Sinus headache refers to head and facial pain associated with congestion, inflammation, or infection of the sinuses (sinusitis). The sinuses are hollow cavities in the skull that have openings into the nose. Colds and allergies cause congestion and inflammation of the nasal passages and can lead to sinusitis. Sinus headache is a symptom of sinusitis.
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Allergies and viral upper respiratory infections increase nasal secretions and cause tissue lining the nasal passages to swell. This results in nasal congestion and stuffiness. The opening into the sinuses become blocked and normal drainage cannot occur. Secretions that are trapped in the sinuses build up and may become infected with bacteria or, rarely, fungus. The swollen tissue, mucous build-up, or infection may create pain and pressure.
Factors that may increase your chance of a sinus headache include:
- Allergies, such as allergic rhinitis or asthma
- Persistent cold or upper respiratory infection
- Ear infections
- Enlarged tonsils or adenoids
- Nasal polyps
- Nasal deformities, such as a deviated septum
- Cystic fibrosis
- Problems with immunity
- Prior sinus surgery
- Facial injuries that block sinus passages
- Traveling in an airplane if you have an upper respiratory infection
- Tooth abscess or infection
- Swimming in dirty water
Symptoms may include:
- Pain and tenderness behind the forehead, cheeks, and around the eyes and ears
- Pain in the upper teeth
- Pain ranging from mild to severe
- Pain that is more intense first thing in the morning
- Pain that may worsen when you bend over
Headache may occur with other symptoms of sinusitis, including:
- Nasal stuffiness and congestion
- Thick nasal drainage
- Postnasal drip
- Stuffy ears
- Sore throat
- Puffiness around the eyes
The doctor will ask about your symptoms and medical history, and perform a physical exam.
For recurring problems, testing may include:
- CT scan—to look for sinus fluid
- Nasal endoscopy—to look inside your nose and possibly take samples of drainage to be tested
Sinus headache treatment aims to:
- Open the nasal passages
- Treat any infection
- Allow sinus cavities to drain
Treatment may include:
Medicines may include:
- Pain relievers
- Antihistamines to treat nasal allergies
- Decongestants to open clogged nasal passages, which allows the sinuses to drain
- Steroid nasal spray to reduce inflammation
- Antibiotics—only if a bacterial infection has developed
Self-care for a Headache
- Breathe warm, moist air. Try inhaling steam.
- Mist of saline nasal spray to moisten the nasal passages and help remove crusty secretions. A saline spray can be used up to 6 times per day.
- Ask your doctor for directions on how to perform nasal irrigation that you can do at home.
- Drink plenty of fluids.
- Use warm or cool compresses on your face.
- Do not smoke. If you smoke, talk to your doctor about how you can quit.
- Avoid second-hand smoke and polluted air.
Surgery is usually not required. People with a structural abnormality or chronic sinusitis that do not respond to medications may benefit from surgery. The doctor may perform one of several procedures to enlarge the opening to your sinuses or clean out your sinus cavities.
To help reduce your chances of a sinus headache:
- Avoid exposure to anything that triggers allergy or sinus symptoms.
- Seek medical treatment for allergies.
- Wash your hands frequently to avoid colds.
- Seek treatment for a persistent cold before sinusitis sets in.
- Avoid alcoholic drinks. Alcohol can cause swelling of nasal and sinus tissues.
- Check with your doctor about using a decongestant before air travel.
American Academy of Otolaryngology—Head and Neck Surgery
Asthma and Allergy Foundation of America
Allergy Asthma Information Association
Calgary Allergy Network
Cady RK, Dodick DW, et al. Sinus headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment. Mayo Clinic Proc. 2005;80(7):908-816.
Hainer BL, Matheson EM. Approach to acute headache in adults. Am Fam Physician. 2013;87(10):682-687.
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Sinus headache. National Headache Foundation website. Available at: http://www.headaches.org/2007/10/25/sinus-headache. Accessed September 26, 2017.
Sinus headaches. American Academy of Otolaryngology website. Available at: http://www.entnet.org/?q=node/1410. Accessed September 26, 2017.
Sinusitis (sinus infection or sinus inflammation). Asthma and Allergy Foundation of America website. Available at: http://www.aafa.org/display.cfm?id=9&sub=18&cont=240. Accessed September 26, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD Last Updated: 7/14/2020