Neurological Disorders What Is a Sinus Headache? By Sanjana Gupta Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness. Learn about our editorial process Published on April 27, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Shaheen Lakhan, MD, PhD, FAAN Medically reviewed by Shaheen Lakhan, MD, PhD, FAAN Shaheen Lakhan, MD, PhD, is an award-winning physician-scientist and clinical development specialist. Learn about our Medical Review Board Print Sellwell / Getty Images Table of Contents View All Table of Contents What Is a Sinus Headache? Sinus Headache vs. Migraine Headache Symptoms Causes Diagnosis Treatment What Is a Sinus Headache? The sinuses are a group of four interconnected cavities in the skull. Since they are located around the nose, they are also known as paranasal cavities. These cavities produce a thin mucus that traps harmful particles like dust, germs, and pollutants. This fluid is typically drained out through the nose, keeping the nose clean and germ-free. The sinuses are normally clear and filled with air, but they can sometimes become irritated, inflamed, and infected. Known as sinusitis,this can happen if the sinuses can’t drain properly and become blocked, which can provide an opportunity for infectious germs to grow there. Allergies, viral infections, and in extremely rare cases, bacterial infections can cause congestion and swelling in the sinuses, says Christopher Gottschalk, MD, a headache specialist at Yale Medicine and professor of neurology at Yale School of Medicine. Sinusitis can sometimes cause headaches, known as sinus headaches. These headaches are classified as a secondary type of headache, because they are a symptom of another condition (sinusitis), rather than being an independent health condition, such as a migraine. This article explores the causes, symptoms, diagnosis, and treatment of sinus headaches, and distinguishes between sinus headaches and migraines. Sinus Headache vs. Migraine Headache Sinus Headaches Are Rare It’s important to note that sinus headaches are in fact extremely rare; most people who have sinus headaches actually have migraine headaches, says Dr. Gottschalk. In fact, the American Academy of Otolaryngology–Head and Neck Surgery Foundation notes that over 80% of people who have self-diagnosed themselves or received a formal diagnosis of sinus headache actually have a migraine headache or tension headache; only around 3% to 5% of people diagnosed with sinus headaches actually have sinus headaches. This happens because some of the symptoms of migraine headaches are very similar to the symptoms of sinus headaches. Migraine headaches can trigger the parasympathetic nerves that control the mucosa in the sinuses, resulting in symptoms such as congestion, runny nose, redness or swelling around the eyes, and pressure in the sinus area, says Dr. Gottschalk. For this reason, migraine attacks that include these symptoms are often mislabeled as sinus headaches, because it is believed that the sinus irritation is the cause of the pain; however, the sinus symptoms are caused by the migraine process itself, explains Dr. Gottschalk. Even patients with migraines think there is a difference between their severe, throbbing, nauseating attacks, which they believe are migraines, and the milder ones with stuffiness and aching pressure above or behind the eyes, which they believe are sinus headaches, says Dr. Gottschalk. He explains that these are in fact two versions of the same thing: severe vs. mild migraines. How to Differentiate Between a Sinus Headache and a Migraine Sinus headaches are accompanied by fever and thick, discolored nasal discharge. If your head or other parts of your face hurt but you don’t have fever or congestion, and your nasal discharge is clear, it’s probably a migraine headache. Migraines are often accompanied by nausea and sensitivity to sound and light. Symptoms of Sinus Headaches These are some of the symptoms of sinus headaches: Pressure-like pain in specific parts of your head or face, on one or both sidesA dull ache behind your eyes, forehead, cheekbones, the bridge of your nose, or upper teethPain that gets worse if you bend forward or move your head suddenlyPain that is worse in the morning, because mucus accumulates in the nasal passages overnightPain that becomes more acute when you experience temperature changes, such as going out into the cold after being in a warm roomFeverNasal congestionThick yellow or green mucus discharge from your noseSore throatPost nasal dripPuffy, swollen, or tender faceDiscomfort or a feeling of fullness in your earsTearing or redness in the eyesInability to smell Symptoms of a sinus headache typically start around the same time as the sinus infection, or right after. They get better or worse in parallel with your sinusitis. Causes of Sinus Headaches A sinus headache is caused by sinusitis, which occurs when there’s a mucus buildup in the sinuses, giving bacteria, viruses, or fungus an opportunity to grow there and cause an infection. As the sinus cavities swell and fill up with liquid, they can cause tenderness and pain in the face. These are some of the causes of sinusitis: Respiratory infections, with the common cold and flu being the most frequent culprit Allergies, such as hay fever Swelling, bone spurs, polyps, or tumors in the nasal passage, which can