Is It Really a Sinus Headache?
Sinus pain doesn't always equal a sinus headache. Find out how to identify the true cause of your headache.
By Diana Rodriguez
Medically Reviewed by Pat F. Bass III, MD, MPH
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When you feel sinus pain and pressure creeping up into your head, you might assume you have a sinus headache. Though that's possible, it could also be another type of headache. Understanding a bit about the anatomy of your sinuses and how they contribute to headache pain can help you determine whether you’re experiencing a sinus headache or a migraine.
Sinus Anatomy and Sinus Pain
The trigeminal nerve is a cranial nerve that is responsible for sensation in your face. It runs across your jaw, cheeks, and forehead, and when it registers pain, that pain is disseminated throughout those areas, as well as around the nose, where the sinuses are located.
The control center for the trigeminal nerve is in the brainstem, which is located at the base of your brain. "When you get a sinus infection or inflammation like allergic rhinitis or swelling, it puts pressure on the nerve, which then sends the signal for headache," says Merle L. Diamond, MD, associate director of the Diamond Headache Clinic in Chicago and a clinical assistant professor in the department of medicine at the Rosalind Franklin University of Medicine and Science/Chicago Medical School.
Sinusitis: When It’s Really a Sinus Headache
If you're self-diagnosing a sinus headache, there's a good chance that you're wrong. What people think is a sinus headache is actually a migraine about 90 percent of the time, according to the American Headache Society.
But when someone has acute sinusitis — brought on, for example, by the common cold or allergies — the sinuses become inflamed and congested, and the person may develop a sinus headache.
"If you get an infection,” Dr. Diamond says, “and you have secretions that are building up in the sinuses — basically, fluid and bacteria — it will cause the nerves to get agitated." Those nerves will then send pain signals, which can result in a headache. But a sinus headache, although uncomfortable, is not usually severe, and it is not disabling. A very severe headache is most likely to be the result of something other than sinusitis.
Sinus headaches are generally located in the forehead and face. They typically cause a dull throbbing pain, which tends to worsen when you lean forward or move quickly, according to the University of Maryland Medical Center.
"Most patients will think when they get a headache and it's in their face that it's due to their sinuses," Diamond says. However, experiencing sinus pain alone does not necessarily trigger a sinus headache.
A genuine sinus headache will be accompanied by symptoms of sinusitis, such as:
- Green or yellow nasal discharge
- Pain and pressure in the face
- Redness around the nose
- Bad breath
- Unpleasant taste in the mouth
- Coughing that increases at night, caused by drainage down the back of the throat
- Decreased ability to smell
When to See Your Doctor
If you have sinusitis, you’ll need to see a doctor to get treatment for your pain and other symptoms. A sinus infection can be viral or bacterial, but only bacterial sinus infections, which also tend to be more severe, can be treated successfully with an antibiotic. Viral infections can be treated with home remedies such as saline nasal spray and over-the-counter medications.
Any time your headaches interfere with your life — if they keep coming back, are severe enough that you can’t function, or you're missing time from work or school — you need to see a doctor so the true cause of your pain can be diagnosed. This is especially important if you have headache pain that isn't associated with a sinus infection.
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