Sinus issues are common health problems that can cause congestion, pain, and pressure in the face and head. The sinuses are air-filled cavities in the bones around the nose and cheeks. When these cavities become inflamed or infected, it can lead to sinusitis. Sinusitis often just affects the area around the sinus cavities, but in some cases, sinus problems can radiate and cause headaches or pain in the entire head.
What are the sinuses?
The sinuses are air-filled pockets behind the forehead, cheeks, and eyes. There are four pairs of sinuses:
- Frontal sinuses – located above the eyes in the brow area
- Maxillary sinuses – located behind the cheekbones
- Ethmoid sinuses – located between the eyes and behind the bridge of the nose
- Sphenoid sinuses – located behind the ethmoids in the upper region of the nose
These sinus cavities are lined with a mucus-producing membrane. Tiny hairs called cilia help move mucus out of the sinuses and into the nose. This mucus drains into the nose and throat, keeping the sinuses clean.
What is sinusitis?
Sinusitis refers to inflammation or swelling of the sinus cavities. This can occur from an infection, allergies, air pollution, structural issues in the nose, or other causes. When the sinuses become inflamed, mucus cannot drain properly from the sinus tissue. The excess mucus builds up in the sinuses, causing congestion and pressure.
There are a few types of sinusitis:
- Acute sinusitis – Lasts less than 4 weeks
- Subacute sinusitis – Persists for 4-12 weeks
- Chronic sinusitis – Lasts for more than 12 weeks
- Recurrent acute sinusitis – Experiencing several acute sinus infections within a year
Common sinusitis symptoms
Sinusitis symptoms depend on which sinuses are affected. Common symptoms include:
- Facial pressure, pain, or fullness
- Nasal congestion and discharge
- Loss of smell
- Headaches
- Fatigue
- Cough
- Fever
- Bad breath
- Tooth pain
How can sinusitis affect your whole head?
In many cases, sinusitis symptoms are localized around the affected sinus cavities. For example, maxillary sinusitis may cause pain in the cheeks, upper teeth, or sides of the nose. However, sinus inflammation can sometimes radiate and cause pain or pressure throughout the head.
Here’s how sinusitis can affect different regions of the head:
Forehead
Frontal sinusitis behind the eyebrows often causes forehead and brow pain. The swollen sinuses put pressure on local nerves, causing dull, aching pain. Forehead pain may also occur if inflammation spreads to other neighboring sinuses.
Top and back of head
The sphenoid sinuses sit deep behind the eyes, near the top and back of the skull. Sphenoid sinusitis can cause pain at the crown of the head or the back of the head. Postnasal drip from sinusitis irritation may also trigger headaches in these areas.
Behind the eyes
The ethmoid sinuses sit between the eyes, right behind the bridge of the nose. Ethmoid sinusitis can cause pain behind and around the eyes. Eye pain may feel like pressure building up behind the eye.
Cheeks
The maxillary sinuses behind the cheekbones are most prone to infection. Maxillary sinusitis typically causes pain in the upper teeth and cheeks. However, the pain and pressure can sometimes extend into the lower cheeks as well.
Whole head
Widespread inflammation in multiple sinuses or severe cases of acute sinusitis may cause diffuse pain throughout the whole head. Some people describe this as a constant dull ache or feeling of tightness encompassing the whole skull.
Other causes of whole head pain
While sinusitis is a common culprit, other conditions can also cause pain or pressure throughout the head. These include:
- Tension headaches – Tight, squeezing pain on both sides of the head caused by stress and muscle tension in the neck and scalp.
- Migraines – Severe headaches, often one-sided, with nausea and sensory sensitivity.
- Cluster headaches – Sudden, piercing pain around one eye that recurs frequently in clusters.
- Medication overuse headaches – Headaches resulting from overuse of pain-relieving medications.
- Dental problems – Toothaches and TMJ dysfunction can radiate and cause diffuse head pain.
When to see a doctor
You should make an appointment with your doctor if:
- Head pain persists beyond a week or two
- Symptoms are severe or worsening
- You have a fever above 101°F
- Symptoms return frequently
- Antibiotics and self-care provide no relief
Chronic or recurring head pain should always be evaluated by a professional. Your doctor can examine your sinuses and nasal passages. They may order imaging scans to check for sinus infection, blockages, or other issues needing treatment.
