A sinus headache is a type of headache caused by various sinus conditions. This headache looks different from patient to patient, presenting with different symptoms for each individual case.

A sinus headache diagnosis is often mistakenly given to patients who have other types of headaches, such as migraines. This can result in patients getting the wrong treatment, some of which can even do more harm than good. This makes it important to tell apart a true sinus headache from other headache types. 

This guide from HealthTap goes over everything that’s important to know about sinus headaches, including the symptoms of sinus headaches, causes, treatments, and ways to tell a sinus headache apart from other types of headaches. 

What is a sinus headache?

A headache can be a condition in and of itself, or a symptom of another condition. If a headache is a symptom of something else, it is called a “secondary headache.” If it doesn’t have an underlying cause, then it’s called a “primary headache.”

A sinus headache is a type of secondary headache. It’s caused by various sinus issues, such as chronic sinusitis. Once the underlying issue is addressed, the sinus headache typically goes away. 

“Sinus headache” is not a term preferred by the International Headache Society (IHS) since it has been replaced by the term “Headache attributed to disorder of the nose or paranasal sinuses.” However, it’s still used to describe sinus-related headaches, especially since it’s such a common symptom of sinus infections. 

A sinus headache is characterized by throbbing pain behind the cheeks, sinuses, and eyes. If it’s a particularly severe headache, the pain may radiate to the side of the head.

Sinus headaches are often confused with primary headache disorders, especially migraine headaches. The chances of misdiagnosing a primary headache disorder as a sinus headache go up significantly if a primary headache disorder is accompanied by symptoms of a sinus infection, such as nasal congestion, runny nose, stuffy nose, decrease in sense of smell, or teary eyes. 

Studies show that as many as 80% of those diagnosed with a sinus headache met the diagnostic criteria for a migraine. 

What are the symptoms of a sinus headache?

A sinus headache is most likely the result of sinusitis, i.e. inflammation and the resulting congestion of the nasal passages. Other sinus-related conditions — such as a deviated septum — have not been found to lead to a headache. For this reason, a sinus headache is often attributed as a symptom of sinusitis. 

Sinus headache symptoms can include the following: 

• Sinus pain (of any type and severity) felt behind the cheeks, eyes, or teeth.

• Pain that gets worse as the sinusitis gets worse.

• Inflammation of the sinuses (as shown on an imaging test, such as a CT scan).

• Pain that resolves within a week of successful treatment for sinusitis. 

Sinusitis is different in every patient. However, some of the following symptoms may also be present in a sinus headache: 

• Sinus congestion.

• Nasal discharge. 

• Foul smell in the nose.

• Bad breath.

• Reduced sense of taste or smell.

• Pain in the teeth or gums.

• Cough.

• Fever.

• Fatigue.

• Muscle pain.

• Worsening of allergies.

It is also possible for a sinus infection to cause a headache without any of the classic symptoms of sinusitis. This can make it hard for patients to recognize the true cause of their headache. 

A comprehensive evaluation by a headache specialist, neurologist, or ear nose & throat (ENT) doctor can increase the accuracy of a diagnosis. 

Is it a sinus headache or migraine?

Sinus headaches and migraines are often confused with one another because they have very similar symptoms. Both conditions cause throbbing pain that can be felt in front of the face. Both conditions also tend to get worse with physical activity. 

Some migraines can even be accompanied by various conditions that affect the sinuses, such as nasal congestion, runny nose, and pressure behind the sinuses. This makes it very likely that the symptoms will be confused by both patients and doctors alike as a sinus headache. 

However, there are some clear differences between the two types of headaches that can be used to tell them apart. 

• Migraines can be accompanied by auras, which include symptoms like nausea, vomiting, and sensitivity to lights and sounds. About 25% of migraines are preceded by an aura about 30 minutes before a migraine attack. 

• Migraines are a chronic headache condition that can affect someone for years. A typical migraine attack can last for hours if left untreated.

• Sinus headaches are not typically accompanied by classic migraine symptoms. In addition to headache pain, the only additional symptoms are generally those affecting the sinuses. The headache tends to start soon after the first sinus symptoms emerge and resolve after the underlying sinus condition is treated. 

What causes a sinus headache?

Most cases of sinus headaches are caused by sinusitis, which is inflammation of the sinuses. 

Acute sinusitis lasts about one or two weeks, and the common cold usually causes it. While a headache isn’t a common symptom of the virus, it’s possible if a sinus infection occurs. 

Chronic sinusitis can last months and has various potential causes. It can stem from a dental infection that spreads to the sinuses, a viral infection, or nasal polyps (which are tissues that grow and block the nasal passages). 

