What causes painful pressure to the sinus?

Could be sinus : If the sinus openings to the outside world are blocked the air inside the sinus gets used up by the lining leading to a vacuum forming. The negative pressure in the sinus pulls on the delicate lining causing pain. That being said, it is far more common for muscle spasms in the face and neck to cause headaches. And severe "sinus" pain is usually a migraine.

Painful Sinuses: Pain is not a a primary symptom of sinus blockage, but it can happen with air pressure "trapped" in the sinuses, a condition called barosinusitis. If pain is the major symptom, consider migraines as a more likely cause. Does the pain/pressure get worse when the weather changes, you fly, or you dive under water? If so, this is air trapped.

Blocked drainage: Sinus pressure may be caused by swelling or by structural abnormailities at the sinus openings. New techniques such as balloon sinsu dilation can open blocked sinuses in a brief office procedure. Allergy testing can help identify causes of swelling. An otolaryngologist can help determine the best course of action. For current research on balloon sinus dilation, check out www.Sinusstudy.Com.