Sinuses are air-filled cavities (spaces) located in your forehead, cheekbones, and behind the bridge of your nose (see illustration). The sinuses produce a thin mucus that drains out of the channels of the nose.
When a sinus becomes inflamed, usually as the result of an allergic reaction, an infection, or a tumor, the inflammation prevents the mucus from draining. This causes a pain similar to that of a headache.
Sinus headaches can cause a deep and constant pain in the cheekbones, forehead, or bridge of the nose. The pain usually gets worse with sudden head movement or straining, and with other sinus symptoms such as nasal discharge, feeling of fullness in the ears, fever, and facial swelling.
Your doctor needs to determine whether the symptoms of headache are actually a sinus problem. If your headache is truly caused by a sinus blockage, such as an infection, you will likely have a fever. Your doctor may order a CT scan or magnetic resonance imaging (MRI), along with a physical exam, to see if there is a blockage in your sinuses.
It is a misconception that allergies cause headaches. However, allergies can cause sinus congestion, which can lead to headache pain. If you have allergies, the treatment for your allergy will not relieve your headache pain. The two conditions generally must be treated separately.
Migraine headaches are associated with nasal congestion and discharge as one of the symptoms — the headache is not necessarily caused by the congestion, but is associated with it. Studies show that more than 95% of headaches that patients or doctors label as “sinus headaches” are actually migraines with associated nasal congestion. The use of decongestants or antibiotics is not needed and may actually make the condition worse.
Treatment of sinus headaches is usually done to relieve your symptoms and treat the infection. Treatment might include antibiotics for the infection, as well as a short period of antihistamines or decongestants to treat the symptoms. If you take decongestants but do not have a true sinus headache, the medication could make your headache worse.
Other medications to treat sinus infections include analgesics (such as aspirin, acetaminophen, or ibuprofen) and vasoconstrictors (drugs which narrow blood vessels). Corticosteroids may be prescribed for some people if the pain continues even after the use of analgesics. When an allergen is causing the sinus flare-ups, preventive allergy therapy is often needed.
Decongestant medications can be used to relieve headaches associated with sinus infections. Decongestants help relieve headache symptoms because they constrict blood vessels that cause headache pain. However, decongestant use can be habit-forming. If your headaches seem to be relieved by decongestants but you do not have a sinus infection, you may actually have a migraine or tension-type headache. These need treatment with different medications.
For treatment of chronic sinusitis, warm moist air may help relieve sinus congestion. Using a vaporizer or inhaling steam from a pan of boiling water (removed from heat) may also help. Warm compresses may relieve pain in the nose and sinuses. Saline nose drops are also safe for home use.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 06/15/2016