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

Causes

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

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for sinus headache include:

• Allergies

• Asthma

• Persistent cold or upper respiratory infection

• Ear infections

• Nasal polyps

• Tooth abscess or infection

• Enlarged tonsils or adenoids

• Nasal deformities, such as a deviated septum

• Cystic fibrosis

• Problems with immunity

• Prior sinus surgery

• Facial injuries that block sinus passages

• Traveling in an airplane with an upper respiratory infection

• Swimming in dirty water

• Sudden temperature changes

Symptoms

Symptoms of sinus headache may include:

• Pain and tenderness behind the forehead, cheeks, and around the eyes and ears

• Pain in the back of the neck or 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 occurring 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. Your nasal secretions may be tested for allergies and infection.

If you suffer from chronic sinusitis, tests may include:

CT Scan–a type of x-ray that uses a computer to make pictures of structures inside the head

Nasal Endoscopy–using a thin, lighted tube 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:

Prevention

The following strategies may reduce the risk of getting 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
http://www.entnet.org

Asthma and Allergy Foundation of America (AAFA)
http://www.aafa.org

References:

American Academy of Otolaryngology website. Available at: http://www.entnet.org.

American Rhinologic Society website. Availablet at: http://www.american-rhinologic.org/.

Asthma and Allergy Foundation of America website. Available at: http://www.aafa.org.

Cady RK, Dodick DW, Levine HL, Schreiber CP, Eross EJ, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment. Mayo Clinic Proc. 2005;80:908-16.

Griffith's 5-Minute Clinical Consult. 1999 ed. Lippincott, Williams, and Wilkins; 1999.

National Headache Foundation website. Available at: http://www.headaches.org/.

Primary Care Medicine. 4th ed. Lippincott, Williams, and Wilkins; 2000.

Textbook of Clinical Neurology. 1st ed. WB Saunders Co.; 1999.