block the sinuses from draining properly A deviated septum or cleft palate, which can also affect the draining of the sinuses Flying or climbing to high altitudes, which can cause the mucosal lining in the sinuses to become swollen due to the differences in atmospheric pressure Frequently swimming or diving, which can cause irritation in the sinuses Why Smokers Can Feel Flu-Like Symptoms When They Stop Smoking Diagnosing Sinus Headaches If you think you might have a sinus headache, you should make an appointment with an otolaryngologist, also known as an ear, nose, and throat (ENT) specialist, or contact your primary care physician. The diagnostic process may involve: Questions regarding your symptoms and medical history A physical examination, wherein the doctor may lightly press your face to check for tenderness, look in your nose to check for discharge and congestion, and shine a light through your sinuses to check for inflammation. A nasal endoscopy procedure, which involves inserting a thin tube with a tiny light and camera into your sinuses, to determine whether there is allergy or acute infection, says Dr. Gottschalk. Imaging tests such as an x-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI), that can reveal sinus blockages or help rule out other brain conditions. Your healthcare provider may suggest these if you have severe or unusual symptoms. 5 Questions to Ask Yourself After an Initial Diagnosis Migraine Misdiagnosis It’s important to note that migraine headaches are often misdiagnosed as sinus headaches. “Any time a practitioner or patient thinks it’s a sinus headache, chances are that it’s actually a migraine. Physicians need to familiarize themselves with these concepts to improve the diagnosis and treatment of migraines,” says Dr. Gottschalk. Migraine medication can in fact be used as a diagnostic tool, in addition to being a mode of treatment, according to a 2021 study. If taking migraine medication offers relief from the headache in a matter of hours, it was probably a migraine rather than a sinus headache, says Dr. Gottschalk. However, there may be a misdiagnosis if clinicians use antibiotic medication to treat sinus headaches, explains Dr. Gottschalk. “If the symptoms get better on their own in a few days, the patient and the clinician think, ‘Aha! We got it right!’ and then continue to treat future attacks the same way.” Dr. Gottschalk explains that this can be problematic not only because you have to contend with the headache for a few days instead of a few hours, but also because it leads to the unnecessary use of antibiotics, which increases the risk of drug-resistant bacteria. Treating Sinus Headaches Treating sinus headaches generally involves treating the underlying sinusitis that’s causing it. Sinusitis caused by a viral infection such as the common cold cannot be cured, but a cold typically runs its course and gets better on its own in a week to 10 days. Antibiotic medication can help if it is in fact a bacterial infection; however, it is not recommended to prescribe antibiotics until migraine medication is prescribed and migraines are ruled out. Your healthcare provider may prescribe the following medications for symptom relief: Painkillers to ease the headache and fever Antihistamines to reduce allergy symptoms Decongestants to clear congestion and swelling in the nose and sinuses Steroids to prevent inflammation Nasal spray or drops to relieve congestion It can be helpful to apply a warm compress to your face, and to inhale steam from a vaporizer or a pan of boiled water for relief. If the headache is on one side of your head, sleep on your other side, to avoid putting pressure on it. A Word From Verywell Sinus headaches can be caused by sinusitis, but they are in fact an extremely rare condition that are usually a misdiagnosis of migraine headaches. If you suspect you have a sinus headache, it can be helpful to see a specialist for an accurate diagnosis and try migraine treatment first. What Are Cluster Headaches? 13 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Cleveland Clinic. Sinus Infection (Sinusitis). Cleveland Clinic. Sinus headaches. International Headache Society. Headache attributed to acute rhinosinusitis. Cleveland Clinic. Cluster headaches. American Academy of Otolaryngology–Head and Neck Surgery Foundation. Sinus headaches. Levine H, Setzen M, Holy C. Why the confusion about sinus headache? Otolaryngol Clin North Am. 2014;47(2):169-174. doi:10.1016/j.otc.2013.11.003 American Migraine Foundation. Sinus headaches. Harvard Medical School. Sinus headache or sign-us up for a migraine consultation. Harvard Health Publishing. Mount Sinai. Sinus headache. Maurya A, Qureshi S, Jadia S, Maurya M. “Sinus headache”: diagnosis and dilemma? An analytical and prospective study. Indian J Otolaryngol Head Neck Surg. 2019;71(3):367-370. doi:10.1007/s12070-019-01603-3 Robblee J, Secora KA. Debunking myths: sinus headache. Curr Neurol Neurosci Rep. 2021;21(8):42. doi:10.1007/s11910-021-01127-w Cleveland Clinic. Common cold. Boston Medical Center. Sinus headaches. Additional Reading Cleveland Clinic. Sinus infection (sinusitis). Harvard Medical School. Sinusitis. Harvard Health Publishing. Nemours Foundation. Sinusitis. By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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