Sinus headaches are headaches that may feel like an infection in the sinuses (sinusitis). You may feel pressure around your eyes, cheeks and forehead. Perhaps your head throbs.
However, many people who assume they have headaches from sinusitis, including many who have received such a diagnosis, actually have migraines.
Sinus headaches result from a condition called sinusitis. This simply means that the sinuses become inflamed and swollen. The virus can cause this and so can bacterial infections. Even fungi can cause sinusitis. Exposure to various allergens such as pollen or chemicals, impaired immune function, or structural irregularities of the breast will cause inflammation and symptoms of sinus headaches. The symptoms are unusually uncomfortable and painful. In general, you can still function, but you feel miserable. It may seem sometimes that the only consolation is that it will not last forever, but that does not prevent us from seeking help with prescription medicines or visiting the doctor.
Symptoms of sinus headache include a sensation of pain, pressure, congestion and fullness in the cheeks, forehead and brow. Usually, the pain becomes more extreme if you bend forward or lie down. No nasal discharge is yellow-green and unpleasant, possibly contaminated with blood. Sometimes this is accompanied by fever, sore throat, cough, general fatigue and weakness, and pain sensation in the upper teeth. These symptoms may be easily confused with a migraine. With a migraine, no runny nose or fever, but it is important to note that many studies have shown that 90% of sinus headaches are actually supposed migraines. The best way to alleviate this confusion is to consult a doctor, especially if this happens to you on a regular basis.
There are features of migraine that do not match the symptoms of sinus headaches. Migraine headaches cause extreme sensitivity to noise and high light, nausea and vomiting and are usually so painful that the only comfortable position is lying on a dark, quiet room, without stimulation. Migraines can include runny nose and congestion, but rehabilitation is clear and watery rather than thick yellow-green like experiences with a sinus headache.
Common symptoms, recurrent sinus headaches are an indication of chronic sinusitis. You are at greater risk for chronic sinusitis, if you have asthma, nasal polyps or tumors, allergies to dust, chemicals, fungi and pollen, a weakened immune system, cystic fibrosis, or if you smoke cigarettes or frequent exposure to secondhand smoke.
Sinus headache symptoms can be treated. More drugs are useful for short term use. Sometimes, however, the condition can be more severe and chronic. If you experience sinus headaches often consult a doctor. They will be able to help more than you can help yourself and feel better.
Signs and symptoms of sinus headaches may include:
- Pain, pressure and fullness in your cheeks, brow or forehead
- Worsening pain if you bend forward or lie down
- Stuffy nose
- Achy feeling in your upper teeth
Sinusitis or migraine?
Migraines and headaches from sinusitis are easy to confuse because the signs and symptoms of the two types of headaches may overlap.
Both migraine and sinusitis headache pain often gets worse when you bend forward. Migraine can also be accompanied by various nasal signs and symptoms — including congestion, facial pressure and a clear, watery nasal discharge. These are due to involvement of the autonomic nervous system in a migraine attack. In fact, studies have shown that approximately 90% of people who see a doctor for sinus headaches are found to have migraines instead.
Sinusitis, however, usually isn’t associated with nausea or vomiting or aggravated by noise or bright light — all common features of migraines.
Sinusitis usually occurs after a viral upper respiratory infection or cold and includes thick, discolored nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth. Headaches due to sinus disease often last days or longer, and migraines most commonly last hours to a day or two.
Sinus headaches are usually associated with migraines or other forms of headaches.
Sinus headaches are associated with pain and pressure in the face and sinuses and can cause nasal symptoms. Most of these headaches are not caused by sinus infections and should not be treated with antibiotics.
Sinus headaches can affect anyone but may be more likely if you have:
- A previous history of migraines or headaches
- A family history of migraines or headaches
- Hormonal changes associated with headaches
Whether or not you take preventive medications, you may benefit from lifestyle changes that can help reduce the number and severity of headaches. One or more of these suggestions may be helpful for you:
- Avoid triggers. If certain foods or odors seem to have triggered your headaches in the past, avoid them. Your doctor may recommend you reduce your caffeine and alcohol intake and avoid tobacco.In general, establish a daily routine with regular sleep patterns and regular meals. In addition, try to control stress.
