"A troublesome headache might not be a migraine or a tension headache," said otolaryngologist Wayland Wong, M.D., "it could be caused by sinus problems.
"The sinuses are air-filled spaces in the skull located behind our cheeks, forehead, eyes and the bridge of our nose. The sinuses work to moisten and cleanse the air we breathe. However sometimes, our sinuses fail to work properly, which leads to sinus pain that may be caused by an infection or nasal congestion.
"One of the first steps a physician takes when seeing a person complaining of headache pain is to determine if the pain is sinus related," Dr. Wong continued. "It is especially important to accurately diagnose the source of the headache pain, so that the correct treatment is prescribed. For example, treating a migraine like a sinus headache or vice versa is not effective. In addition, many headache symptoms can be mistaken for a sinus headache, such as pain in the cheek area which could be the result of a toothache."
Both migraines and sinus headaches have common symptoms including:
- Pain in the head, particularly the forehead.
- Itchy or watery eyes.
- Pain associated with movement.
However, each type of headache also has unique symptoms:
Symptoms of a Sinus Headache Symptoms of a Migraine
Nasal discharge that is yellow/green Clear nasal discharge
Pressure/pain over infected sinus Light/sound/smell sensitivity
Throbbing pain on one or both sides
Sinus headaches usually occur along with congestion. "The drainage passageways of the sinuses into the nose can get blocked and fluid can accumulate in the sinuses, causing pressure," Dr. Wong added. "Many things can cause sinus pressure and pain, such as sinus infections, nasal allergies, nasal polyps, septal deviations as well as enlarged vascular structures in the nose called turbinates. Sinus pain can also be aggravated by the weather or even plane travel due to changes in the air pressure.
"Migraine is usually to blame in people who have frequent, severe headaches. Migraines typically include nausea or vomiting or sensitivity to light or sound. In addition, there is usually severe throbbing pain on one side of the head."
"The treatment of sinusitis is usually directed toward symptom relief and clearing up the source of the inflammation or infection," Dr. Wong advised. "Common treatments can include antibiotics, saline irrigations to wash and moisturize the mucous membranes, decongestants, nasal steroid spray or antihistamines. Other drugs to treat sinus infections include pain relievers and vasoconstrictors, which decrease nasal congestion. If the pain continues after using pain relievers, corticosteroids may be prescribed to further decrease inflammation. New forms of treatment are also available including nasal- powered irrigation systems."
At least 20 percent of people with chronic sinusitis do not respond adequately to medications. "While there is no cure for chronic sinusitis, surgery has been shown to enhance the quality of life in people for whom medical therapy is ineffective," Dr. Wong advised.
Dr. Wong offers balloon sinuplasty for the treatment of chronic sinusitis, using minimally invasive technology to position a balloon into the blocked sinus passageway, which is then inflated to gently open the passageway and facilitate normal drainage.
Migraine treatment isn't just about stopping a migraine once it starts. It also involves preventing the headache and reducing its frequency, severity, and duration. Drugs called triptans are used during a migraine attack to reduce pain and restore function. Other drugs that were first developed to treat epilepsy, depression, and hypertension can be used to prevent migraine attacks.
Learning your migraine triggers and avoiding them is important for migraine sufferers. These triggers may include lack of sleep, alcohol use, food sensitivity, etc. Stress-reducing therapies - such as exercise, relaxation or therapeutic massage may also help prevent the recurrence and severity of migraines.
When to Get Help: If your headaches interfere with your daily life or don't respond to over-the-counter medications, it's time to see a doctor. In addition, seek medical help immediately if you have a headache that:
- Gets progressively and significantly worse.
- Is associated with neurological symptoms like loss of vision or muscle weakness.
- Is accompanied by a fever or a stiff neck.
Dr. Wong is affiliated with Salem Ear, Nose and Throat and the Advanced Sinus Center at Salem Community Hospital. For more information about the treatment of sinusitis, call Dr. Wong's office at 330-337-4900, which is located on the second floor of the Salem Medical Center across from Salem Community Hospital, at 2094 East State Street, Suite A, in Salem.