Sinus Headaches

Sinus headaches may feel like sinusitis and cause pressure around the eyes, cheeks and forehead. Migraines are often mistaken for sinus headaches because the symptoms are similar.

Signs of sinus headaches may include:

• Fatigue
• Stuffy nose
• Pain, pressure and fullness in the cheeks, brow or forehead
• Achy feeling in the upper teeth
• Worsening pain when bending forward or lying down

Unlike sinus headaches, migraines are associated with nausea or vomiting and may be aggravated by noise or bright light. Migraines may last from a few hours to two days, while sinus headaches may last more than a few days.

Sinus headaches typically occur after a viral upper respiratory infection or cold and may cause thick, discolored nasal mucus, pain in one cheek or upper teeth, and decreased sense of smell.

Pain during both a migraine and sinus headaches is worsened when bending forward. A migraine, however, may also cause symptoms such as facial pressure, congestion, and a clear, watery nasal discharge.

Pain and pressure in the face and sinuses, migraines, and other forms of headaches are associated with sinus headaches. Most of these headaches are not caused by sinus infections and symptoms should not be treated with antibiotics.

Sinus headaches are more common among individuals who have:

• A previous history of migraines or headaches
• Hormonal changes associated with headaches
• A family history of migraines or headaches

The following lifestyle changes can help reduce the frequency and severity of sinus headaches:

• Avoid foods that trigger headaches
• Reduce caffeine and alcohol intake
• Avoid or quit using tobacco products
• Establish a daily routine with regular mealtimes and bedtimes
• Exercise regularly to reduce tension and maintain a healthy weight
• Avoid or reduce medication that contains estrogen, such as birth control pills and hormone replacement therapy.

Individuals should schedule an appointment with their doctor if:

• Headache symptoms occur more than 15 days a month
• Headache symptoms require frequent over-the-counter pain medicine
• Over-the-counter medicine doesn’t alleviate a severe headache
• The headache interferes with daily life

A sinus headache may be diagnosed with a CT scan and/or an MRI. These scans will create cross-sectional images of the brain and head.

Sinus headaches may be treated with:

• Over-the-counter pain relievers, such as acetaminophen, naproxen sodium and ibuprofen.
• Triptans, which work by promoting constriction of blood vessels and blocking pain pathways in the brain; medications include sumatriptan, rizatriptan, almotriptan, naratriptan, frovatriptan, eletriptan and zolmitriptan. A single-tablet combination of sumatriptan and naproxen sodium is more effective than either medication on its own.
• Ergots drugs are most effective in patients whose pain lasts for more than 72 hours, but may worsen nausea and vomiting.
• Anti-nausea medication is usually combined with other medications. Anti-nausea drugs include chlorpromazine, metoclopramide or prochlorperazine.
• Glucocorticoids may be taken with other medication to improve pain relief. Glucocorticoids should not be used frequently as there is a risk of steroid toxicity.