Sinus Headache
Condition
Definition
Sinus headache is head and face pain due to congestion, inflammation, or infection of the sinuses (sinusitis). The sinuses are cavities in the skull that have openings into the nose.
Treatment can help manage sinus headaches.
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Causes
Allergies and viral upper respiratory infections such ascolds increase nasal secretions. This causes swelling, congestion, and stuffiness in the nasal passages. The opening into the sinuses become blocked and normal drainage cannot occur. Secretions that are trapped in the sinuses build up. They may become infected with bacteria or, rarely, fungus. The swollen tissue, mucous build-up, or infection may create pain and pressure.
Risk Factors
Things that raise the risk of a sinus headache include:
- Allergies, such as allergic rhinitis or asthma
- Infections, such as:
- Colds or flus—or traveling in an airplane with one
- Ear infections
- Tooth abscess or infection
- Enlarged tonsils or adenoids
- Problems in the nose, such as:
- Nasal polyps
- Nasal deformities, such as a deviated septum
- Certain health problems, such as:
- Cystic fibrosis
- Problems with immunity
- Past sinus surgery
- Face injuries that block sinus passages
- Swimming in dirty water
Symptoms
Symptoms of a sinus headache may include mild to severe pain:
- Behind the forehead, cheeks, and around the eyes and ears
- In the upper teeth
- That is more intense first thing in the morning
- That may worsen when a person bends over
The headache may occur with other symptoms, such as:
- Stuffiness and congestion in the nose
- Thick nasal drainage or dripping down the back of the throat
- Fever
- Tiredness
- Stuffy ears
- Sore throat
- Cough
- Puffiness around the eyes
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
If problems come back, testing may include:
- CT scan—to look for sinus fluid
- Nasal endoscopy—to look inside the nose and possibly take samples of drainage to be tested
Treatment
The goal of sinus headache treatment is to:
- Open the nasal passages
- Treat any infection
- Allow sinus cavities to drain
Treatment may include:
Medicines by mouth or nose spray to:
- Ease pain
- Treat nasal allergies
- Open clogged nasal passages, which allows the sinuses to drain
- Reduce inflammation
- Treat an infection, if one develops
Self-care to treat a sinus headache may include:
- Breathing warm, moist air
- Saline nasal spray—to moisten the nasal passages
- Drinking plenty of fluids
- Warm or cool compresses applied to the face
- Quitting smoking—if a person smokes
- Avoiding polluted air and other people's smoking
Most people do not need surgery for sinus headaches. Surgery may help people who are not helped by medicines and have:
- A structural problem in the sinuses
- Chronic sinusitis
Surgery may be done to enlarge or clean out the sinuses. This can be done with several different procedures.
Prevention
To help reduce the risk of a sinus headache:
- Avoid anything that triggers allergy or sinus symptoms.
- Seek medical treatment for allergies.
- Wash hands often to avoid colds.
- Seek treatment for a persistent cold before sinusitis sets in.
- Avoid alcoholic drinks. Alcohol can cause swelling of nasal and sinus tissues.
- Check with the doctor about using a decongestant before air travel.
American Academy of Otolaryngology—Head and Neck Surgery
Asthma and Allergy Foundation of America
CANADIAN RESOURCES:
Canadian Allergy, Asthma, and Immunology Foundation
Health Canada
American Academy of Otolaryngology—Head and Neck Surgery
Asthma and Allergy Foundation of America
CANADIAN RESOURCES:
Canadian Allergy, Asthma, and Immunology Foundation
Health Canada
References
- Cady RK, Dodick DW, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment. Mayo Clinic Proc. 2005;80(7):908-816.
- Headache—approach to the adult patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/headache-approach-to-the-adult-patient.
- Sinus headache. National Headache Foundation website. Available at: https://headaches.org/sinus-headache.
- Sinusitis (sinus infection or sinus inflammation). Asthma and Allergy Foundation of America website. Available at: https://aafa.org/allergies/allergy-symptoms/sinusitis-sinus-infection.
- Viera AJ, Antono B. Acute headache in adults: a diagnostic approach. Am Fam Physician. 2022;106(3):260-268.
Contributors
- April Scott, NP
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