Sinus Headaches – Features of headache with sinusitis

Patients who have sinusitis often complain of severe headache. There is nothing strange about this because such a painful symptom is one of the main signs and manifestation of this disease.

Headaches are not uncommon in ENT diseases, in particular, diseases of the paranasal sinuses. Diagnosis of lesions of the anterior paranasal sinuses with headache as the main complaint of the patient is rather common.

Diseases of the posterior paranasal sinuses, which are accompanied by headache, are significantly harder to diagnose. This is due to the fact that at an early stage of the disease, headache is the patient’s only complaint. In addition, most doctors make traditional diagnoses (neurology and vascular pathology) at the initial examination due to insufficient awareness of the symptoms of diseases of the posterior paranasal sinuses.

Typically, the headache may be felt in the area of ​​the eyes or the forehead, and sometimes the patient may feel that a tooth hurts. But the main problem is that the headache with this disease is very similar in nature to the painful sensations of a migraine. For example, the headache may begin and be mild in the morning and becomes unbearable in the evening. In this case, the pain is deep and throbbing. Also, painful sensations may increase when bending forward or turning the head.

Features of headache with sinusitis

Despite the fact that the symptoms of migraine and sinusitis are quite similar, they can still be distinguished. For example, in people with migraine attacks, the painful sensations are increased and intensified by loud sounds or light. Also, migraines are often accompanied by nausea and vomiting. With such a pathology, there is no purulent discharge and puffiness under the eyes.

As for the headache caused by sinusitis, it occurs due to an increase in pressure in the paranasal sinuses, which is associated with the accumulation of mucus or pus in them. As a rule, in a healthy person, the removal of accumulated mucus from the sinuses is carried out through the nose. And with inflammation of the sinuses, this does not happen. As a result, bacteria remain in the body and multiply very quickly. Even after taking painkillers, the pain does not go away and may continue to intensify. It becomes less uncomfortable after the “correct” blowing of the nose or when the person is lying down.

Headache can also be associated with other signs of sinusitis, such as:

  • nasal congestion;
  • thick nasal drainage;
  • nasal discharge in white, yellow or green;
  • coryza;
  • fever;
  • fatigue;
  • sore throat;
  • severe cough;
  • bad breath

This condition is quite common in babies or young children, due to childhood sinusitis. Therefore, it is important that parents stay on the alert and observe the existence of nasal secretions and signs of fever, cough, drowsiness and possible difficulties in breathing and swallowing food.

Timely consultation with a doctor for sinus headaches

A doctor can distinguish a headache with sinusitis from similar painful sensations with a migraine. After all, he or she knows the symptoms of both diseases, as well as how the treatments of migraines and sinusitis are carried out. Therefore, in addition to the usual examination, he or she asks the patient a series of questions to determine why the head hurts. For example, the doctor first examines the patient, then checks the sensitivity of various areas on the face. The presence of inflammation of the sinuses is also diagnosed.

As additional measures, computed tomography, X-rays, tests for allergic reactions, etc. may be prescribed. Once the cause of the headache has been identified, the doctor will prescribe appropriate treatment may recommend dietary changes and a healthy lifestyle.


The possible medications that may be prescribed by the doctor for sinusitis include:

  • painkillers;
  • antihistamines to prevent allergies;
  • decongestants to unblock nasal passages;
  • nasal spray with steroids that decrease inflammation;
  • Antibiotics to treat possible bacterial infection.

It is worth remembering that prescription medications should only be taken  as prescribed by your doctor.

Complex surgical correction (CCC)

Complex surgical correction (CCC) of the structures of the nasal cavity will help to treat headaches caused by sinusitis. Such an operation may involve the nasal septum and parts of the lower and middle turbinates.  Endonasal polysinusotomy, for example, is a surgery for polyposis or purulent inflammation in the paranasal sinuses using the technique of minimally invasive surgery. As a result of surgical treatment, nasal breathing and aeration of the paranasal sinuses are restored, and sluggish inflammatory process or a congenital anatomical defect is eliminated. It is important to note that many individuals respond well to a properly prescribed drug treatment, without requiring surgery.


Daniel Murrell, M.D., Kathryn Watson Sinus Headaches, 2015.       

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Maureen Salamon, Medically reviewed by Claudia Chaves, MD, What Are Sinus Headaches? 2020.

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