For some people, the classic symptoms of a
sinus infection, including nasal congestion and discharge, are also accompanied by a dull ache or feeling of pressure in the head and face. This is often called a “sinus headache.”
Here’s what to know about sinus infections, how to prevent and treat them, and how to distinguish a sinus headache from a migraine attack.
Sinuses are air-filled cavities in the skull. There is a pair of sinuses behind the forehead, above the teeth, between the eyes, and behind the nose.
The sinuses are lined with mucous membranes that have tiny hairs called cilia. The cilia move
mucus, a sticky, gelatinous material produced by the mucous membranes, out of the sinuses and into your nose for drainage. Along the way, the mucus traps bacteria and other germs that can cause infection and moves them out of the respiratory system.
If the linings of the sinuses and the inside of your nose become swollen from
allergies or an infection, fluid can build up, causing congestion and producing intense sinus pressure and facial and head pain.
A sinus headache usually occurs with other symptoms, says
Geoffrey B. Trenkle, DO, a board-certified surgeon in otolaryngology and facial plastic surgery based in Los Angeles. These include:
- A stuffy nose
- Thick, often green or yellow nasal discharge
- Sore throat
- Postnasal drip
- Cough
- Bad breath
- Fever (uncommon)
- Pressure and fullness in your face that often get worse when you lean forward
The facial pain related to a sinus headache is generally located around your eyes, cheeks, and forehead.
“Not all headaches that feel sinus-related are due to sinus disease,” says Dr. Trenkle. These headaches might instead be atypical migraine attacks (those that don’t follow the usual migraine patterns) that mimic sinus symptoms, he adds. While
migraine symptoms usually include throbbing pain, sensitivity to light and sound, and sometimes nausea, atypical migraine attacks might manifest as pressure in your sinuses or pain in your face.
“Headache is not a very common symptom, in and of itself, of seasonal allergies or allergic rhinitis [swelling of the nasal passages triggered by things like pollen or pet dander],” says Katherine Hamilton, MD, a neurologist at MedStar Georgetown University Hospital in Washington, DC.
With allergies, it’s much more common to have
nasal congestion symptoms, such as a stuffy nose or runny nose and eye-watering, she says.
But swollen nasal passages from allergies can block airflow and create pressure that resembles a sinus headache, Trenkle explains.
Allergies, or allergic rhinitis, can also increase your risk of a sinus infection.
If you do develop a sinus infection from allergies, you may experience a sinus headache along with other symptoms, such as facial pressure and thick, discolored nasal discharge.
Whether you get sinus headaches regularly or occasionally, here are some tips to help you prevent and manage them.
Prevention
The best way to prevent a sinus headache is to take steps to avoid triggers that can cause sinus inflammation or infection.
- Clean hands: Wash your hands frequently and use hand sanitizer, especially during cold and flu season.
- Social distancing: Stay away from people who have colds or other respiratory infections, as these illnesses can easily spread and trigger sinus problems.
- A humidifier: Use a clean humidifier to add moisture to the air in your home and keep your nasal passages from drying out to reduce the risk of inflammation.
- Hydration: Drink enough water to help keep your nasal mucus thin, which can minimize congestion and infection risk.
- Clean air: Avoid smoke and other irritants that can trigger sinus inflammation.
- Vaccination: Stay up-to-date with your annual flu shot to reduce your risk of infections.
- Allergy management: If you have allergies, work with an allergist to manage them effectively.
Treatment
If you have a sinus headache, these tips may provide relief:
- Nasal Irrigation Try using a neti pot to flush out your nasal passages. A review of studies shows nasal irrigation is a helpful treatment for sinus headaches. But be sure to properly clean the device and use sterile, distilled, or boiled and cooled water.
- Pain Medications Over-the-counter pain medications such as acetaminophen or ibuprofen can help. But limit their use to no more than three days per week, says Dharti Dua, MD, a neurologist and headache specialist at the Ohio State University Wexner Medical Center and College of Medicine in Columbus.
- Nasal Sprays A nasal spray — either a decongestant or a steroid spray — may help. Keep in mind that overuse of nasal sprays (beyond two to three days) can further irritate the sinuses, leading to what is known as rebound congestion.
- Moisture Therapy In addition to preventing sinus issues, a humidifier can also relieve sinus headache symptoms by softening mucus and promoting drainage.
- Oral Decongestants These include Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine), which are available without a prescription. If you have a history of high blood pressure or heart problems, talk to your healthcare provider before using oral decongestants. Also, be aware the FDA has proposed removing oral phenylephrine from store shelves because it doesn’t effectively treat nasal congestion.
- Prescription Medications For severe cases, your healthcare provider may prescribe antibiotics or steroids if needed, says Dr. Dua.
There are times when you should seek medical help for a sinus headache. See a healthcare provider if you experience any of the following.
- You have a severe headache or facial pain that doesn’t improve with the use of over-the-counter medications.
- Your symptoms improve but then get worse again.
- Your symptoms last longer than 10 days without getting better.
- You have a fever that lasts longer than three or four days.
- You have other symptoms, such as nausea or vomiting.
Be sure to get persistent headaches checked out, says Dr. Trenkle. You may be dealing with a sinus infection, migraine, or something else, and getting the right diagnosis means you'll receive the most effective and timely treatment.
Call 911 immediately if you experience the worst headache of your life or a sudden, severe headache along with confusion, fainting, numbness, weakness, or trouble with vision, speech, or walking. These symptoms may indicate a serious condition, such as a stroke, that needs immediate medical attention.
The Takeaway
- Sinus headaches typically come with other symptoms, including stuffy nose, thick nasal discharge, facial pressure that worsens when you bend over, and pain around your nose, eyes, and cheeks.
- Some people who think they have sinus headaches may be experiencing a migraine attack, which can cause similar facial pain and pressure symptoms.
- Allergies rarely cause headaches on their own, but they can increase your risk of developing a sinus infection that may lead to a headache.
- Prevention and treatment tips include using a clean humidifier, staying hydrated, managing allergies, and seeking medical care if symptoms last more than 10 days or worsen after improving.
Additional reporting by Becky Upham.
