Sinus Headache
En Español (Spanish Version)

Definition
Sinus headache refers to head and facial pain associated with congestion, inflammation, or infection of the sinuses (sinusitis). The sinuses are hollow cavities in the skull that have openings into the nose. Colds and allergies cause congestion and inflammation of the nasal passages and can lead to sinusitis. Sinus headache is a symptom of sinusitis.

Sinus Headache: Areas of Pain

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Causes
Allergies and viral upper respiratory infections increase nasal secretions and cause tissue lining the nasal passages to swell. This results in nasal congestion and stuffiness. The opening into the sinuses become blocked and normal drainage cannot occur. Secretions that are trapped in the sinuses build up and may become infected with bacteria or, rarely, fungus. The swollen tissue, mucous build-up, or infection may create pain and pressure.

Risk Factors
Factors that may increase your chance of a sinus headache include:

Symptoms
A sinus headache may cause:

  • Pain and tenderness behind the forehead, cheeks, and around the eyes and ears
  • Pain in the upper teeth
  • Pain ranging from mild to severe
  • Pain that is more intense first thing in the morning
  • Pain that may worsen when you bend over
  • Headache may occur with other symptoms of sinusitis, including:
    • Nasal stuffiness and congestion
    • Thick nasal drainage
    • Postnasal drip
    • Fever
    • Fatigue
    • Stuffy ears
    • Sore throat
    • Cough
    • Puffiness around the eyes
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.

Imaging tests may include:

  • CT scan—to look for sinus fluid
  • Nasal endoscopy—to look inside your nose and possibly take samples of drainage to be tested
Treatment
Sinus headache treatment aims to:

  • Open the nasal passages
  • Treat any infection
  • Allow sinus cavities to drain
Treatment may include:

Medications
Medications may include:

  • Pain relievers
  • Antihistamines to treat nasal allergies
  • Decongestants to open clogged nasal passages, which allows the sinuses to drain
  • Steroid nasal spray to reduce inflammation
  • Antibiotics—only if a bacterial infection has developed
Self-care during the Headache
Self-care includes:

  • Breathe warm, moist air. Try inhaling steam.
  • Mist of saline nasal spray to moisten the nasal passages and help remove crusty secretions. A saline spray can be used up to 6 times per day.
  • Ask your doctor for directions on how to perform nasal irrigation that you can do at home.
  • Drink plenty of fluids
  • Do not smoke. If you smoke, talk to your doctor about how you can quit.
  • Avoid second-hand smoke and polluted air.
Surgery
Surgery is usually not required. People with a structural abnormality or chronic sinusitis that do not respond to medications may benefit from surgery. The doctor may perform one of several procedures to enlarge the opening to your sinuses or clean out your sinus cavities.

Prevention
To help reduce your chance of a sinus headache:

  • Avoid exposure to anything that triggers allergy or sinus symptoms.
  • Seek medical treatment for allergies.
  • Wash your hands frequently 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 your doctor about using a decongestant before air travel.



RESOURCES:
American Academy of Otolaryngology - Head and Neck Surgery

Asthma and Allergy Foundation of America

CANADIAN RESOURCES:
Allergy Asthma Information Association

Calgary Allergy Network

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;80:908-816.

Dambro M, Griffith J. Griffith's 5-Minute Clinical Consult. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2006.

Goetz CG, Pappert EJ. Textbook of Clinical Neurology. Philadelphia, PA: WB Saunders Co; 1999.

Goroll AH, Mulley AG. Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2000.

Hainer BL, Matheson EM. Approach to acute headache in adults. Am Fam Physician. 2013;87(10):682-687.

Headache. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 24, 2014. Accessed September 29, 2014.

Sinus headache. National Headache Foundation website. Available at: http://www.headaches.org/education/Headache_Topic_Sheets/Sinus_Headache. Accessed September 29, 2014.

Sinus headache. American Academy of Otolaryngology website. Available at: http://www.entnet.org/content/sinus-headaches. Accessed July 29, 2014.

Sinus problems. Asthma and Allergy Foundation of America website. Available at: http://www.aafa.org/display.cfm?id=9&sub=18&cont=240. Accessed September 29, 2014.

Last Reviewed September 2014



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