounds, and odors.

  Sinus Tension Migraine Medication Overuse Cluster
One-sided      
Two-sided    
Congestion      
Watery eyes      
Sore throat        
Fatigue
Head pressure    
Improves w/sleep  
 
   
Nausea/vomiting        

Treatment

At-home treatments and over-the-counter (OTC) pain relievers can usually help relieve sinus headache symptoms. Be sure to use them as directed and call your doctor if you don't experience an improvement of your symptoms within a few days.

You may need further treatment for the underlying cause. In some cases, prescription medications or surgery may be recommended.

Home Remedies

These strategies don't work for everyone. But if they do for you, they are worth incorporating into your treatment plan. The following home remedies are simple, safe, and can reduce sinus inflammation and congestion:

  • Room humidifiers: Be sure to clean them out as directed.
  • Steam bath or shower: Adjust the temperature to your comfort level.
  • Ice packs: Place them on your cheeks or nose for no more than a few minutes at a time.
  • Irrigation: A saline-based nasal irrigation system like a neti pot can reduce congestion.

Medications

OTC pain relievers—aspirin, Tylenol (acetaminophen), or Motrin or Advil (ibuprofen)—can help you manage the discomfort associated with sinus headaches.

OTC nasal sprays and decongestants can help relieve the sinus pressure that often leads to sinusitis. Some people are prone to sinus headaches and may benefit from taking such medication for prevention, especially if allergies frequently act up and are triggers.

In some cases, your doctor may give you a prescription 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 your headache.

Caution

Understandably, there may be times when you want to take medication at the first sign of a sinus headache. However, if you are prone to sinus headaches and do this often, you can eventually develop medication overuse headaches. These worsen when the medication wears off, prompting you to take more, and then a cycle of pain continues.

Be sure to talk to your doctor if you experience recurrent sinus headaches so that you can work to avoid this problem.

Surgery

When sinus headaches keep recurring due to an anatomical variation, corrective surgery can help prevent the headaches.

Different procedures are used, including:

A Word From Verywell

Sinus headaches may mimic other headaches and some medical illnesses. Once you get a diagnosis of sinus headache, 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 confirm the cause of your sinus headaches and begin a preventative treatment plan.

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