Sinus Headaches

A woman with a headache touching her forehead

The Pain of Sinus HEadaches

( — You’re congested. You feel pressure around your eyes,
cheeks and forehead. And your head is throbbing. It feels like a sinus headache
— but don’t jump to conclusions.

Headaches often accompany sinusitis, a condition in which the membranes
lining the sinuses become swollen and inflamed. But many people who assume they
have sinus headaches actually have migraines or tension headaches.

When headaches caused by sinusitis do occur, proper diagnosis and treatment
are the keys to relief.


Sinus headache symptoms may include:

  • Pain, pressure, and fullness in your cheeks, brow or forehead
  • Pain may worsen when you bend forward or lie down
  • Yellow-green or blood-tinged nasal discharge
  • Sore throat
  • Fever
  • Cough
  • Fatigue

So what’s the confusion with migraines? The signs and symptoms of the two
types of headaches often overlap. Migraine pain often gets worse when you bend
forward, and migraines can be accompanied by various nasal signs and symptoms —
including congestion, facial pressure and a clear, watery nasal discharge.

Sinus headaches, however, usually aren’t associated with nausea or vomiting,
or aggravated by noise or bright light — all common features of migraines.


Sinusitis can be caused by colds, allergies, bacterial or fungal infections,
an impaired immune system, or structural problems in the nasal cavity. The
resulting pressure changes in the sinuses can trigger headaches.

Risk factors

Sinusitis can affect anyone. You may be more likely to develop
chronic sinusitis if you have:

  • Asthma
  • Nasal growths (polyps)
  • Allergies to dust, mold or pollen
  • A weak immune system
  • A condition that affects the way mucus moves within your respiratory system,
    such as cystic fibrosis

When to seek medical advice

Consult your doctor if:

  • Your symptoms last longer than 10 days
  • You have a severe headache, and over-the-counter pain medicine doesn’t help
  • You have a fever greater than 100.5 F (38 C)

Tests and diagnosis

The cause of headaches can be difficult to determine. The doctor will ask
questions about your headaches and do a physical exam. Be sure to mention if
you’ve had a recent cold, if you have allergies and if you smoke. These factors
may precipitate or contribute to acute sinusitis.

Tender sinuses may be one sign of sinusitis. The doctor may use a thin tube
with a light (endoscope) to examine your nasal passages. He or she may also test
mucus samples from inside your nose for evidence of a bacterial or fungal

Sometimes imaging studies such as CT or MRI scans are recommended as well. CT
scans use a computer to create cross-sectional images (like slices) of your
brain and head (including your sinuses) by combining images from an X-ray unit
that rotates around your body. With MRIs, a magnetic field and radio waves are
used to create cross-sectional images of the structures within your brain.

Treatments and drugs

If you’re diagnosed with sinusitis, your doctor may recommend antibiotics. Be
sure to finish the entire course of medication you are prescribed- even if your
signs and symptoms disappear before all the pills or capsules are gone. This is
the only way to eradicate the germs causing the infection. If the sinusitis is
related to inflammation or allergies, your doctor may prescribe corticosteroid
nasal sprays or pills.

As the sinus infection clears up, the sinus headaches should disappear. In
the meantime, over-the-counter pain relievers, decongestants and saline nasal
spray might help you feel better. Use these products only as directed. It may
help to drink plenty of fluids as well.

If a structural problem in your nasal cavity is contributing to sinusitis or
sinus headaches, surgical correction may be recommended.


To reduce the risk of sinusitis, keep your sinuses healthy.

  • Wash your hands often. Soap and water can help you avoid
    the upper respiratory infections that can lead to sinusitis. You may want to ask
    your doctor about a yearly flu vaccine as well.
  • Avoid irritants. Avoid cigarette, cigar and pipe smoke.
    These and other air pollutants can cause your sinus membranes to swell.
  • Use a humidifier. Adding moisture to dry indoor air can
    help prevent sinusitis — but don’t overdo it. High indoor humidity can promote
    mold and dust mite growth in your home. Be sure the humidifier is clean and kept
    free of mold.

By Mayo Clinic Staff

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