Formula Medical Group
Apple Valley, CA

James Krider, MD

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Headaches, sinus - Sinusitis

What are sinus headaches?

The sinuses are open cavities in facial and head bones. It is believed that these air spaces enable humans to hold up their heads. If the areas occupied by sinuses were filled with bone or tissue, the head would be extremely heavy.

There are four groups of sinuses: the frontal sinuses, which are located just above the eyes; the ethmoid sinuses, which are in the cheek area; the maxillary sinuses, which are located on both sides of the nose and spread out under the cheeks; and the sphenoid sinuses, which are in front of the ears.

The sinuses are lined with mucous membranes, similar to those that line the nose, and are connected to the nasal passages by ducts. Sinus headaches occur when the mucous membranes are clogged or inflamed, a process known as sinusitis, which may accompany a severe cold.


  • Headache pain just above the eyes and/or on either side of the nose.
  • Morning headache that can be exacerbated or relieved by moving your head in certain ways.
  • Nasal congestion.

What causes sinus headaches?

The inflammation that causes a sinus headache is usually triggered by a bacterial or a viral infection that starts in the nose and spreads to the sinuses. The most likely cause is a common cold, which is caused by a virus.

In some cases, the inflammation can be caused by persistent allergies affecting the upper respiratory system. Alternatively, the inflammation may be triggered by irritation due to heavy smoking. Less commonly, the infection may originate in a nearby tooth abscess. In some instances, a secondary bacterial infection

Sinus headaches are caused by inflammation of the mucous membranes that line the sinuses.

Sinus headaches are caused by inflammation of the mucous membranes that line the sinuses.

occurs in the presence of a cold or allergy.

As mucus builds in the area and membranes swell, the passages from the nose to the sinuses become closed. Infected material cannot drain through the nose, and painful pressure builds up, resulting in a headache.

How are sinus headaches diagnosed and treated?

A diagnosis of sinusitis is usually based on a medical history, the presence of characteristic symptoms, and a physical examination of the nose and mouth area. In addition, an x-ray of the sinuses can confirm a questionable diagnosis.

Treatment depends on the underlying cause.

What can I do myself?
Use a humidifier or vaporizer to add moisture to the air, or take frequent hot showers in order to inhale moist steam. Avoid going out in cold weather. If you smoke, stop, and avoid smoke-filled environments as much as possible.

Use over-the-counter decongestants cautiously and never for more than two days. They can cause rebound problems that worsen symptoms.

When should I see my doctor?
If self-help does not bring improvement within a few days, consult a physician.

What will the doctor do?
The first step is getting symptomatic relief. The physician may prescribe medication to re-establish drainage.

If the likely cause is viral, further treatment is probably unnecessary. If an allergy underlies the problem, an antihistamine or allergy shots may be used. A bacterial infection can be treated with antibiotics.

In persistent, chronic cases, the doctor may recommend sinus drainage. This is a surgical procedure that involves washing out the sinuses with sterile water.

The course of sinus headaches

Sinus headaches occur in the presence of nasal congestion. Discomfort tends to be worse when arising in the morning or when leaning over. The base of the forehead may be tender. Sometimes a low-grade fever occurs.

Are sinus headaches dangerous?
Usually not, but they can be uncomfortable. In rare cases, an untreated bacterial sinus infection can be transmitted to the brain, becoming life threatening.

What can I do to avoid sinus headaches?

  • Try to avoid exposure to colds and other viruses.
  • If you have allergies, try to avoid allergens and have appropriate allergy treatment, as recommended by your physician.
  • If you get a cold, keep your nasal passages clear.
  • Do not smoke.

Infection of the frontal and maxillary sinuses can cause a severe headache.

Infection of the frontal and maxillary sinuses can cause a severe headache.
This article was last reviewed November 29, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Bacterial infections
Tooth abscess
Viral infections

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