Sinus Headache

Picture of the sinuses

• A sinus headache results from inflammation and pressure within the sinus cavities of the skull.
• Inflammation of the lining tissues of the sinuses due to infections, allergies, or other irritants causes fluid secretion that can block drainage from the sinuses, causing the sinus pressure within to increase.
• Most sinus infections are due to viral infections.
• The main symptoms of a sinus headache are pain and tenderness over the affected area.
• Other symptoms include:
  • Pain from sudden movements of the head when bending forward
  • Nasal discharge or runny nose
  • Nasal congestion
  • Post-nasal drip
  • Yellow or green discharge from the nose
  • Pain in the upper teeth
  • Fever
  • Chills
  • Tiredness
  • Body aches
• The pain from a sinus headache sometimes is worse in the morning due to mucous collection throughout the night.
• In some people, the main symptoms of a sinus headache may resemble those of a migraine headache.
• Maintaining good hydration and breathing humidified air are two self-care steps to relieve sinus headaches.
• Home remedies to soothe sinus headache symptoms include staying hydrated, using a humidifier to keep the room air moist, and over-the-counter (OTC) medications.
• Decongestant medications may be useful to help promote drainage of the sinuses.
• Most people recover fully from sinus headaches without long-term complications.

A sinus headache is the result of inflammation and a buildup of pressure within the sinuses of the skull.

The sinuses are cavities or pockets located within the bones of the skull. In addition to contributing to the strength and stability of the skull, the sinuses help to humidify and filter the air.

The sinuses are named according to their location in the skull bones:

• Frontal sinuses are located over the forehead and above the eyes on both sides.
• Maxillary sinuses are located over the cheek area, in the bone known as the maxilla, located under the eyes on both sides of the face.
• Ethmoid sinuses are located in the bone that divides the eyes and nose.
• Sphenoid sinuses are located in the sphenoid bone at the center of the skull, behind the eyes.

The sinuses are lined by mucous membranes that secrete fluid and are connected to the nasal cavity by small channels or ducts. The sinuses are sometimes collectively referred to as the paranasal sinuses because of their proximity to the nose.

Inflammation due to any cause (most likely due to irritation or infection) can cause a buildup of fluid and increased sinus pressure, causing the typical symptoms of a sinus headache.

Picture of the sinuses

The pain of a sinus headache is often felt over the affected area(s) and has been described as a sensation of uncomfortable pressure. There may be tenderness when the area is touched. The pain can worsen upon changing head positions or getting up from the bed.

Nasal discharge may accompany inflammatory processes in the sinuses. The drainage may be clear or greenish-yellow in color. Greenish-yellow discharge usually signals that an infection is present.

Other signs of an infection may also develop including:

• Fever
• Chills
• Tiredness
• Body aches

Swollen lymph nodes in the neck can accompany a sinus infection. Pain in the jaw or upper teeth may be felt in cases of inflammation of the maxillary (cheekbone) sinuses.

Most often, sinus headaches are caused when the tissue lining in the sinuses becomes inflamed.

Inflammation of the tissues lining the sinuses is the primary cause of a sinus headache. The inflamed tissues swell and produce secretions that clog the normal drainage system of the sinuses, causing a build-up of fluid and secretions. The pressure of this fluid build-up causes the pain of a sinus headache. Inflammation of the sinuses is known as sinusitis. The inflammation may arise due to:

• Infection
• Allergic reactiond such as hay fever
• Irritation

Most commonly, infectious sinusitis (sinus infection) is due to a viral infection, but bacterial and fungal infections of the sinuses can also occur. Since the maxillary sinuses are located in the cheekbone, infections of the upper teeth can spread into these sinuses. In very rare cases, benign or malignant tumors can invade and block drainage in the sinuses and lead to a sinus headache.

Frequently, sinus headaches are managed by primary care physicians including those that specialize in internal medicine, family medicine, or pediatrics.

For complicated cases, an ear, nose, and throat specialist (otolaryngologist) may be consulted. With unusual infections, such as fungal infections, a specialist in infectious diseases may be consulted.

• Sinus headaches and infections may sometimes be successfully treated at home (see the home remedies section).
• However, you should seek medical care if you are not sure what is causing your symptoms or if you have signs of a severe infection including high fever, symptoms that do not resolve with time, or if over-the-counter pain relievers are not effective in controlling the pain.
• You should also seek care if you notice swelling in the face that accompanies the pain, swelling around your eye or changes in vision, since this could be a sign of an abscess.

Usually, a careful history and physical examination can establish the diagnosis of a sinus headache. Blood tests are usually not necessary.

In some cases, the healthcare professional may order a CT scan to obtain images of the sinuses, but this is not common. A negative CT scan and examination can help rule out sinus disease.

Other causes of headaches, including migraines, may initially present with symptoms thought to be from sinus inflammation.

Treatment for a sinus headache frequently involves both self-care at home with home remedies, and OTC and prescription medications that can help control pain and inflammation.

Neti-pots are one of many forms of self-care for sinus headaches.

There are a number of self-care measures available to help decrease sinus congestion and promote drainage of the sinuses, providing relief for sinus headached:

• Drink plenty of fluids to help you stay hydrated.
• Breathe humidified air.
• Use salt water (saline) nasal sprays.
• Neti-pots, small ceramic pots used for nasal irrigation, can help relieve symptoms in many people.
• Use of over-the-counter medications (see medications section).

• OTC pain medications such as acetaminophen (Tylenol and others) and ibuprofen (Motrin and others) can help control pain.
• Decongestant medications such as pseudoephedrine (Sudafed) may be useful in promoting drainage of the sinuses. People with high blood pressure or heart conditions should check with their healthcare practitioner before using these medications. A number of over-the-counter decongestant medications are available, either singly or in combination with antihistamines, pain relievers, and/or anti-inflammatory medications.
• Decongestant nasal sprays are also available that contain decongestant medications, but these should not be used for more than three days, due to the possibility of rebound inflammation, a worsening of the condition once use of the spray has stopped.
• Inhaled steroid preparations are sometimes prescribed to treat allergic sinusitis, and bacterial infections of the sinuses are treated with antibiotics.
• Antihistamines may be useful if allergies such as hay fever are the cause of congestion.

Usually, sinusitis or a sinus headache will not require surgery, but surgery to widen the openings of the sinuses and promote drainage may be considered in severe, recurrent, long-standing cases of sinus infections and headache.

If your symptoms do not resolve with treatment or if symptoms worsen, contact your healthcare professional.

Sinus headaches may be prevented with the following measures:

• Good handwashing and hygienic practices can help prevent colds and upper respiratory infections.
• Smoking cessation can also decrease your risk of airway infections.
• For people with allergies, avoid triggers to help prevent sinus infections.
• Keep the body well hydrated and humidify the air since these can help promote efficient drainage of fluids from the sinuses.

Most people with sinus headaches recover completely, although many people may develop sinus headaches again in the future.

Complications of sinus headaches are not common. Rarely, an untreated sinus infection can erode through the bones and involve adjacent structures, including the eye socket or brain, potentially causing pain and swelling of the eye or symptoms of meningitis or encephalitis. Infection that spreads to the blood vessels in the area of the sinuses can cause inflammation and blood clots. The cavernous sinus is a collection of veins located near the sphenoid sinus that can potentially become infected and form blood clots.