- Exercise regularly. Regular aerobic exercise reduces tension and can help prevent headaches. If your doctor agrees, choose any aerobic exercise you enjoy, including walking, swimming and cycling.Warm up slowly, however, because sudden, intense exercise can cause headaches.Obesity is also thought to be a factor in headaches, and regular exercise can help you maintain a healthy weight or lose weight.
- Reduce the effects of estrogen. If you’re a woman who has headaches and estrogen seems to trigger or make your headaches worse, you may want to avoid or reduce the medications you take that contain estrogen.These medications include birth control pills and hormone replacement therapy. Talk with your doctor about the appropriate alternatives or dosages for you.
The cause of headaches can be difficult to determine. The doctor will question you about your headaches and do a physical exam.
Sinusitis Headache Diagnosis
Your doctor may perform imaging tests to help determine the cause of your headache, including:
- CT scan. CT scans use a computer to create cross-sectional images of your brain and head (including your sinuses) by combining images from an X-ray unit that rotates around your body.
- Magnetic resonance imaging (MRI). With MRIs, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.
Sinusitis Headache Treatment
The goal is usually to relieve your symptoms and treat an infection if you have one. You might take antibiotics, as well as antihistamines or decongestants for a short time. You can also use inhaled nasal decongestants, but only for up to 3 days. Longer use can make your symptoms worse.
You can also take pain relievers, or if they don’t help, your doctor can prescribe corticosteroids to ease the inflammation in your sinuses. If an allergic reaction causes your sinus flare-ups, you might need a preventive allergy treatment.
You can also feel better with simple at-home tricks, such as drinking more fluids, using a humidifier, or saltwater nasal spray.
If you take decongestant and pain-relieving medicines too often, you might get medication overuse headaches. It’s important to touch base with your doctor if you’re using any medication for a long time to relieve your headaches. Decongestants also can raise your blood pressure, so if you have high blood pressure, talk to your doctor before you take one.
In rare cases, they may recommend sinus surgery to remove polyps or open up small or constantly swollen sinuses.
Allergies and Sinus Headaches
Ever heard that allergies cause sinus headaches? It’s not quite that simple.
Allergies can cause sinus congestion, which can make your head hurt. Treatment for your allergies can ease that congestion, but it won’t relieve your headache pain. You usually have to treat the two conditions separately. See your doctor to make sure you get the right help.
Most people who assume they have sinusitis actually have migraines or tension-type headaches.
Migraines and chronic or recurrent headaches may be treated with prescription medication that is either taken every day to reduce or prevent headaches or taken at the onset of a headache to prevent it from getting worse.
The Medications for Sinus Headaches
To treat these types of headaches, your doctor may recommend:
- Over-the-counter pain relievers. Migraines and other types of headaches may be treated with over-the-counter medications, such as acetaminophen (Tylenol, others), naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB).
- Triptans. Many people with migraine attacks use triptans to relieve pain. Triptans work by promoting constriction of blood vessels and blocking pain pathways in the brain.Medications include sumatriptan (Imitrex, Tosymra, others), rizatriptan (Maxalt), almotriptan, naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax). Triptans are available as tablets, nasal sprays and injections.A single-tablet combination of sumatriptan and naproxen sodium (Treximet) has proved to be more effective in relieving migraine symptoms than either medication on its own.
- Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans. Ergots seem most effective in those whose pain lasts for more than 72 hours.Ergotamine may cause worsened nausea and vomiting related to your migraines and other side effects, and it may also lead to medication-overuse headaches.Dihydroergotamine (D.H.E. 45, Migranal) is an ergot derivative that is more effective and has fewer side effects than ergotamine. It’s available as a nasal spray and in injection form. This medication may cause fewer side effects than ergotamine and is less likely to lead to medication-overuse headaches.
- Anti-nausea medications. Because migraines are often accompanied by nausea, with or without vomiting, medication for nausea is appropriate and is usually combined with other medications. Frequently prescribed medications are chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compazine).
- Glucocorticoids (dexamethasone). A glucocorticoid may be used in conjunction with other medications to improve pain relief. Because of the risk of steroid toxicity, glucocorticoids shouldn’t be used frequently.
- Fioricet – Fioricet contains a combination of acetaminophen, butalbital, and caffeine Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow. Fioricet is used to treat tension headaches that are caused by muscle contractions. But it is widely used to treat all kinds of Headaches.