Understanding sinus headaches

Sinus headaches are generally the result of pressure in the sinuses, the air-filled spaces above, behind, and beneath your eyes. Sinus headache pain is most often felt at the center of the face, the bridge of the nose, and the cheeks (see Figure 3). It may also occur behind the eyes and be accompanied by clear or white postnasal drip.

Figure 3: Sinus headache pain Sinus headaches often produce steady pain in the cheeks, on the bridge of the nose, or in the center of the face. The pain can also occur behind the eyes, and it’s usually accompanied by nasal congestion, postnasal drip, or both.

The sinuses are lined with a thin membrane that swells and produces mucus in response to irritation. Normally, the mucus drains through small openings, known as ostia, which connect the sinuses to the nasal passage. The sinuses can be the source of head pain for three reasons: inflammation of the inner membrane, unusually high or low air pressure within the sinuses, or a buildup of fluid in the sinuses that can't drain out through the nose.

Inflammation of the sinus membranes is called sinusitis and is usually caused by an allergy or a viral infection. Sometimes, particularly when drainage from the sinuses is blocked, bacteria that normally live in the sinuses take advantage of the situation, producing a bacterial infection. A bacterial sinus infection not only causes pain, but also often produces foul-smelling, yellow-green discharge from the nose. This discharge can also be coughed up from the back of the throat and can leave a bad taste in the mouth. A bacterial infection can also cause fever, and, at its worst, chills and uncontrollable shaking (see Figure 4).

Figure 4: Sinus infection Normally, mucus drains through small openings in the nasal passages known as the ostia. But these openings can become blocked from an infection or an allergy. This congestion can lead to a bacterial sinus infection, which is often accompanied by yellow or green postnasal drip, a bad taste in the mouth, and a sinus headache.

Typically, the air pressure inside the sinuses is the same as the pressure in the nose and in the air around you. But blockage of the ostia can result from unusually high or low air pressure inside the sinus, which can produce sinus pain. Any condition that causes the sinus membranes to become swollen can narrow, or completely block, the ostia. When these openings are blocked, nasal congestion can occur, and the buildup of fluid can likewise cause sinus headaches.

Treating sinus headaches

Treating a sinus headache depends on what's causing it. Sinus headaches may be caused by allergies that lead to inflammation of the sinus membranes and sometimes obstruction of the ostia, or perhaps by an infection. A conversation with your doctor to sort out the cause of your sinus headache can be helpful. To confirm a diagnosis, he or she may order some diagnostic tests, such as a CT scan. If you develop a high fever, severe pain, or uncontrollable shaking from chills, it's important that you contact your doctor immediately.

People with allergies seem especially susceptible to sinus headaches. Treating the nasal and sinus allergies is often effective for keeping sinus headaches at bay. There are medications that can help. Discuss your situation with your doctor. He or she can help determine the optimum approach for you.