Sinus headaches cause a dull, deep, throbbing pain in the front of your head and face. They are caused by an inflammation in your sinuses, air-filled cavities around your nose, eyes, and cheeks. Bending down or leaning over generally makes the pain worse, as does cold and damp weather.
Sinus headaches often begin as soon as you get up in the morning, and may be better by afternoon. Sinus headaches can be difficult to diagnose, however, because symptoms are similar to tension headaches and migraines.
Signs and Symptoms
Sinus headaches generally have these symptoms:
Other symptoms may be related to sinus inflammation (sinusitis):
Migraines can also feel worse when you bend forward and can be accompanied by nasal congestion. But a migraine is more likely to be made worse by noise or light, and to be accompanied by nausea.
Sinus headaches can be caused by sinus congestion and inflammation, called sinusitis. Sinusitis, in turn, is caused by either a respiratory infection, such as a cold or flu, or allergies, like hay fever.
Healthy sinuses allow mucus to drain and air to circulate throughout the nasal passages. When sinuses become inflamed, these areas get blocked and mucus cannot drain. When sinuses are blocked, they provide a place for bacteria, viruses, and fungus to live and grow rapidly. Although a cold is most often the culprit, sinusitis can be caused by anything that prevents the sinuses from draining.
Your doctor will ask questions in order to distinguish sinus headaches from migraines or tension headaches. If you have had a recent cold, allergy flare up, or symptoms of sinusitis, it will help your doctor make a definite diagnosis.
Your doctor will look in your nose to check for congestion and nasal discharge. Your doctor will also press on areas of your face to check for tenderness. Your doctor may shine a light through the sinuses to look for sinus inflammation; if the light does not shine through, your sinuses may be congested.
If your doctor suspects chronic sinusitis, you may need imaging tests, including an x-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI). If your doctor suspects allergies may be causing your sinusitis, you may need an allergy test. Sometimes, you may need a referral to a specialist, known as an ear, nose and throat (ENT) doctor or an otolaryngologist. This specialist may perform a nasal endoscopy using a fiber optic scope to look at your sinuses.
The best way to avoid or get rid of a sinus headache is to treat the underlying sinus inflammation. Your doctor may prescribe antibiotics or corticosteroids. Lifestyle changes, such as using a humidifier or irrigating your nasal passages with salt water, may also help. Several dietary supplements and herbs may help prevent colds and flu or shorten their duration, or work together with antibiotics to treat your infection and support your immune system.
Doing the following things can help reduce congestion in your sinuses:
Other techniques that might help include:
Antibiotics -- Your doctor may prescribe antibiotics if he or she suspects you have a bacterial infection. To treat acute sinusitis, you may take from 10 - 14 days of antibiotics. Treating chronic sinusitis may take longer, usually 3 - 4 weeks.
Nasal corticosteroids -- These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. They are most effective at reducing symptoms, although it can take from a few days to a week after you start using them to see improvement.
Antihistamines -- Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter remedies, to treat allergies. Over the counter antihistamines are short acting and can relieve mild to moderate symptoms. All work by blocking the release of histamine in your body.
Decongestants -- Many over the counter and prescription decongestants are available in tablet or nasal spray form. They are often used with antihistamines.
Triptans -- In one study, 82% of patients with sinus headaches had a significant response to triptans, a medication commonly used for migraines.
Surgery and Other Procedures
For chronic sinusitis that doesn’t respond to medication, your doctor may recommend endoscopic sinus surgery, which may be done to remove polyps or bone spurs. Enlarging the sinus opening is also sometimes recommended. A newer procedure called balloon rhinoplasty involves inserting a balloon inside the sinus cavity and then inflating it.
Sinus surgeries are done by an ENT specialist.
Nutrition and Dietary Supplements
Several supplements may help prevent or treat sinus headaches, either by reducing sinus inflammation or by helping to ward off colds. (See Sinusitis for more details.) Because supplements may have side effects or interact with medications, you should take them only under the supervision of a knowledgeable health care provider.
The use of herbs is a time honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner.
As with supplements, there are many herbs that may help reduce your chances of getting a sinus headache by preventing or treating a cold, boosting your immune system, or reducing sinus inflammation.
Sinupret, a proprietary formulation containing European elder (Sambucus nigra), common sorrel (Rumex acetosa), cowslip (Primula veris), European vervain (Verbena officinalis), and gentian (Gentiana lutea) -- In two studies, Sinupret was found to work better than placebo in relieving symptoms of sinusitis. The herbs it contains may work by thinning mucus and helping the sinuses to drain, and they may also help strengthen the immune system.
Although research is lacking, other herbs have been used traditionally to treat headaches:
People who take blood thinners or women who are pregnant or breastfeeding should not take these herbs. People who allergic to aspirin should not take willow bark. Feverfew can interact with several medications. If you are allergic to ragweed you may also be allergic to feverfew.
One of the most common reasons people seek homeopathic care is to relieve chronic headaches. Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for sinus headaches based on their knowledge and clinical experience. In one study of homeopathy for sinusitis, more than 80% of the participants had significant improvement in their symptoms after taking the homeopathic remedy for 2 weeks.
Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
The following are remedies commonly prescribed for sinus congestion and headache:
Although studies are few and have found conflicting results, some people may find that acupuncture helps relieve symptoms of sinusitis. An acupuncturist diagnoses headaches not as migraine, tension, or sinus, but rather as conditions deriving from "energetic" imbalances. Acupuncturists usually describe sinusitis as "dampness" which creates inflammation and congestion in the mucus membranes. This dampness is cleared by strengthening the spleen meridian and by working with the stomach meridian. Practitioners often perform needling therapy and/or moxibustion, a technique in which the herb mugwort is burned over specific acupuncture points, for this condition.
Although there are no studies on using chiropractic to treat sinus headaches, some practitioners suggest that it may decrease pain and improve sinus drainage for some people.
For headaches in general, relaxation techniques can be helpful. That's especially true if the headaches are come back often, as sinus headaches often do. You may want to try these techniques:
If you are not better in a few weeks, your primary care physician may send you to see an ear, nose, and throat specialist for tests to find the cause of your sinus congestion.
Sinus congestion often acts up during pregnancy. There are many herbs and medications that pregnant and breastfeeding women should not use. Check with your doctor before using any herbs or supplements if you are pregnant or breastfeeding.
Warnings and Precautions
You should go to the emergency room or call 911 if you experience the following:
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Review Date: 10/12/2011
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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