Sinus Headaches

One of the most common complaints I see in the office is people complaining of sinus headaches. While sinus problems can and do cause headaches, most people with long term or recurrent headaches who think they have CHRONIC sinus headaches usually have another cause. While there are many causes of facial headaches, migraine is one of the more common. Classical migraines present as one-sided headaches often preceded by visual changes and associated with nausea and photophobia (discomfort to light). Most people with headaches that cause nausea and photophobia, especially if bad enough to send people to bed, are migraines. Migraines can be manifested in many different ways and some variations can cause other symptoms like dizziness without even having a headache. There are some very effective newer drugs that many people have never been offered, so the correct diagnosis and treatment are critical.

Another very common cause of headaches are the tension variety. The actual causes are complicated and varied but usually involve some degree of muscle tightness. Often people complaining of headaches in the forehead, both temples, or the back of the neck have this kind. Stress and anxiety can trigger these but so can arthritis in the neck and even cervical disk problems. Muscle tension around the jaw joint can do the same thing and surprisingly sometimes causes pain in the midface. Usually there is some tenderness of the joint in front of the ear which is often associated with an achy ear pain that occasionally sends sharp shooting pains into the temples or neck. The neck muscles on the side below the ear are usually sore too.

Another frequent cause of cheek pain is dental disease. Usually pressure on the bad tooth reveals tenderness or pain.

Sinus infections also cause midfacial headaches, especially with frontal sinusitis which causes pain and tenderness in the forehead above the nose. Most people with headaches from sinus infections usually have definite signs and symptoms of sinus disease like thick yellow-green drainage, nasal blockage, decreased smell and sometimes fever. Sinus infections usually do not cause chronic headaches in adults, but I see some in children with severe allergies and chronic infections that have been undiagnosed or inadequately treated. Kids can get migraines too, and sometimes a sinus CT is necessary to diagnose hidden sinusitis.

There are other causes of facial headaches such as nasal sores, pressure points in the nose from crooked bones in the septum, and occasionally tumors. Sometimes allergies or chemical fumes can trigger tension or migraine headaches. It can be complicated and some people have several kinds of headaches. The vast majority of people can be helped with the correct diagnosis and treatment. Sometimes that requires evaluation by different specialties including Ear, Nose, and Throat, Neurology, and dental specialists. So if your headaches are not well controlled, ask your family doctor which specialist would be most likely to help.