Treatment for Sinus Headache

Sinus Headache is experienced in the sinus and nose area. This type of headache is bilateral in nature, where symptoms are felt on both sides of the sinus, face and nose. Sinusitis, whether allergic, nonallergic or fungal, can cause changes in the pressure in the sinuses.

However, sinus infections themselves are often not the cause of the headache. Indeed, sinus infections will often trigger neck pain, which in turn causes the referred pain around the head and is the actual cause of the headache. In a 2019 study, researchers reported 84% of sinus headache sufferers reported neck pain associated with headaches.

We treat many sinus headache sufferers at the Gold Coast Headache and Migraine Clinic, and we employ cutting-edge methods to determine whether your symptoms are stemming from your neck or brainstem. Once treatment starts, we expect a significant improvement to rapidly occur in 90% of our patients with sinus headaches and within the first 3 weeks of treatment consultations.

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What are Sinuses?

Your sinuses are the hollow spaces found behind your forehead, cheeks and nose. They are named according to the area of the face they are located; the frontal sinuses are located in the forehead, the maxillary sinuses are located behind your cheeks, the sphenoid sinuses are located just behind your eyes and the ethmoid sinuses are located behind your nose. They form a network of cavities that allows air-flow and the drainage of mucus that helps to prevent infections and the introduction of pathogens into the body [1].

Your sinuses can often get inflamed as a result of allergic reactions, bacterial infection or viral infection. This sinus inflammation can cause increased mucus production in your sinuses, resulting in a painful sinus blockage commonly referred to as sinus congestion or nasal congestion. Nasal congestion can also be caused by a deviated septum or nasal polyps (swelling in the nasal passages). This sinus pain can be felt in the forehead, eyes, nose, cheeks or even teeth.

What is Sinusitis?

Sinusitis is a condition characterised by inflammation or swelling of the tissue lining the sinuses, which are the air-filled cavities in the bones of the face and skull around the nose. Sinusitis can be acute (short-term) or chronic (lasting longer than 12 weeks).
Acute sinusitis is often caused by a viral infection, such as the common cold, and may also be triggered by bacterial infections. Symptoms of sinusitis include:

Facial pain or pressure
Nasal congestion
Thick nasal discharge
Postnasal drip
Cough
Fatigue
Fever
Reduced sense of smell or taste

Chronic sinusitis may be caused by various factors, including infections, nasal polyps, deviated nasal septum, or allergies. Symptoms of chronic sinusitis are similar to those of acute sinusitis but may be milder and persist for an extended period with more frequent headaches.

Sinus Headache vs Migraine

The location of pain experienced in a sinus headache can be similar to that experienced in migraine headaches. Sufferers of sinus headache will generally also experience:

Blocked or runny nose during headache
Watery eyes during headache
Swollen nasal passages
Sinus congestion/ nasal congestion
Increased sinus pressure or sinus pain

What is the cause of Sinus Headache?

The common belief is that Sinus Headaches are caused by respiratory infections like a cold or flu, or allergies such as hay-fever. An infection inside the sinus (sinus infection) results in headache and migraine-like pain. When an allergen, such as dust or pollen, enters the body, the nasal cavity and sinuses sense this as a threat or pathogen. This threat is detected by the trigeminal nerve, passing that information on to ‘superior salivatory nucleus’, which proceeds to fill the sinus with excess mucus, so that the pathogen or allergen is removed out the nose or digested when swallowed. The pressure that can develop is what is experienced as a headache or migraine [2].

In the patients that we see with sinus headaches, they are found to have dysfunction in the upper cervical spine, resulting in a sensitised brainstem that we can use to reproduce their headaches. Those that have this sensitised brainstem will also have an over-sensitive trigeminal nerve. Activity that was previously not perceived as a threat by the trigeminal nerve is now triggering sinusitis. This overreaction can now cause subsequent infection due to the increase in bacteria-dense mucus in the sinuses and nasal cavity. From here, frequent and recurrent sinus headaches can be triggered [3].

Prevention

Incorporating some lifestyle changes may help you with preventing sinus headaches. These may include:

Exercising
- Physical activity has been shown to improve general well-being and quality of life. With the correct training, exercises can improve muscular endurance and/or strength. You could try to add in simple exercises daily to improve your function.
Avoiding Triggers
- Try to avoid certain foods, smells, environments and/or activities that have triggered your headaches in the past.
Reducing stress
- Having stress in our lives can often cause muscular tension, typically along the neck and shoulder muscles. This can play a role in headaches. Finding relaxation strategies such as breathing techniques and/or doing things you enjoy doing are good ways of reducing stress.

I’ve tried it all, is there anything else that can help relieve sinus pain?

Our Treatments for Sinus Headaches

Many of our patients have tried every sinus infection headache treatment available. These include; pain relievers, decongestants, antihistamines, air humidifiers, nasal sprays, nasal rinsing or even sinus surgery. Despite these continued attempts, they still suffer from their sinus headache pain. Moreover, relying on medication for sinus headaches can result in medication overuse headaches. For these patients, at the Gold Coast Headache and Migraine Clinic, we specialise in assessing the role of the upper cervical spine and the sensitised brainstem, as being the root cause of these headaches.

If we can assess and determine that, in fact, the upper cervical spine and the sensitised brainstem are the root cause, then treatment can start right away. We use safe, gentle techniques that are non-invasive and medication-free. We expect to see results rapidly, within the first 5-6 treatment sessions, as we do with 85-90% of our patients. At The Gold Coast Headache and Migraine Clinic, we aren’t in the business of giving false hope, if we find that the brainstem and upper cervical spine aren’t a cause of your headaches, we will unfortunately not be able to help you but will let you know in session one and refer you on to a practitioner who can.