Sinus Headaches

Overview

What are sinuses?

Sinuses are a series of connected, hollow spaces behind your cheekbones, forehead and nose

(see illustration). The sinuses produce thin mucus. As air travels through the sinuses to your lungs, the mucus traps harmful particles like dust, pollutants and bacteria. The mucus drains out through your nose.

What is a sinus headache?

About 80% of the time, what people call a sinus headache is actually a migraine with nasal symptoms. A true sinus headache develops because of a sinus infection (sinusitis). The infection causes pain and pressure in the sinuses.

How common are sinus headaches?

Sinus headaches are very common with an infection. You can also feel like you have a sinus headache when you have migraines, which affect 12% of people.

Symptoms and Causes

What causes sinus headaches?

Sinus infections cause sinus headaches. Anything that makes mucus buildup in the sinuses can lead to a sinus infection, such as:

  • The common cold is most often to blame.
  • Seasonal allergies trigger mucus production.
  • Nasal polyps, abnormal growths in the nose or sinuses. Nasal polyps can block mucus from draining.
  • Deviated septum, which is when the line of cartilage and bone down the center of the nose isn’t straight. A deviated septum can prevent mucus from properly draining.

Too much mucus gives germs an opportunity to grow. As germs build up, they irritate the sinuses. In response, sinus tissue swells, blocking the passage of mucus. Swollen, irritated sinuses filled with liquid make your face feel tender and achy.

Do allergies cause sinus headaches (allergy headaches)?

Allergies themselves don’t cause headaches. However, allergies can cause sinus congestion (stuffy nose), which can lead to sinus pressure, pain and infection. If you have seasonal allergies (allergic rhinitis), you’re 10 times more likely to suffer from migraines, too.

What does a sinus headache feel like?

When you have a sinus headache, your face hurts. Typically, pain gets worse when you move your head suddenly. Depending on the sinus affected, you may feel a constant dull ache behind the eyes or in your:

  • Cheekbones.
  • Forehead.
  • Bridge of the nose.

What are the other symptoms of sinus headaches?

Besides facial pain, sinus headaches cause other symptoms, including:

  • Fever.
  • Stuffy nose.
  • Thick, colored mucus discharge from the nose.
  • Feeling of fullness in the ears.
  • Swollen or puffy face.

Can you have a sinus headache without being congested?

If you don’t have congestion, it’s probably not a sinus headache. The pain in your face is more likely due to a migraine (severe headache) or tension headache.

What’s the difference between a sinus headache and a migraine?

It’s easy to confuse the two, since migraines can also cause facial pain, nasal congestion and a runny nose. With a migraine, nasal discharge is clear. If you have a real sinus headache — caused by a sinus infection — you’ll also have a fever and thick, discolored nasal mucus.

Diagnosis and Tests

How are sinus headaches diagnosed?

Most of the time when people diagnose themselves with a sinus headache, it’s really a migraine. So, it’s important to see your healthcare provider to get an accurate diagnosis and appropriate treatment.

Your healthcare provider will perform a physical exam and ask about your symptoms. If your symptoms are severe or ongoing, you may also need imaging tests. A magnetic resonance imaging (MRI) test can rule out serious brain conditions. Multiple imaging tests can reveal sinus blockages and include:

  • X-rays.
  • Computed tomography (CT) scan.
  • Nasal endoscopy (a thin, flexible tube with a tiny camera that views inside your nose and sinus).

Management and Treatment

How do I get rid of a sinus headache?

To get rid of a sinus headache, you have to treat the underlying cause. But you can take steps to ease sinus pressure and pain at home:

  • Apply a warm compress to painful areas of the face.
  • Use a decongestant to reduce sinus swelling and allow mucus to drain.
  • Try a saline nasal spray or drops to thin mucus.
  • Use a vaporizer or inhale steam from a pan of boiled water. Warm, moist air may help relieve sinus congestion.

Sinus infection

Viruses, bacteria and sometimes fungi cause sinus infections. Viral infections often go away on their own. But if your infection is bacterial or fungal, you need antibiotics or antifungal medications. Your healthcare provider may also recommend other medications to ease discomfort, such as:

  • Antihistamines to prevent allergy symptoms.
  • Decongestants to reduce swelling in the nose and sinuses.
  • Pain relievers to ease headache pain.
  • Steroids to reduce inflammation.

Migraines with sinus symptoms

Sinus headaches that are actually migraines need a different type of treatment. The first step is to relieve your pain. You should know that frequently using over-the-counter medications when you have a headache can cause even more headaches (rebound or medication overuse headaches).

Your provider may recommend prescription medication for migraine pain. You may also need a preventive medication that helps you have fewer migraine attacks.

Prevention

How can I prevent a sinus headache?

You can prevent recurring sinus infections (chronic sinusitis) by treating the root cause. For allergies, seeing an allergy specialist for treatment can help. For a deviated septum, your healthcare provider may need to perform surgery. If you have nasal polyps, you may need a procedure to remove them.

Outlook / Prognosis

How long do sinus headaches last?

Viruses cause most sinus infections. A viral sinus infection typically resolves on its own. Similar to how the common cold clears up by itself, your sinus headache should feel better within about a week. If it doesn’t go away, see your healthcare provider. You may have a bacterial or fungal sinus infection that requires medication.

Living With

What can I do about recurring sinus headaches?

Many sinus headaches, especially those that recur, are actually migraines. But it’s smart to see your healthcare provider to figure out the cause of your headaches.

You may find that the best long-term solution is figuring out what triggers your migraine headaches so you can avoid them. It’s helpful to keep a headache diary to track potential triggers. Triggers you can control include:

  • Alcohol.
  • Caffeine.
  • Specific foods, such as chocolate, red wine or strong cheese.
  • Lack of sleep.
  • Stress.

A note from Cleveland Clinic

People often mistake migraines for sinus headaches. But treatment for those two conditions is very different, so it’s important to pinpoint the real problem. If you’ve had more than one sinus infection or get frequent sinus headaches, seek medical care. Getting to the bottom of what’s going on will help you find a successful treatment.

Last reviewed by a Cleveland Clinic medical professional on 08/18/2020.

References

  • American Academy of Asthma Allergy & Immunology. . Accessed 8/18/2020.Headaches Connected to Allergies and Sinus Problems (https://www.aaaai.org/conditions-and-treatments/library/allergy-library/allergy-sinus-headaches)
  • American Migraine Foundation. . Accessed 8/18/2020.Sinus Headaches (https://americanmigrainefoundation.org/resource-library/sinus-headaches/)
  • Centers for Disease Control and Prevention. . Accessed 8/18/2020.Sinus Infection (https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/sinus-infection.html)
  • ENT Health by American Academy of Otolaryngology-Head and Neck Surgery. . Accessed 8/18/2020.Sinus Headaches (https://www.enthealth.org/conditions/sinus-headaches/)
  • FamilyDoctor.org. . Accessed 8/18/2020.Decongestants: OTC Relief for Congestion (https://familydoctor.org/decongestants-otc-relief-for-congestion)
  • National Headache Foundation. . Accessed 8/18/2020.Sinus Headache (https://headaches.org/2007/10/25/sinus-headache/)

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