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Sinus Headaches

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Updated May 15, 2014

Sinus headaches occur when the sinuses become inflamed or congested.

Sinus headaches occur when the sinuses become inflamed or congested. Many "sinus headaches" are actually migraines. Sinus headaches are often accompanied by symptoms such as nasal drainage, fever, congestion, or facial pain.

Photo © A.D.A.M.
Many people have what they call “sinus headaches,” but it turns out the majority of them may actually have migraine headaches instead. True sinus headaches are more uncommon, and result from an underlying condition such as sinusitis or allergies. The lining of the sinuses get inflamed and painful, and eventually they may become clogged. This blockage adds to the pressure and pain felt in the sinus.

Typical Symptoms

The pain of a sinus headache occurs directly over the affected sinus. The pain is typically constant, dull, and made worse with motion of the head. Many people with sinus headaches say that they can actually feel pain in their teeth. Along with the headache, one may have a fever, nasal drainage or congestion, ear pressure or a feeling of “fullness,” or facial pressure and pain. If a sinus headache is due to allergies, it may be accompanied by typical allergy symptoms like itchy and watery eyes, sneezing, or runny nose. In most cases, sinus infections do not cause nausea or vomiting, or light (photophobia) or sound sensitivity (phonophobia).

Treatment

The best way to treat a sinus headache is to treat the underlying cause. In the case of allergies, using an antihistamine (Benadryl or Claritin) or nasal steroid (like Flonase or Rhinocort) may be enough. If it is a sinus infection than a nasal decongestant, like Sudafed, may be a reasonable choice. If the infection is bacterial, your healthcare professional may choose to put you on an antibiotic, like Augmentin. Many upper respiratory infections are viral, and in those cases, an antibiotic would not be of use. For the pain, you can use Tylenol or another anti-inflammatory like ibuprofen or naproxen. A humidifier may be useful in promoting drainage and opening the nasal passages. Over-the-counter nasal sprays, like Afrin, can be used. But you should never use them for more than 2 days since you can actually experience “rebound congestion” where your nasal symptoms worsen rather than improve. Saline nasal spray is a much safer alternative.

Sources:

Cady, RK, Dodick, DW, Levine, HL, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment. Mayo Clin Proc 2005; 80:908.

Levine, HL, Setzen, M, Cady, RK, et al. An otolaryngology, neurology, allergy, and primary care consensus on diagnosis and treatment of sinus headache. Otolaryngol Head Neck Surg 2006; 134:516.

”Sinus Headache.” University of Maryland Medical Center. Review Date: June 1, 2003. Retrieved November 13, 2008.

”Sinus Headaches.”. National Headache Foundation. Retrieved November 13, 2008.

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