The sinuses are cavities located around the forehead, the bridge of the nose, and in the cheeks. Sinus headaches occur due to pressure inside a person’s sinuses, causing pain.
Sinus headaches often occur due to a sinus infection, or sinusitis. They can also occur due to allergies, chronic inflammation, or structural issues, such as nasal polyps. Treatment depends on the cause, but people can usually manage sinus headaches at home.
In this article, learn the symptoms, causes, and treatments for sinus headaches and how to tell the difference between sinus headaches and migraine.
A thin membrane, similar to that of the nose, lines the sinuses. If a person has an infection or allergy, the membrane can swell up, which can cause pressure and pain. Fluid can also build up in the sinuses, which can also create pressure.
A person may feel sinus pain in their cheeks, the bridge of the nose, the area above the nose, or the crown of the head. The pain may occur on both sides, or just one side, depending on the cause.
Some people find that the pain worsens after coughing, leaning over, or bending down. Sometimes, the pain radiates into the teeth when bending over.
Sinus pain can last for a short time or be a longer-term problem. Doctors sort cases into four categories:
- acute — lasts less than 4 weeks
- subacute — lasts between 4–8 weeks
- chronic — lasts more than 8 weeks
- recurrent — returns more than 3 times per year
Several things can cause or contribute to sinusitis.
Sinus headaches are
During a sinus infection, the sinuses become inflamed, and the body produces more mucus. This, on its own, can cause a sinus headache.
However, if bacteria start to grow inside the sinuses, a person may develop a bacterial infection. The bacteria produce gases that cause sinus pressure, which also causes pain.
The symptoms of a sinus infection include:
- blocked or runny nose
- thick mucus when blowing the nose
- mucus in the back of the throat — postnasal drip
- tooth pain
- reduced sense of smell
- unpleasant breath
If the infection is bacterial, a person may also have a fever.
Allergies, particularly hay fever, can also cause sinus headaches. This is because allergies can cause blocked or inflamed sinuses. A person with allergies may also experience:
- red or watering eyes
- an itchy mouth or throat
- itchy eyes
- nasal congestion
If someone has a condition that prevents mucus from draining effectively from the nose and sinuses, they may be prone to blockages and infections. Examples of these conditions include:
- Nasal polyps: These are painless growths that can develop inside the nose. They may cause blockages if they grow large enough.
- Deviated septum: This occurs when the septum, which divides the nose into two cavities, is not symmetrical. This makes one nasal passage significantly smaller than the other, which can result in the smaller side being congested.
- Enlarged adenoids: Adenoids are small patches of tissue located at the back of the nose. If they are too big, they can prevent the sinuses from draining. Young children do not have fully developed sinuses, so enlarged adenoids can cause chronic sinusitis in this age group.
- Dental issues: According to a 2021 review, nearly 30% of chronic sinusitis cases that affect both maxillary sinuses, which are in the cheeks, may have dental problems as the underlying cause. If the roots of the upper teeth extend into the sinuses, for example, it can cause blockages and become a site for recurring infections.
What helps a sinus headache depends on the cause.
Over-the-counter (OTC) medications can help with many cases of sinusitis. If someone has a viral illness, OTC pain or cold medications can relieve pain and a blocked or runny nose. If the headache is the result of allergies, OTC antihistamines may help.
People may also be able to purchase OTC nasal sprays that contain saline to flush the nasal passages or that contain steroids. However, people should not use steroid sprays for a prolonged period without consulting a doctor.
If OTC treatments do not work, a doctor may prescribe decongestant medication. For allergies, a nasal spray containing antihistamines or steroids may help reduce inflammation and other symptoms.
For bacterial infections that do not improve on their own, a doctor may prescribe antibiotics. This will not work with a viral infection. Additionally,
Taking antibiotics unnecessarily can cause significant side effects and bacterial resistance. A doctor may recommend waiting to see if a person’s symptoms improve before taking them.
