Sinus Headache

Darrell Hulisz, RPh, PharmD
Published Online: Monday, July 1, 2002

The sinuses are air-filled spaces within your skull. They are located behind the forehead, behind the cheekbones, between the eyes, and behind the eyes. When they become infected, inflamed, or obstructed, you may experience headache. Inflammation within the sinuses is called sinusitis. This guide will explain headaches caused by sinusitis and how they can be treated.

What Causes Sinus Headaches?
Sinus headache may be caused by an allergy such as hay fever, an infection such as the common cold, or small growths called polyps. Other symptoms associated with sinus headache include nasal congestion, a runny nose, cough, fever, sore throat, sneezing, and itching in the eyes and nose. The type of symptoms you experience depends on what causes your sinuses to be inflamed.

When Do I Need Medical Attention?
You should see a physician if you experience severe headache that comes on suddenly or is different from any you have experienced in the past. Also, any headache that does not clear up in a few days requires medical attention, especially if you have other symptoms. Your doctor will ask you what may have ?triggered? your headache. Tell your doctor about any allergies, such as reactions to plants, animals, ragweed, grass, or any medications. Also tell your doctor when you first noticed your symptoms and what makes them worse or better. Your doctor will determine whether you have a sinus infection, an allergy, polyps, or another medical condition causing similar symptoms, such as a dental problem.

Treatment
The treatment for sinus headache will depend on the cause.

Antibiotics
If your doctor prescribes an antibiotic, you should begin taking it immediately. Be sure to take all the medication, even if your symptoms have gone away. Remember, many cases of sinusitis are not caused by bacteria, so do not be discouraged if your doctor does not prescribe an antibiotic.

Decongestants
If your headache is due to an allergy, your doctor may prescribe a nasal spray containing a medication to decrease swelling or an oral antihistamine with or without a decongestant. Decongestants are intended to be used only for short periods of time. They may be taken as a nasal spray or in a pill form. You should not take these pills without your doctor?s approval if you have ongoing medical conditions, such as heart disease. These pills can raise your blood pressure, cause an irregular heartbeat, and produce insomnia, jitteriness, and other side effects. Oral decongestants come in many different strengths and brands. The usual adult dose for Sudafed is 60 mg up to every 6 hours, but no more than 240 mg daily. Your pharmacist can detect any interactions involving the other medicines you take. Nasal spray decongestants should be used for only 3 or 4 days because your body builds up a ?tolerance.? You will require more and more of the spray to get relief. If you use the spray longer than 4 or 5 days, you will probably experience even more nasal congestion when you stop using it.

Pain Relievers
Some pain relievers have side effects. For example, aspirin should be avoided in children because of its association with Reye?s syndrome. Consult your doctor or pharmacist before using these agents. Most people can tolerate them, but some have experienced serious side effects?stomach upset, ulcers, and kidney problems. Because pain relievers can interact with numerous other drugs, check with your pharmacist. Unless they are prescribed by your physician, you should not use them if you have kidney disease, uncontrolled high blood pressure, bleeding disorders, severe congestive heart failure or severe liver failure, or if you are pregnant.

Additional Help
It is important to drink plenty of water. You may also want to use a cool-mist humidifier. If your sinus headache persists for many months, even with treatment, your doctor may refer you to an ear-nose-throat specialist (an ENT physician). An ENT physician is specially trained in both medical and surgical procedures to treat sinus conditions. Surgery is a last resort for most patients with sinusitis. Yet, it may be the best choice for patients who have polyps or when drug therapy has not been effective.



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