Nobody likes headaches, and sinus headaches can be among the worst. In fact, sinus headaches are one of the most common complaints that lead patients to seek the help of an ear, nose, and throat specialist. These deep, throbbing pains throughout the front of the head and face are often confused with tension headaches or migraines but actually stem from congestion and inflammation in the sinuses. Pressure can also be felt in the ears and this can be the only presenting symptom of a sinus condition.
What Causes Sinus Headaches?
Sinus headaches are caused by infections and inflammation in the sinuses that cause tissues to swell up, blocking the openings between the sinuses and the nasal passages. Once this happens, the patient becomes very sensitive to pressure from mucus that builds up in the sinuses with no way to drain out. Outside factors that change the pressure, such as flying or even weather changes, further exacerbate the pain.
How Do You Tell If You Have Sinus Headaches?
While sinus headaches have many of the same symptoms that characterize other bad headaches, there are a few attributes that generally set them apart. The pain is normally localized around the eyes, cheeks, or forehead, and it leaves that area of the face sensitive to touch. Sinus headaches are also typically worse in the morning due to a full night of mucus collecting in the sinuses. Sinus headaches are often accompanied by cold symptoms like a sore throat, postnasal drip, or colored discharge from the nose. As with migraines, the pain may also worsen when encountering temperature changes or when moving the head suddenly. Unlike migraines, though, sinus headaches are typically not accompanied by nausea and are not affected by light or sound.
Diagnosing a Sinus Headache
Official diagnosis normally begins by simply tallying up the symptoms in a detailed medical history. During the diagnostic procedure, Dr. Rubinstein may also perform simple tests such as pressing on different areas of the face to find sensitive areas near the sinuses or shining a light near the sinuses to check for inflammation. Additional risk factors will also be taken into consideration. These include things like a history of allergies or asthma, nasal polyps or swelling, and frequent swimming or flying. If the signs seem to indicate the sinuses as the culprit behind the headaches, the diagnosis may be confirmed with imaging tests like a CT scan or by using a long, flexible tool called an endoscope to examine the nasal passages and sinus for signs of infection and inflammation.
How Are Sinus Headaches Treated?
Treatment for a sinus headache requires correcting the underlying infection and inflammation. In many cases, sinus headaches can be successfully treated noninvasively. Most patients begin with simple at-home remedies to reduce congestion. This can include use of a humidifier, saline sprays, and even sitting in a shower or steamy bathroom to get rid of headaches faster. Over-the-counter medications like antihistamines and decongestants may also be useful.
If these remedies are insufficient, Dr. Rubinstein may prescribe nasal corticosteroids to reduce inflammation or stronger antihistamines or decongestants. If the underlying infection is bacterial, a course of antibiotics can also be used to correct the problem. If allergies are suspected, allergy testing and immunotherapy can help alleviate the headaches. Most patients don’t need surgical intervention if treated early before the sinuses become permanently closed due to chronic inflammatory tissue which becomes resistant to allergy medications, allergy shots, and antibiotics. In some cases, triptans, a family of drugs used to control migraines, may also be useful, although these will only control the pain and are not considered a long-term cure. If migraine or tension headaches are suspected, Dr. Rubinstein will refer his patients to his neurology colleagues for further testing and treatment.
Surgical Remedies for Sinus Headaches
Once all other remedies have been exhausted, surgery can be considered. For most patients, balloon sinus dilation using endoscopic visualization of the blocked sinuses is the best option. This procedure involves using an endoscope to provide visual access to the interior of the sinuses and nasal passages so that Dr. Rubinstein can widen the passages using a balloon much like in angioplasty of the heart. This procedure allows better drainage and airflow, which helps infections to heal and discourages further infections. Some patients will require more traditional endoscopic procedures to remove polyps.
Recovery from Surgery
In most cases, discomfort after a balloon procedure and even more traditional endoscopic procedure is minimal, although some medication will be prescribed. Most patients report noticeable improvement in symptoms within several days following the procedure.