How to Prevent and Treat Sinus Headaches

Step one: Figure out what’s causing your pain in the first place. Here are three common culprits.

That painful throbbing in the middle of your face, the ache just above your eyes, the swelling that makes it all feel worse. Sounds like another sinus headache in progress.

Whether it’s a rare occurrence that comes on suddenly or a chronic discomfort that lingers far too long, sinus headaches can sideline you from everyday activities. The best way to prevent that from happening? Understand what might be causing your pain in the first place.

3 Common Causes of Sinus Headaches

When you have this kind of headache, it might feel like there’s a solid block of pressure behind your entire face. That’s because your sinus cavity is composed of several sections: the frontal sinuses in the bone of the forehead, just over the eye sockets; the maxillary sinuses in the cheekbones under the eyes; the ethmoid sinuses on either side of the bridge of the nose; and the sphenoidal sinuses directly over the bridge of the nose.

A variety of things can cause the pain, but here are some of the most common culprits.

Sinus Headache Cause #1: Seasonal Allergies

Sinus headaches may be due to inflammation and swelling that is often related to allergies, says Omid Mehdizadeh, M.D., a board-certified otolaryngologist (ENT) and laryngologist at Providence Saint John’s Health Center in Santa Monica, California. One way to know that allergies are to blame, he says, is if you have other allergic symptoms such as:

• Itchy or watery eyes
• Sneezing
• Runny nose and/or congestion
• Clogged ears
• Pain in the cheeks, teeth, between the eyes, or forehead
• Throat irritation or cough
• A steady sense of sinus pressure

Sinus Headache Cause #2: Sinus Infection (Sinusitis)

When sinus headaches are caused by an infection, Dr. Mehdizadeh says they may also involve:

• Fever
• Thick, discolored (not clear) nasal discharge
• Sore throat
• Pain that gets worse when you bend forward

Sinus infections happen when fluid builds up in your sinuses, allowing germs to grow. According to the Centers for Disease Control and Prevention (CDC), these are some factors that could increase your risk of getting a sinus infection:

• Having a previous cold
• Smoking and/or exposure to secondhand smoke
• Structural problems with the sinuses (such as nasal polyps)
• Taking medication that weakens the immune system

Sinus Headache Cause #3: Deviated Septum

A deviated septum is one potential cause of ongoing sinus headaches. This happens when the interior wall of bone and cartilage that separates your nostrils is out of alignment. “That can lead to several types of sinus problems,” Dr. Mehdizadeh says, “including frequent sinus headaches.”

Other signs you might have a deviated septum and should check in with your doctor include:

• Difficulty breathing through one or both nostrils
• Frequent nosebleeds
• Recurring sinus infections
• Mouth breathing during sleep
• Preference for sleeping on a particular side

Could It Be a Migraine?

Although it might seem unimportant to determine whether your issue is a sinus headache or a migraine—pain is pain, after all—it is important to do some detective work with your doctor. That’s because the course of treatment and, ultimately, prevention depends on the root cause.

The crucial first step is ruling out any infection that could be causing you grief, says Frederick Godley, M.D., a Rhode Island-based otolaryngologist and president of the Association of Migraine Disorders. “If there’s no evidence of an infection or inflammation, then treating a sinus headache as if it’s a sinus infection or allergies isn’t the right course of treatment,” he says. “For example, antibiotics won’t help if you actually have a migraine.”

The symptoms can be very similar, he says. Both may cause nasal congestion or watery eyes, for example. Many people who report sinus pain and pressure may be dealing with a migraine. Since there are many effective migraine medications and treatments, it’s a good idea to determine whether this might be the case for you, Dr. Godley says.

If you can answer yes to two of the following questions, your headache is more likely to be a migraine:

• Have you had a headache that’s interfered with your activity in the past three months?
• Are you sensitive to bright light when you have a headache?
• Do your headaches come with nausea or vomiting?

“After years of migraine attacks, it is thought that the nervous system can become hyperreactive,” Dr. Godley explains. “That means pain may be firing in the sinuses, even though that’s not where the problem is located. It’s like a mirage.”

Because sinus headaches might actually be migraine-related issues or a symptom of other problems, it’s important to talk with your doctor about what else could be going on, Dr. Mehdizadeh adds.

Sinus Headache Prevention and Treatment

Once you’ve confirmed you’re not dealing with a migraine, the next step is to consider other potential triggers—starting with the list above.

Because sinus headaches are so often associated with allergies, many people can minimize their headache frequency by addressing allergy triggers. For example, if you have seasonal allergies, Dr. Mehdizadeh suggests keeping the windows closed, asking your doctor about over-the-counter allergy medications such as antihistamines, and rinsing your sinuses with a nasal irrigation system.

Just be sure to rinse only with distilled, sterile, or previously boiled and cooled water. Tap water straight out of the faucet isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated, according to the Food and Drug Administration.

If you think you might be dealing with a sinus infection, deviated septum, or anything else, go ahead and call your doctor. Be prepared to tell them what you’re experiencing, including the frequency, duration, and intensity of your pain, along with any other symptoms (like the color and consistency of your nasal mucus).

That way, you and your doctor can begin to connect the dots, identify likely causes, and formulate the best treatment plan for you.

In the meantime, the CDC recommends the following at-home strategies to help relieve sinus pain and pressure:

• Put a warm compress over your nose and forehead.
• Stand over a bowl of hot water or take a hot shower and breathe in the steam.
• Use a decongestant or saline nasal spray—but for no longer than three days.

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