Overview

Sinus headaches are headaches that may feel like an infection in the sinuses (sinusitis). You may feel pressure around the eyes, cheeks and forehead. Perhaps your head throbs.

But, this pain might actually be caused by a migraine.

Symptoms

Signs and symptoms of sinus headaches may include:

  • Pain, pressure and fullness in the cheeks, brow or forehead
  • Worsening pain if you bend forward or lie down
  • Stuffy nose
  • Fatigue
  • Achy feeling in the upper teeth

Sinusitis or migraine?

Migraines and headaches from sinusitis are easy to confuse because the signs and symptoms of the two types of headaches may overlap.

Both migraine and sinusitis headache pain often get worse when you bend forward. Migraine can also be accompanied by various nasal signs and symptoms — including congestion, facial pressure and a clear, watery nasal discharge. These are due to involvement of the autonomic nervous system in a migraine attack. In fact, studies have shown that most people who see a health care provider for sinus headaches are found to have migraines instead.

Sinusitis, however, usually isn't associated with nausea or vomiting or aggravated by noise or bright light — all common features of migraines.

Sinusitis usually:

  • Occurs after a viral upper respiratory infection or cold
  • Includes thick, discolored nasal mucus
  • Is associated with a decreased sense of smell
  • Causes pain in one cheek or upper teeth

Headaches due to sinus disease often last days or longer, and migraines most commonly last hours to a day or two.

When to see a doctor

Consult your provider if:

  • Your headache symptoms occur more than 15 days a month or require frequent pain medicine available without a prescription
  • You have a severe headache, and pain medicine available without a prescription doesn't help
  • You miss school or work because of frequent headaches or the headaches interfere with your daily life

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Causes

Sinus headaches are usually associated with migraines or other forms of headaches.

Sinus headaches are associated with pain and pressure in the face and sinuses and can cause nasal symptoms. Most of these headaches are not caused by sinus infections and generally should not be treated with antibiotics.

Risk factors

Sinus headaches can affect anyone but may be more likely if you have:

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

Prevention

Whether or not you take preventive medications, you may benefit from lifestyle changes that can help reduce the number and severity of headaches. One or more of these suggestions may be helpful for you:

  • Avoid triggers. If certain foods or odors seem to have triggered your headaches in the past, avoid them. Your provider may recommend you reduce your caffeine and alcohol intake and avoid tobacco.

    In general, establish a daily routine with regular sleep patterns and regular meals. In addition, try to control stress.

  • Exercise regularly. Regular aerobic exercise reduces tension and can help prevent headaches. If your provider agrees, choose any aerobic exercise you enjoy, including walking, swimming and cycling.

    Warm up slowly, however, because sudden, intense exercise can cause headaches.

    Obesity is also thought to be a factor in headaches, and regular exercise can help you maintain a healthy weight or lose weight.

  • Reduce the effects of estrogen. If estrogen seems to trigger or make your headaches worse, you may want to avoid or reduce the medications you take that contain estrogen.

    These medications include birth control pills and hormone replacement therapy. Talk with your provider about the appropriate alternatives or dosages for you.

May 17, 2022
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