Sinus headache is a type of headache that results from the build-up of pressure in the sinuses in the nose, forehead and cheeks. It leads to a consistent deep pain in this area of the head, which gets more severe with sudden movements or straining of the head. The suitable treatment for sinus headache depends on the specific cause of the associated sinusitis.
Sinus headaches occur as a result of inflammation and obstruction of the sinuses, which may be caused by a number of different factors. These include:
- Allergic rhinitis
Allergic rhinitis typically occurs seasonally and is more likely to cause symptoms in the spring when the pollen count is high or in autumn as the weather changes.
Sinus headaches are characterized by a deep pain that is localized to the sinuses in the cheekbones, forehead and the bridge of the nose, which intensifies with movement or straining of the head.
Other symptoms that often accompany a sinus headache include:
- Nasal discharge
- Feeling of fullness in the ears
- Swelling and tenderness of the face
- Fever and chills
The symptoms of sinus headache are closely related to that of migraine, and the two conditions are often misdiagnosed for this reason.
The diagnosis of sinus headache begins with a thorough medical history and physical examination. A scope device can sometimes be inserted up the nasal passages to obtain a direct visualization of the affected area, which is useful in diagnosis.
It is important to determine the cause of the sinus headache, as this will have a significant impact on the treatment of the condition. For example, a bacterial infection will require a short course of antibiotics, whereas allergic sinusitis will respond better to antihistamine medications.
In some cases, additional testing may be required to confirm the diagnosis of a sinus headache. This is particularly important for persistent headaches with a potentially serious underlying cause. Magnetic resonance imaging (MRI) and computed tomography (CT) scans can help to investigate the cause further.
The aim of treatment for sinus headaches is to relieve symptoms and, if present, eradicate any infection.
There are several non-pharmacological techniques for chronic sinusitis to reduce congestion and the associated pain, such as:
- Inhaling warm, moist air from a vaporizer or steam bucket can help to relieve congestion.
- Alternating hot and cold compresses applied alternatively can also help to reduce congestion (e.g. 3 minutes hot compress followed by 30 seconds cold compress, repeated several times a day).
- Saline nose drops to irrigate or rinse the nose and remove mucus and irritants that may cause inflammation.
Simple analgesic medications, such as paracetamol, ibuprofen and aspirin, also play a role in the treatment of sinus headache. A course of antibiotics is indicated to eradicate bacteria if the sinus headache is likely to be caused by an infection.
Antihistamine and decongestant medications are often useful to relieve the pressure that has built up inside the sinuses and reduce the associated pain, particular for allergic rhinitis. However, these medications are not effective for other types of headache and may worsen pain, so it is essential that an accurate diagnosis is made before commencing treatment.
For some cases, treatment with vasoconstrictor or corticosteroid medications is able to provide effective pain relief of sinus headache.
For chronic sinusitis that does not respond well to medication, further investigations may need to be made to identify the cause. In some cases, surgery to enlarge the sinuses or remove an obstructive tumor is required to improve drainage and reduce the pressure.