But is there really such a thing as a “sinus headache”? Headache is one symptom of sinus disease, but sinus disease is actually an infrequent cause of recurrent headaches, says Ellen Drexler, MD, the vice-chair in the regional department of neurology at Maimonides Medical Center in New York City. “In fact, studies have shown that most people who identify themselves as having ‘sinus headaches’ can actually be diagnosed with migraine,” Dr. Drexler says. A study published in the Archives of Internal Medicine found that of the 2,991 participants who thought they had at least six “sinus” headaches in the six months prior, 88 percent of them actually had migraine, according to the International Headache Society guidelines on diagnosing migraine. Headaches that interfere with your ability to function or come with other symptoms such as nausea and light sensitivity may be migraine attacks and not due to sinusitis, according to the American Migraine Foundation.
Sinus Anatomy and Headaches
Sinuses are air-filled cavities located in your forehead, above your teeth, between your eyes, and behind your nose. The sinuses are lined with a mucous membrane that has tiny hairs called cilia. The cilia move mucus, a sticky, gelatinous material produced by the mucous membrane, out of the sinuses and into your nose for drainage. Along the way, the mucus traps bacteria and other germs that can cause infection, and moves them out of the respiratory system. When the linings of the sinuses and the inside of your nose become swollen from allergy or infection, fluid can build up. When that happens, bacteria can grow in the fluid and cause an infection. The congestion and infection can produce intense sinus pressure and facial and head pain.
The Signs of a Sinus Headache
A sinus headache rarely occurs without other signs of congestion. When headache is your only symptom, it’s probably not related to your sinuses. Other signs or symptoms of a sinus headache are facial pain, teary or reddened eyes, postnasal drip, and head pain that gets worse when you’re leaning forward, says Lauren Doyle Strauss, DO, a headache specialist and an assistant professor at Wake Forest Baptist Health in Winston-Salem, North Carolina. The facial pain related to a sinus infection is located in the sinus areas around your eyes, cheeks, and forehead. Sore throat, cough, and bad breath are also common symptoms of sinusitis, according to the CDC. A headache can occur as part of an upper respiratory infection or follow a typical cold — possibly causing pain over the involved sinus, explains Drexler. In this case, there is often tenderness over the sinus area, and the pain usually begins an hour or so after the person gets out of bed in the morning. Congestion and mucus production — often yellowish or greenish if there is a bacterial infection, or clear discharge if it’s a viral infection — are associated signs, as is fever.
Can Allergies Cause a Sinus Headache?
“Headache is not a very common symptom, in and of itself, of seasonal allergies or allergic rhinitis,” says Katherine Hamilton, MD, an assistant professor of clinical neurology and a headache specialist at Penn Medicine in Philadelphia. With allergies, it’s much more common to have symptoms such as nasal congestion, like a stuffy nose or runny nose, and eye-watering, she says. But allergies, or allergic rhinitis, can increase your risk of a sinus infection, according to the CDC. One indication of whether you have allergies or sinusitis is your nasal discharge: In allergies it’s normally thin and clear, whereas in a sinus infection the mucus is yellow or green and thick, according to the Mayo Clinic. If you do have a headache that persists, it may not be just allergies, but rather an indication that you have migraine, says Dr. Hamilton. “Typically, headache can be due to a sinus infection or viral or bacterial infection, but it’s rare to have a significant headache from just allergy symptoms,” she says.
Prevention and Treatment of Sinus Headaches
The best way to prevent a sinus headache is to avoid a sinus infection. The CDC recommends washing your hands frequently, getting a flu shot, avoiding close contact with people who are sick, not smoking, and using a clean humidifier to moisten the air. By humidifying the air, you can decrease sinus pressure, which should translate into decreased incidence of headaches, says Kiran Rajneesh, MBBS, a neurologist and pain medicine specialist at the Ohio State University Wexner Medical Center in Columbus. Dr. Rajneesh also suggests drinking a lot of water. “Hydrating is important because it can help keep the mucus thin and loose, which can decrease infection and irritation,” he says. Over-the-counter pain relievers such as acetaminophen or ibuprofen can help relieve a sinus headache. A nasal spray — either a decongestant or a steroid spray — may help as well, according to Michigan Medicine. Keep in mind that overuse of nasal sprays (beyond two to three days) can further irritate the sinuses, leading to what is known as rebound congestion. If you have a history of high blood pressure or heart problems, talk to your doctor before using oral decongestants (such as phenylephrine or pseudoephedrine). A neti pot, which looks like a little teapot with a long spout, may be used to flush out nasal passages to improve congested sinuses, says Rajneesh. Research published in the Canadian Medical Association Journal in September 2016 found that people with chronic sinusitis who used a neti pot with a salt solution had improvement in symptoms, including fewer headaches, and used fewer over-the-counter medications. RELATED: 9 Natural Ways to Relieve Sinus Pain and Headache There are times when you should seek medical help for possible sinus infection. According to the CDC, you should see a doctor if any of the following is true:
You have severe headache or facial pain that doesn’t improve with the use of over-the-counter medications.Your symptoms improve but then get worse again.Your symptoms last longer than 10 days without getting better.You have a fever than lasts longer than three or four days.
In these cases, your doctor may or may not decide that you need antibiotics. Many sinus infections clear up on their own, according to the agency. Additional reporting by Becky Upham.