Diagnosing sinusitis
To diagnose sinusitis, your doctor will ask about your symptoms and medical history. Make sure to tell them if you have allergies, asthma, nasal polyps, or other respiratory conditions. Your doctor will perform a physical exam of your head and sinuses to check for pain, swelling, or drainage.
They may use some of these tools to assess your sinuses:
- Nasal endoscopy – A tiny camera on a flexible tube inserted in the nose to view the sinus openings and drainage pathways.
- Nasal cytology – Microscopic analysis of cell samples from your nasal cavities.
- CT scan – Cross-sectional X-ray images giving detailed views of your sinus anatomy.
- MRI – Magnetic resonance imaging to evaluate soft tissues and identify sinus obstruction.
These tests can confirm if you have an infection, reveal any structural issues, and rule out other causes like tumors or cysts.
Sinus headache vs. migraine
Sinus headaches and migraines are often confused. But there are some key differences:
| Sinus Headache | Migraine |
|---|---|
| Pain focused around the sinuses, especially the forehead, cheeks, and brow | Throbbing, pounding head pain, often one-sided |
| Pain worsens with bending over or straining | Pain increases with physical activity |
| Nasal congestion, runny nose | Nausea, sensitivity to light/sound |
| No nausea or vomiting | Aura symptoms like visual disturbances |
Migraines arise from overactive nerves and changes in brain chemicals. They require different treatment than sinusitis headaches.
Sinus headache treatment
Treating the underlying sinus inflammation is key to resolving sinus headaches. Treatment may involve:
- Nasal steroids – Corticosteroid nasal sprays like Flonase help reduce swelling in the sinus passages.
- Nasal saline irrigation – Rinsing the nasal cavity with saltwater solutions can flush out mucus.
- Antihistamines – Oral antihistamines like Claritin or Zyrtec help control allergic symptoms.
- Decongestants – Oral decongestants like pseudoephedrine (Sudafed) narrow swollen blood vessels.
- Pain relievers – Ibuprofen, acetaminophen, or naproxen sodium for headache pain relief.
- Antibiotics – Prescription antibiotics if your doctor diagnoses a bacterial sinus infection.
- Surgery – Endoscopic surgery to improve sinus drainage or remove nasal polyps if other treatments fail.
Identifying and avoiding your headache triggers is also recommended. Triggers may include air pollution, tobacco smoke, respiratory irritants, weather changes, and strong odors.
When to see an ENT
If your sinus headaches persist despite medication and self-care, see an ear, nose, and throat (ENT) specialist. An ENT can evaluate your sinuses in depth and provide advanced treatments.
They may recommend CT scans, nasal endoscopy, allergy testing, or sinus surgery if needed. Surgery like balloon sinus dilation or endoscopic sinus surgery can open blocked passages to improve sinus drainage and pressure.
Preventing sinus headaches
You can take some proactive steps to prevent recurrent sinus headaches:
- Use a humidifier to keep nasal passages moist
- Rinse sinuses daily with saline solution
- Avoid smoking and secondhand smoke
- Reduce exposure to respiratory irritants
- Treat allergies with antihistamines and nasal steroids
- Get regular aerobic exercise to boost circulation
- Stay hydrated by drinking plenty of water
Practicing good sinus hygiene and managing medical conditions can help minimize headache flare-ups.
When to see a neurologist
You should see a neurologist if you have frequent or severe headaches with symptoms like:
- Nausea, vomiting, or dizziness
- Sensitivity to light and sound
- Visual disturbances like auras
- One-sided head pain or pain around the eyes
- Headaches waking you from sleep
A neurologist can help determine if you have migraine headaches instead of sinus headaches. They may order imaging tests like an MRI to rule out other neurological conditions.
Conclusion
Sinusitis can certainly cause pain that radiates across the head. The inflamed sinuses put pressure on surrounding nerves and tissues, leading to diffuse headaches. Treating the sinus inflammation and infection is key to resolving the pain.
However, recurring head pain should always be evaluated by your doctor. They can examine your symptoms, perform imaging tests, and determine if there are any underlying problems needing specific treatment. With proper diagnosis and care, your outlook for relieving sinus headaches is good.