If someone repeatedly experiences a sinus headache or has sinusitis for months, a doctor may refer them to an ear, nose, and throat (ENT) specialist.
The ENT specialist will ask about symptoms, take a medical history, and examine the person’s nose and face. They may also take images of the head with an X-ray, CT scan, or MRI scan to see if there is a structural cause for the symptoms.
If the ENT thinks it would be beneficial, they may recommend a type of surgery known as functional endoscopic sinus surgery (FESS). FESS involves widening the sinuses by removing some tissue causing a blockage or inflating a tiny balloon to widen the passages. A doctor then removes the balloon.
Home remedies cannot cure a sinus infection or allergies, but they may help relieve some of the symptoms, including a sinus headache.
Some people find breathing in steam helpful for relieving sinusitis. A
If someone wants to try this remedy, they can do this by:
- boiling some water and allowing it to cool slightly
- pouring the water into a large heatproof bowl
- leaning their face over the bowl
- covering their head with a small towel
- breathing slowly in and out through the nose
Cleaning the nose with salt water
People can purchase nasal rinsing kits with premixed saltwater solutions. Alternatively, they can make the solution at home. To do this:
- Purchase 1 pint of distilled or sterile water. Alternatively, boil regular water from a faucet for
3–5 minutesand then leave to cool.
- Dissolve 1 teaspoon (tsp) of salt and 1 tsp of baking soda into the water.
- Wash the hands with soap and water.
- Stand over a sink and pour a small amount into a cupped palm. Sniff the water into one nostril, or use a nasal irrigation device, such as a neti pot.
- Repeat in the other nostril. Allow as much water to flush out of the nose as possible. If it runs down the back of the throat, spit it out.
People should dispose of any leftover salt water, and make a fresh solution if using this technique repeatedly. A person should also clean any nasal irrigation devices thoroughly after each use. People should not use nasal rinses in children unless instructed by a doctor.
Many people confuse sinus headaches with migraine headaches. Migraine is a neurological condition that causes episodes involving moderate-to-severe headaches, along with other symptoms.
According to the American Migraine Foundation, migraine is underdiagnosed. In several studies, many people who thought they had sinus pain actually had migraine pain. It is one of the most common misdiagnoses for migraine.
Migraine headaches and sinus headaches can share similar symptoms, including:
- pain in one area of the face or forehead, often on one side of the head
- pain that worsens with physical activity
- a blocked nose or watery eyes
However, migraine can also cause:
- sensitivity to light or sound
Some with migraine also experience auras, which are temporary sensory disturbances. These may include tingling sensations on the skin, visual hallucinations, or auditory hallucinations. Sinus headaches cannot cause auras.
Migraine headaches are also typically more severe than sinus headaches. They can prevent normal functioning at work, in social settings, or at home. The treatment for each condition is different, so if a person has frequent headaches, they should consult a doctor for a diagnosis.
If a sinus headache is not causing too much pain, a person may be able to manage it at home. A person should rest, drink plenty of fluids, and take OTC medications to relieve the pain, if possible.
However, anyone with severe pain should consult a doctor. A person should also seek medical advice if:
- the pain gets better and then worse again
- symptoms do not improve after
- someone has a fever lasting more than 3–4 days
Seek medical help immediately if someone experiences any of the following:
- vision changes
- severe facial pain or pressure
- high fever
- shortness of breath
- difficulty thinking
- swelling around the eyes
- neck stiffness
Sinus headaches occur when pressure or blockages inside the sinuses cause pain. The pain may be around the forehead, bridge of the nose, or cheeks. Often, it occurs due to a viral infection. Bacteria, fungi, and allergies can also be a cause.
Usually, a sinus infection will go away on its own. People can take OTC medication to relieve symptoms. However, if someone has persistent allergies, structural differences inside the nose or sinuses, or a weakened immune system, they may experience recurring or chronic sinus pain. People can also mistake migraine pain for sinus headaches.
If a sinus headache does not improve within 10 days or keeps recurring, a person should seek medical advice.