Because such a wide range of conditions can lead to sinusitis, treatment can be drastically different from case to case. This makes it important to get an accurate diagnosis. 

Another condition that can lead to sinus headaches is called “mucosal contact,” which happens when the nasal septum makes contact with the nasal wall, causing release of a molecule called substance P. The release of substance P can cause inflammation in the brain and may even manifest as headache pain. Undergoing sinus surgery is often enough to relieve the headache. 

How are sinus headaches treated?

An accurate diagnosis is an important step toward treating a sinus headache. Patients may try to self-diagnose a sinus headache, which can lead to seeking the wrong treatment. 

A primary care or other healthcare provider should be the only one to make a diagnosis. 

If a patient presents with symptoms of a migraine (or another type of primary headache), their treatment will be different from the treatment for a true sinus headache. 

If the cause of a patient’s headache is related to sinus problems, then it’s important to treat the condition to get symptom relief. 

The following treatment options may be available for sinusitis: 

• Decongestants
  Decongestant medication helps shrink the blood vessels in the nose, which may reduce inflammation. It is available over-the-counter or with a doctor’s prescription, and it is often administered as a nasal spray. According to general guidelines, it may be best not to use nasal decongestants for more than a few days because of a condition known as rebound congestion. 

• Corticosteroids
  This medication works by easing swelling, inflammation, and congestion in the nasal passages. It is typically used as a prescription nasal spray for sinusitis.

• Saline nasal sprays
  This nasal spray uses salt to help clear out the nasal passages. This can reduce mucus and the stuffiness that it causes. It is generally safe to use over a long period of time until symptoms go away. 

• Allergy medications
  In some cases, allergies can make sinusitis symptoms much worse. Allergy medications like antihistamines can be prescribed by a doctor for additional relief. 

• Pain relievers
  Over-the-counter medications (OTC) such as ibuprofen (Advil), acetaminophen (Tylenol), or aspirin can generally be taken for a short period of time for moderate to severe pain. 

Antibiotics are sometimes prescribed by doctors to treat sinusitis. However, it’s important to make sure that the cause of sinusitis is bacterial and not viral. If sinusitis is caused by a virus, antibiotics won’t help. 

Even if a patient’s sinusitis is bacterial, a doctor may not prescribe antibiotics — in some cases, mild sinusitis caused by a bacterial infection may go away on its own.

If the condition is especially severe, antibiotics may be necessary. It’s important to take the full course of antibiotics prescribed by a doctor to prevent the infection from coming back and getting worse, which may require a second round of antibiotics. 

How can you care for a sinus headache at home? 

In addition to the treatment prescribed by a doctor, an at-home plan of care can go a long way towards relieving symptoms. 

The following at-home strategies may help support recovery from a sinus headache:

• Rest
  Since sinus headaches are caused by a bacterial or viral infection of the sinuses, getting plenty of rest can help the body fight off the pathogen. 

• Warm compress
  Applying a warm compress on the cheeks or forehead may help relieve some of the congestion and sinus pressure. 

• Humidifier
  A humidifier can help keep the sinuses moist, which may ease congestion. Taking a hot shower can produce a similar result. 

• Saline rinse
  Running a homemade saline solution (warm water mixed with salt) through the nasal passages may help to clear congestion and relieve some of the painful pressure.

How can sinus headaches be prevented? 

The best way to prevent a sinus headache is to prevent chronic sinusitis. The following strategies can help keep sinusitis at bay: 

• Avoid dental infections
  Seeing a dentist for regular cleanings can help prevent a tooth or gum infection from spreading to the sinuses.

• Avoid upper respiratory infections
  Getting vaccinated, wearing a mask, and avoiding contact with those who are sick can help prevent upper respiratory infections. 

• Manage allergies
  Avoiding common allergens (such as pollen) and treating allergy symptoms can help keep chronic sinusitis from getting worse. 

• Avoid pollution
  Car exhaust, cigarette smoke, and other sources of air pollution may inflame the nasal passages. If avoiding these irritants is not possible, a face mask may prevent them from entering the sinuses.

Takeaways 

A sinus headache is often caused by sinusitis, or inflammation of the sinuses. Unfortunately, many providers misdiagnose more serious headache conditions as a simple sinus headache, which can lead to poor treatment outcomes. 

Getting the right diagnosis from a healthcare provider is an important step in finding the right treatment for a sinus headache. HealthTap can connect you with a low-cost doctor that can work with you to get to the bottom of your headache.

Schedule your appointment today.