Most headaches people experience are tension headaches. Most “sinus headaches” are actually migraine variants. In fact, the International Headache Society Classification of Headache disorders does not include “sinus headaches” as a category. However, many patients with rhinosinusitis and/or allergies describe sinus headaches as pain or pressure behind the cheekbones, eyes, or the forehead. These headaches are often accompanied by other sinusitis symptoms such as congestion, nasal discharge, decreased sense of smell, and sometimes even facial swelling. A sinus related headache is thought to occur when mucus or pressure from the sinuses cannot efficiently drain into the nasal cavity due to inflammation or obstruction.
Sinus headaches must be treated by determining the cause of the inflammation. Allergens can often cause inflammation, so antihistamines could be used in this setting. Decongestants could also be used to help temporarily decrease mucosal swelling. If the inflammation was caused by bacterial infection of the sinuses, antibiotics may be of benefit. Overall, to prevent sinus headache, it is important to take preventative measures such as cleaning out nasal cavity through rinsing methods, avoiding allergens, and proper nasal ventilation. If there is any doubt to the origin of a headache, examination (including nasal endoscopy) may be coupled with a CT scan to see if there is sinus disease in the region of the pain.